A physical therapist's experience with headaches

Half the world’s population has headaches! These headaches range from mild headaches that resolve on their own, to severe migraine headaches and chronic severe headaches. In the 30 years I have been seeing patients, almost half of my patients have come with the diagnosis of headache. Based on research and my own experience, physical therapy can significantly improve or resolve almost all headaches. The strategies a physical therapist uses can help reduce your dependency on medication, reduce the intensity and frequency of your headaches or completely resolve your headaches.

In my experience, headaches mainly originate from the muscles of the shoulders, neck, face and their corresponding joints, especially the cervical spine vertebrae and the temporomandibular joint (TMJ or jaw joint). Now this pain doesn’t just appear, although many of my patients over the years tell me that often. Headaches usually start as the result of changes in activity or posture (sleep position or quality of sleep; job change or physical activity change; postural change at work or home; or some other stressor that is medical or related to life changes). Headaches can also result from a chronic poor posture, position, or activity that presents itself as a headache.

The first step your therapist is going to help you with is identifying where, why, and how your headache began and the likely cause of your headache. The therapist will problem solve with you in identifying any recent changes or chronic postures/habits you do throughout your normal day from waking up in the morning to going to bed at night. This is done by an in-depth history or interview with your PT.

Some common postural or activity related causes of headache I’ve seen are:

  • poor head position when sleeping
  • the hand causing the jaw to be out of alignment when sleeping or resting the chin on the fist at work
  • tilting the head when on the phone or computer at work
  • tilting the head when watching TV or driving the car
  • clenching your teeth when stressed or overnight
  • excessive movement of the neck or jaw when talking
  • chewing your fingernails
  • biting your lip or cheek
  • poor posture when working out, especially when lifting weights
  • improper technique when looking down to read, text or use cell phone
  • specific work-related postures, especially if repetitive

Once the likely cause of your headache is discovered, the therapist will design a personal, specific treatment plan which will include most, if not all, of the following treatment aspects:

Education: you will be educated on why your posture or habits have caused certain body parts to become stiff or sore and cause you headaches. You will better understand the anatomy of the problem and then be trained on ways to modify your posture, habits, or work positions to start reducing your pain. You will be also given specific exercises to improve muscle strength and flexibility, joint stability and proper movement mechanics to further reduce your headaches.

Home Program: Your therapist will give you changes to make at home or work to best reduce and eliminate your headaches. The closer you follow those instructions, the more success you will have. Some of these exercises are to help you break the bad habits or postures while others will be specific for strengthening or improving muscle and joint function.

Manual therapy: Soft tissue mobilization, stretching or mobilization to the muscles and joints of your shoulders, neck, TMJ and head will be performed in almost all cases to help improve your body’s function and relieve pain. This may also include “dry needling” another manual technique that I have witnessed and performed that can have a dramatic effect on headache pain. To learn more on what dry needling is, click here.

Other: Additional treatments include postural taping, ultrasound, and/or electrical stimulation. Therapists may also make customized recommendations for helping you improve your overall health including, but not limited to, sleeping habit changes, diet, general conditioning and stress reduction.

A few causes of headaches are not related to muscles, joints, posture, habits or functional changes, and your therapist has the knowledge to determine the proper referral to another qualified health professional. The sooner you seek care, the sooner we can help you discover the cause of your headache and help you relieve your pain and improve the quality of your life!

If you’re in pain, and you’re ready to handle your problem rather than live with it, call a 21st Century Rehab location near you. We’d love to help address the CAUSE of the issue so you can get back to feeling normal again.

"I am thankful for 21st Century Rehab and I want to thank Steve Cassabaum for his expertise in treating my facial, neck, and TMJ pain. Steve is the only person I have EVER known that can treat TMJ and teach techniques in a manner that his patients can continue the exercises at home with confidence. Thank you, Steve; you make a difference!"

-Sheri O.

 

Steve Cassabaum, DPT

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