3 Common Types of Chronic Headaches and How Physiotherapy Can Help

Headaches are a common ailment experienced by people of all ages and backgrounds. However, there are many different types of headaches. While there are various types of headaches, the 3 most commonly diagnosed are cervicogenic headache, migraine, and tension-type headache. In this article, we will take a closer look at the clinical features of these headaches and subsequently explore the best practice conservative management techniques and how physiotherapy can help alleviate symptoms of these headaches.

3 Common Types of Chronic Headaches & Physiotherapy Treatment

1) Cervicogenic Headache

Firstly, Cervicogenic headaches are the most commonly diagnosed headaches. Cervicogenic headaches are typically unilateral without side shift, with pain that usually starts in the neck (upper cervical) and radiates to the occipital, frontoparietal, or orbital regions. The frequency of these headaches can be chronic or episodic, with mild to severe pain that can last from 1 hour to weeks. Non-throbbing and non-lancinating in nature, cervicogenic headaches are triggered by neck movements, postures, limited range of motion, or pressure over C0 – C3. Associated symptoms are usually absent or similar to migraine but milder, with decreased neck range of motion.

Physiotherapy Treatment for Cervicogenic Headache

Joint mobilization and deep neck flexor exercises are two evidence-based physiotherapy treatment options for cervicogenic headaches. Patients can undergo eight to twelve joint mobilization treatments over six weeks to improve their range of motion and reduce pain. Physiotherapists can also perform deep neck flexor exercises twice daily over six weeks to strengthen neck muscles and reduce headache frequency at the same time.

2) Migraine

Migraines are characterized by throbbing, pulsating pain, which can be unilateral with side shift in 60% of cases, and located in the frontal, periorbital, or temporal regions. The frequency of migraines ranges from 1-4 per month, with moderate to severe pain lasting from 4-72 hours. Migraines are typically triggered by multiple factors, and associated symptoms can include nausea, vomiting, visual changes, phonophobia, and photophobia.

Physiotherapy Treatment for Migraine Headaches

Physiotherapy can help with migraines by addressing the underlying musculoskeletal factors that may be contributing to the condition. The treatment is typically focused on restoring normal function to the neck, head, and shoulder regions.

Some of the ways that physiotherapy can help with migraines include:

1. Posture correction: Poor posture, such as forward head posture, can put pressure on the neck and upper back muscles, which can contribute to migraines. Physiotherapy can help correct posture and reduce the strain on these muscles.
2. Manual therapy: Techniques such as soft tissue mobilization, myofascial release, and joint mobilization can help reduce muscle tension and improve joint mobility, which can reduce the likelihood of migraines.
3. Exercise: Specific exercises can help strengthen weak muscles and improve the flexibility of tight muscles. This can help prevent migraines from occurring due to muscle tension.

3) Tension-Type Headaches

Tension-type headaches is characterized by diffuse bilateral pain that is dull in nature. The frequency of headaches can range from 1-30 per month, with mild to moderate pain that can last for weeks. Like migraines, tension-type headaches are triggered by multiple factors, with associated symptoms that can include decreased appetite, photophobia, or photophobia.

Physiotherapy Treatment for Tension-Type Headaches

A combination of massage, cervical exercises, cranio-cervical manual therapy, and joint mobilization can be used. This treatment can be effective in reducing the frequency and intensity of tension-type headaches.

Physiotherapy treatment for chronic headaches

Headaches can be debilitating and negatively impact your quality of life greatly. While medication can provide temporary relief, conservative management techniques such as those offered by physiotherapy can certainly provide long-term benefits. By addressing underlying musculoskeletal issues, we will be fixing the root cause of these headaches.

Joint mobilization, deep neck flexor exercises, massage, and multidisciplinary care certainly play a crucial role in managing headaches. If you’re experiencing headache symptoms, consider visiting a physiotherapist for an evaluation. Your physiotherapist will be able to develop a personalized treatment plan that specifically suits your needs. Our team of physiotherapists are experienced and well-equipped at treating chronic headaches. Do give us a call or drop us a message to find out how we can help.