The stress of the holidays are over and you are likely charging full throttle into your New Year’s resolutions. Maybe you have goals of eating better, exercising more and meditating twice a week. What about those headaches you’ve been experiencing? Is getting rid of them on your list?
I have developed a special interest in treating patients with headaches for several reasons. Primarily this interest sprung from growing up with my dad having chronic migraines ever since I can remember. I also dealt with migraines for a period of time in college. In physical therapy school I learned about hands on treatments for different types of headaches including migraines. There is evidence that hands on treatment or manual therapy can be effective for most types of headaches including migraines. So, why was this never presented as an option for my dad or me? Luckily, my migraines subsided over the course of a year and a half. My dad’s continued. And, this is what has spurred my deep interest in headache treatment.
There is an effective headache treatment of each type of headache that exists. And one of the keys to get rid of headaches once and for all is determining what type or types (as you can have more than one headache type at a time) you have.
So let’s start with three main headache types. Cervicogenic, Tension and Migraine.
Common headache types
Cervicogenic headaches are often unilateral, meaning they are on one side of the head and the headache pain typically does not switch sides. As illustrated by the image in the infographic, the pain is often starts at the base of the skull and radiates to the front of the head or behind the eye. This type of headache is often preceded by neck pain, meaning you may feel your neck being stiff or painful and then notice your headache starting. Also, patients with cervicogenic headaches often notice an increase in headaches with sustained postures, for instance working at a computer or having your head turned slightly to one side. These type of headache pain is actually coming from dysfunction in the joints or muscles of the neck and physical therapy focusing on restoring the normal motion in your neck joints and muscles is highly effective.
Tension type headaches are the most common headache type but ironically the least studied. The most well accepted theory on the cause of these headaches is an increase in resting tone or tightness in the muscles of the face, jaw and neck. They present more often in females than males and are often described as a tightening around the skull and temples. This headache often presents with the other two headache types covered in this article. Effective treatment of this type of headache includes gentle stretching of the soft tissues and muscles of the neck and face in addition to evaluating breathing patterns and relaxation exercises.
Migraine headaches are often present on one side of the head and are often described as pulsatile in quality. With migraines, the pain can switch sides between or within headache episodes. An aura can be present prior to the onset of the migraine. An aura refers to the feelings and symptoms you notice shortly before the migraine begins. Symptoms of aura include blind spots or tunnel vision, seeing zig-zag patterns, prickling sensation in the skin, dizziness and confusion. Migraine suffers can also experience nausea, vomiting and sensitivity to light or sound. Different types of prescription medication are often useful in managing migraine frequency and duration. Studies have shown that cervical(neck) mobilization and manipulation (like you would receive from a skilled physical therapist) can be as effective in managing migraine symptoms as some medications. This has certainly been my experience in the clinic, with many of my patients being able to reduce or eliminate their migraine medication after several physical therapy sessions.
If you want to eliminate your headaches once and for all, you need to first determine what type of headache or headaches you are dealing with. The description and behavior of your headaches in combination with a detailed hands-on exam of the head, neck and upper body are critical to determining what treatment options are best for you. Many patients find lasting relief by working collaboratively with a physician and physical therapist. My goal is to eliminate your headaches and look forward to working with you to make a positive impact in your life.