Physio: Managing headaches

In general, headaches can be classified into four categories and physiotherapy can help.

  • May. 11, 2014 12:00 p.m.

Long hours in front of the computer, family demands, erratic sleep schedules, and traffic jams are few of the daily stresses that can trigger headaches. In general, headaches can be classified into four categories:

• Headaches associated with viral illness (respiratory infections, influenza, and sinusitis)

• Cervicogenic headaches due to an irritation of joints, muscles and nerves in the neck

• Migraine/Cluster headaches due to a change in pressure of blood vessels supplying the head

•Tension headaches due to sustained muscle contractions in the head, jaw, neck and shoulders.

Headaches originating from the neck and shoulders are usually described as a constant, steady, dull ache on one or both sides of the head. One may experience a pulling, gripping feeling at the back of the neck or even a band around the head. The symptoms are generally provoked by neck movements and sustained postures. Rounded shoulders, an extended neck, and a protruding chin owing to poor ergonomics at work can contribute to excessive strain on the joints at the base of skull, ligament tension and muscle overactivity/inflexibility. Tension in the soft tissues and the reduced mobility in the joints may further irritate the nerves and compress the blood vessels supplying the head and neck. In addition to poor postural habits, an injury or strain of structures in the neck due to whiplash following motor vehicle accidents, falls while skiing/snowboarding, and head-high tackles at football can also contribute to headaches.

An initial visit to your physiotherapist usually involves a comprehensive examination incorporating a thorough account of your headache experience (onset, nature, intensity, progression, aggravating factors, associated symptoms, family history, etc.) Your therapist may ask you questions to screen for more sister forms of headache that should be directed to the doctor for further investigation.

The physical examination involves a detailed analysis of the joints, muscles and neural structures in the spine as well as an assessment of your posture. The purpose of the physical examination is to reproduce your symptoms and faulty movement patterns that could cause headaches or put undue strain on the neck.

A range of techniques is available depending on the cause of one’s headache and their experience and preferences with past treatment.

Soft tissue therapy to the muscle and fascia of the cervical region aimed at releasing tight muscles and fascia followed by mobilization or manipulation of the upper segments of the neck, jaw and pelvis to correct joint abnormalities is found to be effective.

Postural retraining is also an essential part of headache management. It may be necessary to improve shoulder girdle and thoracic posture with mobilization, manipulation and scapular exercises. The position of the pelvis also dramatically influences thoracic and cervical posture

Craniosacral therapy aimed at restoring movement between the bones of the skull and freeing the underlying membranes, fascia and nerve tissue is also found to be beneficial as an adjunct to conventional manual therapy techniques. Imbalances in the cranial system can occur during a difficult birthing process, concussions, and dental procedures involving tooth extractions/ root canals.

Manual therapy provides a gentle, non-invasive alternative to treat headaches. An individual’s response to treatment will also depend on his/her diet and lifestyle choices reflected by their current state of health and harmony within the body.


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