Can Physiotherapy help my headache?
Do you suffer from headaches? Is the condition affecting your quality of life? If so, you are not alone – over 50% of the population have a headache disorder! If you experience regular or persistent headaches, you’ve probably wondered, ‘can physiotherapy help my headaches?’. The good news is, that many can get relief with headache treatments from an experienced Physiotherapist.
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In the following blog, I will attempt to answer the following questions:
- What are the causes of chronic recurrent headache?
- Is Physiotherapy the right treatment for my headaches?
- How can Physio help headache sufferers?
- When should I see a Doctor about my headaches?
Let me first introduce myself. I am a Senior Physiotherapist with over 30 years of experience in Physiotherapy working in England, Scotland, Melbourne and now Brisbane. I have worked with elite athletes, as well as general sports injuries and occupational health conditions. In addition to general musculoskeletal conditions, I have a special interest in treating headaches and neck disorder with over 20 years of experience in this area.
Chronic or recurrent headaches are a common condition in both adults and children. Headaches have a significant impact on your quality of life, impacting your sleep, your ability to work, socialise and also results in reduced activity levels.1
Headache sufferers often seek medical advice, undergo multiple investigations and treatment and trial lots of medication, all at significant time and financial cost. Headaches can also be really concerning. Significant anxiety around the possible causes of headache is common, and there can be confusion about where to seek help.1
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Because of our expertise in hip conditions, hypermobility, sports injuries, and dance injuries and performance, we also have people visiting us from all over Queensland, Australia and even international visitors. We also have a telehealth service for remote patients.
What are the causes of chronic or recurrent headaches?
There are many different types of headache. In this blog, I will discuss the most common types of headache that Physiotherapy has been shown to help.6-12
Tension type headache is one classification of headache that affects a large percentage of people, with women more commonly affected than men.1,2,4 The causes of this type of headache are largely unknown but thought to be due to the nerves becoming sensitised, most likely involving multiple factors.
Other classifications of headache that Physiotherapy can help with are cervicogenic headaches, which are linked with underlying problems in the neck, and headaches attributed to temporomandibular disorders, or problems around the jaw.2-5 Examples of common causes of headache are described below.
Can poor posture cause headaches?
What constitutes ‘good posture’ is still a topic of contention and beliefs have shifted over time. It’s not that there is one particular gold standard position that everyone should use when sitting or standing. It’s more about sustaining a position for prolonged periods, particularly when the position holds joints at the end of their range or forces the same muscles to work continuously.
A ‘forward head’ posture has often been reported in those who develop neck pain or headaches with prolonged sitting or standing. This position puts the joints at the top of the neck into an end-range, compressed position. This can be more stressful if the load is asymmetrical, for example keeping the head tilted to one side. This can be a common problem in violinists.
In addition, if the weight of the head is sitting forward of your body, muscles at the back of the neck that support the head and anchor into the top of the upper back and shoulders have to work continuously to hold the head up against gravity – and the head is heavy! Muscles start to get fatigued and achy, and the tension that develops in them may contribute to a tension type headache.
If this type of postural habit is sustained and frequent, it can cause irritation in the joints in the neck and muscle imbalances may develop, particularly in the presence of persistent pain. For example, deep postural muscles may become weaker and less able to support the head and neck, and the longer superficial muscles may become unhealthy and fatigued.
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Referral from irritated or arthritic joints in the neck
Inflammation or degenerative change in the upper joints of the neck may cause inflammation of the surrounding soft tissues (muscles, tendons, fascia), as well as irritation of the local nerves that supply the skin of the head. Joints, nerves and other structures may then cause pain that radiates to the head.3,5
Arthritis in the joints of the neck can also impact on the health and balance of the surrounding muscles. This can in turn leave the joints less supported and more painful, without a targeted exercise program.
Disorders of the jaw (temporomandibular joint or TMJ disorders) and headaches
Clenching or grinding of the teeth has been linked with headaches due to inflammation in the region around the TMJ (jaw joint) and tension in the muscles. The local nerves can become compressed and refer to the head.4
As with the joints of the neck, other causes of TMJ inflammation or arthritis also have the potential to cause headaches. This might be related to a past injury or repetitive or sustained loads over time.
Hypermobility and headaches
Many people with generalised joint laxity or hypermobility, suffer with headaches that can be attributed to the increased stress on the neck and jaw. This includes those diagnosed with Hypermobile Ehlers Danlos Syndrome and Hypermobility spectrum disorders.13
People with hypermobility have ligaments that are more stretchy than normal. This means the joints, including those of the neck and jaw may sag into end-range compressed positions more easily. Muscles often also have to work harder to support the extra-bendy joints. If the deep postural muscles are not up to the task, that a lot of fatigue and tension may develop in the more superficial muscles around the neck.
Headaches related to past trauma, like whiplash
Trauma, for example in a motor vehicle accident or a direct injury to the side of the face, causes inflammation in joints, and surrounding soft tissues in the neck and/or jaw. This for some people can refer pain to the head.
For most people any acute injury will resolve, but for some the joints and soft tissues remain irritated, scar tissue forms and muscle imbalance develops. As a result, the referred pain may become recurrent or chronic.2
Not sure what could be causing your headaches?
Book today, and let one of our Brisbane Physiotherapists help you get on top of your headaches, and provide you with the appropriate course of action to help you get back to enjoying life! You can read more about headaches below!
Is Physiotherapy the right treatment for my headaches?
If any of the following applies to you, you may have pain that is referred from muscles, joints or nerves originating around your jaw or your neck.4,6,13 Physiotherapy can help by addressing the underlying problems (or impairments) in these areas:
- You are not able to turn your head as far as you previously could
- Your jaw does not open as wide as it once did
- You can hear sounds in your neck joints or your jaw when you move
- Your dentist has told you that you grind your teeth
- Your pain is worse after long periods at work, driving, or playing a musical instrument
- You have tenderness when you press at the base of your skull
- You have had an accident in the past, such as a motor vehicle accident or a blow to the side of your face or head
- You have neck pain and stiffness and tension in the tops of your shoulders before or at the time of your headache
- If you are hypermobile, you may have full or excessive range in your jaw or neck but the movement is painful and causes headaches
How can Physio help headache sufferers?
There is good evidence that directed physiotherapy can help in the treatment of headaches, even headaches that have been recurrent for several years!6 Effective Physiotherapy treatment will be based on a detailed assessment, will target structures that are the problem (impairments) and be directed by what you want to achieve (goal orientated).7-12 Let’s take a look at some of the components of a Physiotherapy program for neck or jaw related headaches provided by PhysioTec Physiotherapists.
A thorough assessment is key in the Physio management of headaches
An experienced Physiotherapist will undertake a thorough assessment to identify the underlying factors that are contributing to or causing your pain, and to establish if Physiotherapy will likely help you. This is essential to guide the direction of treatment and to ensure that once you have relief, that you can understand and manage the cause to prevent or have strategies to reduce future episodes.
The assessment will also include screening tests to exclude any conditions that may benefit from further investigations. You and your Physiotherapist will discuss what you wish to achieve and set realistic goals which will guide the subsequent treatment program.
Education - Understanding your headaches
Understanding what is causing your symptoms and that there is a plan of action can make a real difference. If you understand the problem and the solution, you are more likely to engage actively in a treatment program, with more positive results.
Postural training for headaches
Your physiotherapist can help you identify how your posture could be impacting your muscles, joints and nerves and help you with cues to retrain and improve your everyday positions. This may include advice about your work set up, driving position, or sitting postures and positioning for musicians.
You may be aware of your posture but do not feel you can change it. You may also not realise how frequently in a day you remain in positions that aggravate the problem. Physiotherapy with regular exercises and cues can help you retrain your posture into one that is less fatiguing and avoids holding joints in irritating positions.
Guided individualised exercise program for headache management
If the assessment shows you have weakness in your postural muscles in your spine, you will be given exercises to address this impairment. If the assessment has identified that you have an imbalance around the jaw muscles, we can also give you specific exercises to address this issue.
In addition to improving health, coordination and endurance of your deep postural muscles around your neck and jaw, an individualised progression of strengthening exercises can help you achieve your functional goals.
Trigger point therapy for headaches
For some people, hands-on treatments to the muscles around the back of your head, the top of your shoulders or around your jaw can be helpful. Treatment aims to relax or reduce the tone in the muscles and may improve your comfort and ability to exercise the area, once the muscles are more relaxed. Dry needling can also be used to reduce pain from these muscles. The main goal is to normalise tone and allow for effective postural muscle training.
Joint mobilisation techniques for headaches
Joints that are stiff or inflamed may benefit from joint mobilisation from a Physiotherapist with manual therapy skills, particularly if in addition to other treatment strategies. Light mobilisation can reduce the pain and help to reduce the tone in the overactive muscles. This can allow for more effective muscle and postural retraining.
Hands-on treatments are most useful in the early stages of rehabilitation, to ease your pain and allow you to complete the strategies that are most likely to provide longer term solutions, like postural strategies and exercise.
Other helpful advice for managing headaches
Your PhysioTec Physiotherapist can help advise you regarding how best to participate in your sport or recreational activities, your music or art and even sleeping positions or pillows. Tips and strategies to avoid the headaches, and also what to do if symptoms recur are a valuable addition to the Physiotherapy treatment program and your ongoing self-management.
When should I see a Doctor about my headaches?
As you can see from the above information, most headaches are not a cause for concern. However, it is advisable to visit your General Practitioner if you experience a headache for the first time that lasts more than 1 day and;
- You are pregnant
- The pain is severe
- You have not been diagnosed as having migraines with or without aura and you have symptoms of dizziness, avoidance of light, visual disturbances, changes in your speech, loss of consciousness
- Numbness and pins and needles with weakness in your upper or lower body.
If you are unsure, one of our PhysioTec Physiotherapists
will be able to advise you further.
I hope you have found this information helpful and it has answered many aspects of your question: ‘Can physiotherapy help my headache?’.
If you have been suffering with headaches and have been unsure what to do or who to see, come in and see us at PhysioTec. We’ll let you know if we think Physiotherapy can help, and if not, we’ll point you in the right direction to get help for your headaches.
Struggling with headaches? Visit us at PhysioTec. Our skilled Physios, can evaluate your condition and develop a personalised plan to enhance your recovery, helping you get back to doing the activities you love!
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Author
This blog was written by Rachel Crosbee, one of our musculoskeletal physiotherapists, and our lead hypermobility physiotherapist. Rachel has broad interests in treating a wide variety of musculoskeletal problems from acute to chronic, spine, lower and upper limb conditions. She also has a particular interest and expertise in treating neck pain and headaches.
You can read more about Rachel here.
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- Jard Svensson, Anneli Peolsson, Anna Hermansen, Jeremy J. Cross, Allan Abbott, Joshua A. Cleland, Marie Kierkegaard, Marie Halvorsen & Åsa Dedering (2024) The effect of neck-specific exercise and prescribed physical activity on headache and dizziness in individuals with cervical radiculopathy: Further analyses of a randomized study with a 1-year follow-up, Physiotherapy Theory and Practice
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