HEADACHES

Headaches are an extremely common occurrence through out our population and can effect all ages both young and old. There are several different types of headaches each of which vary in cause and consequently treatment. A thorough assessment is absolutely pivotal in determining what headache you are suffering from and the large amount of overlap between different headaches makes it vital you seek the opinion of a Physiotherapist. Once your type of headache is determined the most effective form of treatment can be administered, read on to find out more about headaches.

What are the different types of headaches?

The 3 most common types of headaches are cervicogenic, tension-type (TT) headache and migraine. As you read further you’ll notice there is a lot of overlap between the 3.

Cervicogenic

A cervicogenic headache, as the name suggests, originates from the cervical spine and in particular the very top of the neck. A cervicogenic headache is usually one sided, described as non-throbbing and starts as neck pain and moves to the forehead, temporal or sometimes described as being behind the eye. The head pain can be made worse by moving the neck (rotating head side to side) or placing the head in an awkward posture, even external pressure over the upper part of the neck may worsen the head pain. A cervicogenic headache can even be accompanied by nausea, dizziness, blurred vision and even sensitivity to light and loud noises.

Tension-type Headache

The exact mechanisms of which cause TT headaches are still unknown though changes in pain processing in the brain are thought to play a role. A TT headache typically occurs more in the temporal region on both sides, its described as a pressing/tightening feeling and is not aggravated by physical activity though can last from 30 minutes to 7 days. It can be accompanied by nausea and vomiting and even sensitivity to light or loud noise.

Migraine

A Migraine is the most severe of all headaches and is a truly disabling and unpleasant experience for any sufferer. A migraine can present with and without an aura which is recurrent attacks lasting minutes of visual, speech and sensation symptoms that are usually followed by a headache and migraine like symptoms. A migraine can last from 4-72 hours and it is usually one sided, pulsating in nature and is aggravated by or causes avoidance of normal physical activity. When suffering from a migraine, nausea and/or vomiting may be present as well as sensitivity to light and sound.

What can physio do?

First and foremost your physiotherapist will determine if what you’re suffering from is actually a headache. This might sound silly but there are a range of various other conditions that can mimic headache symptoms, sinus problems and TMJ/jaw issues to name a few. As you’ll note from reading above not all headaches are the same and consequently not all headaches are treated the same way.

Your physiotherapist will ask questions regarding the following:

-Frequency/pain/duration/location of your headache
-Visual disturbances/double vision
-General health
-Vomiting
-Recent Falls

This allows your Physiotherapist to determine which headache you’re most likely suffering from, it is then a management plan can be put in place. A thorough assessment of cervical joint mobility, muscle endurance and posture will also be undertaken and any deficiency noted and included in the management plan.’

Only certain headaches have been proven to benefit from Physiotherapy and at Saanich Physiotherapy we manage our patients based on what research recommends. If it is found your headache is not amenable to physiotherapy you will be advised to speak to your GP where proven medication can be prescribed.

What treatment does Physiotherapy provide?

Cervicogenic and Tension type headaches are much more amenable to physiotherapy treatment than migraine headaches. Your Physiotherapist will use a combination of neck joint mobilisaton, soft tissue massage around the neck and shoulder region as well prescribe a home exercise program according to neck postural muscle deficiencies as indicated from the assessment.

The head is a heavy part of the body often weighing more than 5kg which is a lot considering it must be held upright all day. The muscles responsible for holding the head in the correct position must be functioning adequately for the correct posture to be maintained. Neck pain and headaches can alter the neck muscle efficiency and endurance and this must be corrected with specific rehabilitation exercises in order to prevent neck pain and headaches from reoccurring.
The flexor muscles of the neck are often targeted in physiotherapy rehabilitation for headaches

A quick note

Today the 3 main types of headaches have been discussed though it is worth mentioning there are many many more headache types and even subgroups of each type of headache. Your physiotherapist will be able to determine from their thorough assessment of your presentation whether your headache is likely to be helped by physiotherapy intervention and if it needed referral onwards for further management.

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