Headaches affect 47% of the global
population on a regular basis. Some people
suffer from them monthly, weekly and
sometimes even daily, and the headache
can range from being a nuisance to being
completely debilitating, disrupting your
ability to drive, work, concentrate, do daily
chores or even stand upright.
difficult thing about headaches is that there
is so much variety between individuals, in
terms of headache types, symptoms and
triggers, it makes them very hard to diagnose
correctly, and therefore often treatments are
According to the International Headache
Society there are over 130 distinct disorders
identified and over 300 causes of headaches.
Fortunately, most of the common headaches
can be identified and treated effectively if
you know what to look for. One of the most
common headaches generates from issues
in the soft tissue structures around your neck,
and your physical therapist is well-trained
in not only being able to diagnose these
types of headaches but also in treating them
through soft tissue manipulation and being
able to give you exercises to help strengthen
weak muscles and prevent the headaches in
Unfortunately, many people end up
resorting to medications, home remedies and treatments, expensive examinations or investigations, costly changes to bedding
and pillows and even visits to the dentist for
gum guards to prevent clenching or teeth
grinding. Sometimes we try and brush things
off as an inevitable consequence of our ‘life’
be it your job, stress level, or the amount of
time you spend sitting in front of a computer.
But living with headaches doesn’t have
to be a case of ‘suck it up and deal with it’.
There is a lot of research out there to support
ways in which physical therapy can help
you manage and prevent different types of
SHOULD YOU BE CONCERNED
ABOUT A HEADACHE?
In a small percentage of patients there
is unfortunately a sinister cause of your
head pain, which should be thoroughly
investigated. There are ‘Red Flags’ which
are important signs of a possible, more
ominous, underlying condition (eg.
aneurysm, meningitis, tumor etc.) which
need urgent investigation. Fortunately, these
are extremely rare occurrences, but if you
experience any of the following symptoms,
please seek the advice of your doctor as
soon as possible.
Headache ‘Red Flags’ include, any of the
a) Your worst ever headache or a
different headache to your usual
b) A sudden change in the type or
pattern/intensity of your headaches
c) History of cancer
d) During or following pregnancy
e) Headache at night or waking in the
• Exertion triggers your headache (eg.
exercise, cough, sneeze or sex)
• Age is greater than 50 years
• Despite treatment, your headache persists
• Acute onset i.e.. comes on very quickly
• Central nervous system findings (eg. weakness, memory loss, slurred speech)
• HIV or other immune system compromise
• Fever or other systemic symptoms (eg. unexplained weight loss, high temperatures, rash).
Fortunately, the vast majority of headaches do not require urgent medical investigation and should respond positively to treatment depending upon an accurate diagnosis. The majority of headaches diagnosed are:
• Tension headache
• Cervicogenic headache (originating from the neck)
• Followed by cluster and sinus headaches.
These are the most common headache causes and interestingly (or frustratingly), they can also co-exist. You can simultaneously suffer one, two or more types of headache or a migraine at the same time where one may cause another or overlap with each other.
These are known as mixed or multisource headaches and can take longer to resolve as your therapist works through treating the different causes. For example, a dysfunctional painful neck can cause an increase in surrounding muscle spasm, which will increase your blood pressure. In this scenario, you could have a cervicogenic (neck) headache, with a tension headache
and a resultant migraine!
This table will help you to differentiate
between common headache types and help
you understand which headache you might
have. This will better help you understand
and manage your headache as well as seek
the right treatment. If you don’t feel you fit
exactly into any one of these categories, get
diagnosed by a local healthcare practitioner.
They will be able to assess you and your
history and symptoms and may identify
where you ‘fit’. Remember every person and
every headache is individual and may vary or
present slightly differently from the norms.
Finding the primary source or cause is
the key to successful treatment. Whether you
have managed to identify your headache
type or not we have information resources
available on how you can manage and treat
each of these different types of headache.
The resources also explain in more detail
how physical therapy treatment, massage
and specific exercises can eliminate, or at least in more severe cases reduce, the
intensity and frequency of your pain.
Physical therapy has been shown over
the years, both clinically and through
research, to have beneficial effects for
headaches. Manual, hands-on therapy
manipulating or mobilizing your neck can
be hugely beneficial in eliminating your
headache; or at least reducing the intensity
and duration of the headache.
Soft tissue work including trigger point therapy and
massage too can be effective in relieving
spasm in the head and neck muscles possibly
contributing to your headache.
has also been shown to help people cope
better during headache episodes, reducing
associated stress and anxiety. Acupuncture,
laser and ultrasound are additional therapies
that could help with neck or cervicogenic
headaches, and sinus headaches.
Contributing factors to headaches
have been shown to include poor postures
and repetitive movements that may strain
These could include desk or
computer set up, studying and working with a chin forward/poking chin posture,
bad ergonomics at work, constantly turning
to one side, hanging washing on a line
– looking up for long periods or similarly
constantly looking down. Any one of these
postures or bad habits can cause muscle
spasm, muscle imbalance and weakness as
well as strain the joints in your neck all of
which can refer pain to the head and result
in headache. Your therapist can
identify poor posture and muscle weakness
as well as assess your work or home space
and daily activities where they can give
advice to make corrections and perform
THE LAST WORD
If you suffer from regular headaches, don’t
despair. There are treatments and advice
you can receive from your therapist
to help manage your headaches. If you
would like us to send you these additional
resources including self-help advice just get
in touch through our website, or through our