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  • Writer's pictureDavid Wilderman

Oh My Aching Head! Can Physical Therapy Help My Headache?

There are numerous types of headaches, with just as many different causes. According to the International Headache Society, there are several different categories of headache:

  • Tension

  • Migraine and Cluster

  • Secondary headaches (due to an underlying condition), often caused by sinus infections, fever, infectious disease, and in rare cases, tumors

  • Cranial neuralgias, facial pain, and other headaches

Although severe headaches that frequently recur can impact the quality of your life and restrict your ability to conduct daily tasks, most headaches are harmless. There are effective treatments for almost every type of headache. Physical Therapists can help determine your type of headache, it’s cause, and develop an appropriate treatment plan that will help reduce both frequency and intensity.

What Exactly Are My Headaches?

Pain of any type that occurs in any part of the head is called a headache. Headaches, like back pain, are one of the most common of all physical complaints and can be extremely frustrating to manage. Tension headaches, generally caused by muscle spasms, are the most common type of headaches in adults. They may be the result of poor posture, fatigue, stress, or from a neck or jaw problem. Problems in the head, neck, or jaw, such as an injury or arthritis, can lead to increased tension in the muscles at the back of the head and neck which can lead to increased pressure on the nerves of the head and face. Poor posture can cause these muscles to become overworked, which can then trigger a headache.

What Does a Tension Headache Feel Like?

A Tension headache usually starts at the back of the head and radiates to the top of the head and eyes. There may be an increase in facial pain near the jaw bone (TMJ dysfunction) or along the cheeks. There is often a feeling of “tightness,” a sensation of someone pulling their hair, or feeling like they are wearing a tight cap. These headaches can worsen with certain positions, such as prolonged sitting at a desk, and may ease with rest.

How Can Physical Therapy Help My Headache?

Your Physical Therapist should perform a thorough evaluation, including a review of your medical history. He/she will most likely ask you questions and will perform certain tests to try and pinpoint the most likely cause of your headache. These may include:

  • Assessment of posture when sitting and standing

  • Measuring cervical (neck) and shoulder ranges of motion

  • Testing muscle strength

  • Testing sensation of the upper extremities

  • Assessing the mobility of the joints and muscles of your neck

  • Asking you to draw your area(s) of pain on a body diagram

  • Asking you the location and nature of your symptoms

  • Asking you whether you have ever injured your neck, head, or jaw before

If the Physical Therapist determines that your headache is, indeed, a Tension headache, he/she will work with you to design a treatment plan to meet your goals. If, on the other hand, the Physical Therapist determines that your headaches are NOT muscular in cause but instead are a sinus, migraine, or cluster headache, he/she will most likely refer you to another health care professional for additional diagnostic tests and treatment.

Your Physical Therapist should work with you to correct the issues causing your discomfort and should teach you how to prevent Tension headaches in the future by education in posture and lifestyle changes, including:

Improving Posture–Recommending slight modifications to everyday activities can make a vast improvement in posture, such as keeping the chin tucked in, pulling your shoulder blades down and back, and pushing your chest out.

Increasing cervical (neck) flexibility–Using Manual Therapy to increase range of motion and relieve pain by helping to stretch out tight muscles in the back of the neck.

Increasing strength of the neck, upper back, and shoulders–Performing therapeutic exercises will help to strengthen and stabilize muscles of the shoulder blade, upper back, and neck, which will also help to improve posture and endurance. This will make sitting and standing for longer periods of time more tolerable.

Modifying your work station or home office–Tips may include:

  • Finding an appropriate desk chair

  • Adjusting your computer screen so that it is no lower than the level of your eyes

  • Adjusting the position of your mouse

  • Using a headset instead of a regular phone

If you or someone you know suffers from headaches, don’t wait to take action. Call my office at once at (302)691-9055 or visit my website at to schedule your FREE 30-minute consultation to see how Physical Therapy can help you. Don’t delay–schedule now!

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