The headache is a common medical complaint. In fact, 46% of the adult population struggles with headaches on a regular basis. Identifying the source of head pain is complicated, but necessary to determine the most appropriate treatment.
The International Headache Society classifies headache into 13 major categories with 129 subcategories. However, most headaches fall into one of these three categories: migraine, tension-type, and cervicogenic headache. Tension-type headache is the most common, making up around 42% of all headaches. About 15% of headaches are cervicogenic, while 11% are migraines.
It may surprise you to learn that ibuprofen is not the only remedy for headache pain. In fact, patients with tension-type and cervicogenic headaches may be helped by outpatient physical therapy.
Tension Headaches
Patients with tension headaches typically have mild to moderate pain on both sides of the head that does not get worse with physical activity. There is usually no nausea associated with tension headaches. People usually can continue to function at work or during the day while having a tension headache, but these headaches can become chronic and progress into a daily headache lasting several hours or days or even become continuous.
Research has shown that tension headache is the result of central sensitization of the nervous system rather than the common idea that “muscle tension” in the neck muscles causes the headache. Central sensitization involves overactivation of the brain and spinal cord – often as a result of anxiety or stress – without having the ability for the body to use the normal ways to slow down the nervous system and get things back in balance. Similar to a teeter-totter, the nervous system must have the proper balance. When tipped to the overactivation side, it goes into “crazy mode” and headaches can be the result.
Cervicogenic Headaches
In this type of headache, pain is usually located only on one side of the head. Cervicogenic headaches are caused by pain signals produced by structures in the neck, such as discs in the upper neck and the small joints that hold the neck bones together. Problems with movement where the joints in the neck become too tight can cause this type of headache. Poor posture can also be a major contributing factor for cervicogenic headaches by creating problems with movement and proper muscle control of the head. Many computer-related activities, prolonged sitting, falls, trauma such as motor vehicle accidents, and changes in our necks related to aging can create problems that lead to cervicogenic headaches.
Physical Therapy Approaches
Physical therapy treatment for tension and cervicogenic headaches focuses on improving movement, posture, muscle control and strength. Common treatments include manual therapy, which includes soft tissue mobilization, joint mobilization of individual vertebrae, and manipulation techniques for the spine. Muscle control exercises are also done to improve neck and trunk stability and get the muscles working properly.
We also work on posture and ergonomic education, body mechanic training, relaxation exercises and stress management with many patients. Strengthening exercises for the upper back, neck, and shoulders is an integral part of most individual treatment programs.
Most of the time, there is not one quick fix for problem headaches. Electrical stimulation, heat and cold can also be used at times to regulate the pain system. Due to the multiple factors that contribute to the production of headache, it is necessary to address a variety of different interventions in the successful treatment plan for each headache patient.
