Can Physiotherapy Help With Headaches?

What causes headaches, and what are my treatment options?

Headaches have plagued all of us at some point in our lives, with the research suggesting that 99% of people will experience headaches. The more common causes of headaches are typically stress, dehydration, noise, and occasionally one-too-many glasses of wine.

But another common cause that we don’t often consider is muscle tension and limited joint mobility, more specifically, the muscles and joints of the neck and upper back.

What might be causing my headaches?

When the neck muscles get stiff and irritated, the effects can radiate upward and affect the head as well. Because we like our fancy words, we call these Cervicogenic Headaches. These headaches can be caused by a number of things, including whiplash, an injury, osteoarthritis, tension, or even just sleeping in the wrong position. Even if you don’t have a specific identifiable injury that started your headaches, don’t worry. This is relatively common with cervicogenic headaches.

Hallmark symptoms of this type of headache include:

• One-sided head pain that does not shift from side to side

• Aggravation with certain postures or activities, such as sitting at a computer or sleeping on your stomach.

• Muscle and joint tenderness in the upper neck

“The most important thing to remember is that your Physiotherapist can provide at least two things that a hot pack never will: evidence-based advice and reassurance.”

What are my treatment options?

While a hot pack and some rest might provide some temporary relief, it likely won’t help get to the root of the problem. Physiotherapy is the first line of treatment for Cervicogenic Headaches. First, your Physiotherapist will complete a thorough assessment; we want to screen to rule out other causes of headaches and identify exactly what is going on in the neck so that we can offer the best treatment and follow-up. That might sound strange, but headaches can actually be pretty tough to diagnose as most people who are experiencing a “tension headache” or “migraine headache” (the other two common forms of headaches) also experience neck pain. Some people, about 40%, even get extra lucky and experience two types of headaches at the same time! Yikes.

The good news is, once we know what’s going on we can start treatment to ‘loosen up’ the region and restore normal movement. This typically involves manual (hands-on) therapy directed at the joints and muscles in the neck and upper back, as well as exercises to help improve neck mobility and strength to help decrease the intensity and frequency of cervicogenic headaches. There is some good research suggesting that 8 to 12 sessions of physiotherapy using manual therapy and exercise can reduce pain experienced from cervicogenic headaches by 50% in most individuals. Even more impressive is that the results from these treatments tended to be long lasting and that the decreases in pain and severity of headaches were still present a year after concluding treatment.

The most important thing to remember is that your Physiotherapist can provide at least two things that a hot pack never will: evidence-based advice and reassurance. Your physiotherapist will not only assess and treat you, but they will also offer some tips for managing pain, as well as stretches and strengthening exercises to limit the chances of it happening again. They can tell you exactly what’s going on, what some of the likely causes are and, importantly, offer support and reassurance that it can and will get better.

Steve Young, Physio

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