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  • Dr. Kristen K. Schulte, PT

Headache? Reach for your physical therapist.

Are you a “headache” person? If so, then you are not alone. 47% of the global population reports a regular occurrence of severe headaches. Even if you aren’t among that statistic, we have all experienced a headache before, right?

But what really is a headache? Oftentimes, people group all severe headaches into the “migraine” category, but that is not entirely accurate. True migraines are thought to be a result of a blood flow issue to the brain and are often felt as a throbbing pain in one or both sides of the head and may be accompanied by nausea, vomiting, light or sound sensitivity, and sometimes with visual dizziness or disturbance) referred to as an aura. (Anyone who has suffered from a true migraine knows that that was an extremely simplified description of the pain they suffer regularly, and for that, I apologize.)

If this does not match your headache description or a physician has not officially diagnosed you with such, then I do not doubt that you suffer, but you likely are experiencing a different type of headache. The latest research describes as many as 14 types of headaches, but besides migraines, two extremely common categories are labeled as cervicogenic and tension. As luck would have it, these two types are also very easily treated with physical therapy!

Cervicogenic Headache. It is estimated that 15-20% of headache sufferers experience cervicogenic headaches. These headaches are classified by pain on one side of the head that starts in the base of the skull and wraps around to the front of the head, even to the back of the eye at times. Sustained head positions (sleeping or long period of sitting at work) usually trigger the symptoms, and an MRI or X-ray of the neck and head will appear normal. Jaw pain often accompanies these headaches. Cervicogenic headaches are the results of a vertebrae in the neck being pinched or muscles at the base of the skull being tight and containing knots (also called trigger points). These triggers radiate into the head and voila! you have a cervicogenic headache.

Tension Headaches. This type of headache is the most common among adults and may last 30 minutes to several days. Tension headaches feel like a dull pain or pressure in a band-like shape around the head and neck. While tension headaches can also crop up after a long day of work, they are more the result of weak postural muscles causing the shoulder and neck muscles to tighten, putting extra pressure on the surrounding joints and nerves. This can also explain why tension headaches also occur with periods of stress. Some muscles aren’t working enough and others are working too hard, and you finally feel like your head is too heavy to be supported by your neck.

How do we treat it? I am guilty of it, too, when I get a headache: Reach for the ibuprofen! What if I told you that physical therapy was actually more effective than taking pain-relieving medication in this case? With either cervicogenic or tension type headache, taking a medication will block the pain and may relax the muscles for a while but will not change the root cause of the headache, which is why the headache will return days or weeks later and could eventually become constant. Physical therapy can gently loosen a pinched vertebra and manually release the tight muscles. One of my favorite techniques for headaches is dry needling because it is so effective in loosening muscles and eliminating trigger points. Oftentimes, dry needling and manual therapy can relieve a headache immediately, and with the help of prescriptive exercise, the patient is able to normalize poor mechanics and strengthen specific muscles prevent future occurrence.

You don’t have to be part of the 47% of headache sufferers, and you don’t have to become reliant on pain medication. So next time you have a headache, instead of reaching for the pill bottle, reach for your phone and give us a call.


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