Treating Headaches with Physiotherapy

Headaches can be normally be split into two categories, primary and secondary headaches. Primary headaches are normally benign and recurrent headaches which are not caused by disease or structural problems. Secondary headaches are normally caused by disease or a medical condition including inflammatory disorders or injury to the head and neck.A common type of headache is a cervicogenic headache. This normally brings on pain in the head that is referred from structures in the neck, normally the upper cervical joints and muscles. It is thought that neck pain can cause headaches due to its nerve supply. Sensory fibres from the neck coverage with the trigeminal nerve which supplies sensation to the face and scalp. Essentially the brain gets mixed up as to where the pain signals are coming from.Approximately 47% of the population suffer from headaches with approximately 15-20% of these originating in the neck.Physiotherapy has shown to be very effective in treating secondary headaches referring from the neck. A detailed history regarding location, severity, frequency and duration of headaches symptoms is first important to rule out any serious pathology or lesion. Physio treatment aims to normalise the musculoskeletal system as much as is possible in order to reduce soft tissue tension and restore mobility and alignment of cervical spine joints.Assessment of movement, posture and palpation of joints and muscles of the neck and jaw can also help determine where the pain is coming from. Certain movements and palpation of specific joints can often reproduce the headache and therefore help localise where the pain is originating from. Pain will often start on one side from the back of the head and neck and migrate to the front of the head. Sometimes there is a pain referral down one arm.One common example of pain referring from musculature of the neck is overuse of the upper trapeziums muscle. In many people this muscle is overactive, especially with sitting postures when using a computer. This in turn leads to increased tightness and the development of trigger points (knots) in the muscle as it fatigues. These trigger points then refer pain up the neck and into the temples causing headaches.Depending on the main source of pain, physiotherapy treatment will focus on:

• Mobilisation, traction and manipulation of stiff joints of the cervical spine.
• Soft tissue massage, dry needling and stretching of tight, overactive muscles.
• Taping to assist in improving posture and offloading irritated structures.
• Prescription of strengthening exercises of deep neck flexors, and scapular stability muscles to improve posture and stabilise unstable joints.
• Neural mobility stretches and release of neural pathways.
• Education and advice regarding ergonomic set up at work, sleeping and sitting postures.

The above treatments will assist in achieving full range of movement and restore normal mechanics to your cervical spine.The following tips are useful to help avoid developing headaches originating in your neck:

• Be aware of maintaining good sitting posture.
• Avoid prolonged periods of sitting or static postures where possible.
• Have an ergonomic assessment of your work station.
• Keep hydrated throughout the day
• Exercise regularly to maintain flexibility and circulation of blood to the head
• Avoid sleeping on your stomach

If you have been experiencing headaches and have not yet tried physiotherapy treatment to manage the pain, contact us here to make an appointment. We have a number of experienced physiotherapists at Ballsbridge Physiotherapy Clinic who regularly treat this common complaint.