Did you know, that chronic headache symptoms can be treated with physical therapy?
Many people look to medication and invasive techniques such as botox and nerve blocks to treat chronic headaches. In some instances, however, physical therapy can be a more conservative route to managing (and in some cases, eliminating) headache symptoms. Often times, headaches can be a result of muscular and/or joint dysfunction whether they contribute to the headache directly or via referred pain. There are a number of potential culprits which contribute to chronic headache symptoms.
One such culprit is temporomandibular joint dysfunction. You may recognize this term better as “TMJ” or simply “jaw pain.” TMJ dysfunction is often a result of excessive clenching of the teeth whether it is due to stress throughout the day, or done unconsciously while sleeping. This ultimately causes tension and tightness in the muscles surrounding the jaw and around the temples causing pain and limiting movement of the jaw. TMJ can cause referred pain into the shoulder blades and mid back and can also refer pain in the form of chronic headaches.
Another potential cause of headache symptoms is increased tension and tightness in the upper trapezius muscles which run from the bones of the neck and attach to the shoulder. These muscles commonly carry a lot of tension and develop trigger points (hyperirritable points within the muscle) as a result of poor posture and/or increased stress. This improper overuse of the upper trapezius muscles can ultimately lead to referred pain up the neck and into the temples resulting in headache symptoms.
A more direct cause of headache symptoms includes tightness in the cervical spine and its surrounding musculature resulting in lack of range of motion of the neck. This dysfunction can be caused by a direct injury, such as whiplash, or can be a result of chronic poor posture. This lack of normal movement can cause pain and discomfort that can eventually trigger headache symptoms.
There are various physical therapy treatment methods that can work to manage and/or eliminate headache symptoms. Every client is different and requires an extensive evaluation and examination to determine which intervention(s) is most appropriate in treating his or her unique symptoms and dysfunction. The goal of physical therapy treatment is to normalize the musculoskeletal system in order to reduce tightness in affected muscles, improve mobility, and most importantly, educate the client to ensure long term results.
Cervical traction is a method of stretching the head away from the neck, either manually or mechanically, with the ultimate goal being to provide prolonged stretch to the muscles in and around the cervical spine to decrease tightness and discomfort.
Trigger point dry needling (TPDN) is an intervention which uses a thin filiform needle to penetrate the skin and muscle. The ultimate goal of TPDN is to deactivate trigger points and thus decrease overall muscular tightness and increase range of motion.
Deep tissue massage is a beneficial method of releasing chronic muscle tension by focusing on the deepest layer of muscle tissue.
Manual stretching and cervical mobilization techniques are used to improve the amount and quality of motion within the cervical spine.
Ice is an important tool used to decrease inflammation and reduce pain.
Client education is most important in long term management of symptoms and focuses on postural training to ensure client’s understanding of optimal body positioning. This includes body positioning in situations such as sitting in front of a computer at work, sitting while traveling long distances, and provocative positions to avoid in general. Clients also benefit most from a home exercise program consisting of self-stretching techniques and appropriate strengthening exercises to ensure muscular balance for the best opportunity to achieve optimal posture at all times.
There are many different types of headaches and migraines and unfortunately not all can be treated with only physical therapy. Consulting with a neurologist is an important step in the right direction to improving symptoms and attaining a better quality of life. If you or someone you know is suffering from chronic headaches/migraines, considering physical therapy a viable addition to your current treatment regimen.
Posted by Gabriella Cifelli, DPT