While all kinds of conditions can cause headaches, a physical therapist (PT) considers that an individual's musculoskeletal issues and headaches may be related. Sometimes problems with muscles and joints in the neck refer pain to the head or problems with the neck structures themselves can cause pain. Therefore, during your first physical therapy visit, the PT will carefully evaluate your symptoms to try to identify the underlying cause of your headaches and then develop a treatment plan.
Factors that can contribute to headaches:
Poor posture. The use of improper body mechanics can cause tension in the neck, shoulders, and muscles in the upper back. Bad posture habits that can lead to headaches include hunching forward when you sit and forward head posture.
Your shoulders shouldn't be rounded when you sit. They should be in alignment with your ears. Also, if your work requires that you bend your head forward for extended periods of time (e.g. computer use), the position puts a strain on neck muscles.
Neck joint problems. As the cartilage contained in the facet joints of the neck begin to wear down, the joints can become inflamed, causing pain. The joints where the skull and neck meet can also become inflamed and cause neck pain and headaches.
Muscle tension/weakened disc. Tight muscles in your face, neck, back, and between the shoulders can pull the neck vertebrae out of alignment, which can impinge spinal nerves – a condition that can send pain messages to the brain.
Problems with discs in the neck can also lead to headaches, as the weight of your head adds more pressure on the area. Headaches caused by neck problems often start at the base of of the skull with the pain traveling to the shoulders, face, forehead, and temples.
Physical Therapy Treatments
Treatment options a physical therapist may use to help alleviate headache pain include:
Stretching exercises. Gentle stretching can help reduce pain caused by tight neck muscles. You can do most neck stretches either lying on your back or in a seated position.
Strengthening exercises. A physical therapist can instruct you on how to do exercises to strengthen the muscles in your neck, shoulders, and back. Muscles in the neck that become short and weak can put the spine out of alignment and cause pain.
Education on proper postural positions. Proper sitting and walking postures help relax the body and relieve tension in the upper back, back of the neck, and jaws. Inadequate back support strains muscles and puts stress on the spine – factors that can contribute to fatigue, back pain, muscle pain, and headaches.
When you stand, you should stand erect and not lean forward. Tighten your belly and allow the muscles in the front of your thighs to pull you forward when you walk. Correct sitting posture requires distributing your body weight evenly on both hips, bending your knees at a right angle, and keeping both feet flat on the floor.
Hands-on manipulation. Physical therapists often use manual manipulation techniques in combination with exercise to alleviate pain and discomfort related to muscle tension and spasms. Treatment involves applying passive, therapeutic pressure on muscle tissue and joints.
Use of heat and ice. Applying a heating pad to your head or neck can help relax tense muscles, especially when a headache is first coming on. The application of a cold compress is another option, as it can dull pain by numbing the area.
Cervical traction. A physical therapist may use manual cervical traction to help reduce headache pain – if only temporarily – by stretching the muscles, joints, and soft tissue structures of the neck. Mechanical cervical traction can take pressure off the discs in the neck, relieve pressure caused by a compressed nerve, and help improve range of motion in the neck and cervical spine.
Depending on the cause of your headaches and based on additional symptoms you may have, a physical therapist will develop a program that offers treatment alternatives to specifically meet your needs.