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What we treat: Headaches

 In Flex Blog

Headaches are common across all ages of life. They can present in multiple different ways with varying distributions of pain throughout the head. Headaches can be traumatic (after a blow to the head such as a result of a fall or sporting incident) or non-traumatic. The International Headache Society classifies headaches into three broad categories: 

  • Primary (which includes the common tension-type headache, migraines, exertional headaches, medication overuse and chronic daily headaches)
  • Secondary (including cervicogenic and temporomandibular/jaw headaches, infection or drug induced headaches, or headaches caused by trauma/concussion)
  • Cranial neuropathies and other headaches (including occipital and trigeminal neuralgia)

Most headaches don’t require medical assessment and are managed well by physiotherapy or other treatment modalities. However, certain symptoms such as sudden onset of a severe headache, increased frequency or severity of headaches, a new onset of headache with an underlying medical condition or systemic illness, headache associated with head trauma, or headache with neurological or vascular signs (weakness, drowsiness, numbness, dizziness, imbalance) should be checked by a medical professional. 

Common types/presentations of headaches 

The most common types of headaches are tension-type headaches, migraines with or without aura and cervicogenic headaches. Cervicogenic headaches arise from dysfunction in the cervical spine (neck), and therefore are often associated with neck pain. The pain can arise from several structures in the neck including muscles, joints and nerve tissue, with the headache mainly located on one side of the head. Cervicogenic headaches often come on gradually, and neck pain and stiffness are often aggravated by head and neck movements or repetitive postures. Changes in sedentary or dynamic posture can also contribute to the development of cervicogenic headaches, as can trauma such as whiplash, or you may wake one morning with a stiff and sore neck. Neck pain can also be present in other forms of headache including tension type and migraine, however in these types of headaches the pain usually spreads to the neck rather than originating from the neck. Often people can have a mixture of headache types.

How we manage headaches 

Physiotherapy is effective at treating and managing cervicogenic headaches and other forms of headache with associated neck pain. As headaches can present in multiple different ways and have varying underlying causes, it’s important to have a thorough examination to identify the correct management and rule out more serious pathology. When presenting to us with headaches, your practitioner will take a thorough history by asking questions about the onset, nature and location of your pain/headaches. We will then perform a physical examination looking at posture, range of motion, neuromuscular control and palpation, to identify problem areas. 

Treatment may include

  • Soft tissue work/massage
  • Joint mobilisation
  • Postural taping
  • Education around the structure of the neck and posture and how this relates to your pain
  • Motor control exercises of important muscles
  • Postural control and strength/stretching exercises 

If you are suffering from headaches that are having an effect on your life, please get in touch with our friendly team today to see one of our experienced Physiotherapists.

References

Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013;33(9): 629–808.

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