By: Gema Sanchez, PT
Headaches are one of the most common disorders of the nervous system, affecting approximately 47% of the global population. For three of the most common headaches; tension type headaches, cervicogenic headaches, and migraine headaches; several studies indicate that physical therapy can be a good treatment option.
Tension type headaches are the most common type of headaches and affect 38% of adults every year. Several studies indicated that these types of headaches respond well to specific exercise. In a study by Van Ettekoven and Lucas, patients performed exercises against an elastic resistance band in conjunction with manual techniques. They found that the patients had a significant decrease in frequency, duration, and intensity of headaches for up to six months after the program. In another study, Anderson and colleagues had office workers with frequent neck and shoulder pain perform 10 weeks of resistance training using an elastic resistance band. Their findings showed decreased frequency of headaches in these patients in response to as little as 2 minutes of daily resistance training.
Cervicogenic headaches affect 22-25% of the adult population. This accounts for 15-20% of all chronic and recurring headaches. These headaches are thought to arise from joint and muscle impairments of the neck. Two recent reviews looked at studies assessing the effectiveness of conservative physical therapy management on cervicogenic headaches. Both reviews concluded that neck spinal manipulation is effective in the management of cervicogenic headaches. In addition, one review also concluded that the most effective intervention for patients with cervicogenic headaches may be a combination of mobilization, manipulation, and neck and shoulder strengthening exercises.
Migraine headaches are reported by approximately 15% of the population. These headaches are believed to come from the blood vessels and the nervous system. Migraine headaches are usually managed using medication such as Propranolol and Topiramate. There are some patients, however, who do not tolerate medication due to side effects or who prefer to avoid medication for other reasons. For these individuals, manual therapy may be an alternative treatment option. In 2011 Chiabi and colleagues performed a systematic review of seven studies on manual therapies for migraine treatment. These included two massage studies, one physical therapy study, and four chiropractic spinal manipulative therapy studies. Treatments included massage, trigger point therapy, myofascial release, soft tissue work and stretching, postural correction, exercise, relaxation, mobilization, and manipulation. They concluded that the current studies suggest that massage therapy, physical therapy, relaxation, and chiropractic spinal manipulative therapy might be as efficient as medication (Propranolol and Topiramate) for prevention of migraines.
Physical therapy treatment for patients with headaches will vary depending on the type and origin of the headaches. At New Heights, we treat headaches using many different techniques including specific neck and shoulder strengthening exercises, stretching, postural correction, and manual techniques such as graded mobilization, myofascial release, augmented soft tissue mobilization (ASTYM), muscle energy techniques, and tender point therapy.