Headaches: What it is, causes, and treatment

What is a headache?

‍

A headache is a common medical condition characterized by pain or discomfort in the head or neck region. It is one of the most prevalent health complaints given by adults and children, and can range from mild to severe, with varying durations and frequency. It may not be the primary reason for seeing a physician or physical therapist but is often mentioned when asked if there are any other symptoms of any kind anywhere else in the body. Headaches can occur as isolated incidents or be chronic, affecting individuals for an extended period.

‍

Headache is related to pressure on other structures such as blood vessels, cranial nerves, sinuses and the membrane surrounding the brain.

‍

There are different types of headaches, and each may have specific causes and symptoms. Some of the most common types of headaches include:

‍

1. Tension headaches: These are the most frequent type and often feel like a constant, dull pressure or tightness around the forehead or the back of the head and neck; sometimes described as a painful, “tight” scalp.
2. Migraine headaches: Migraines are severe, throbbing or pulsating headaches that can last for hours or even days. It is often one-sided, around or behind one eye. They may be accompanied by other symptoms like sensitivity to light and sound, nausea, vomiting and visual disturbances.
3. Cluster headaches: Cluster headaches are intense headaches that occur in clusters or cycles. They cause severe, sharp pain on one side of the head and may be accompanied by red or teary eyes and nasal congestion.
4. Sinus headaches: These headaches are caused by inflammation or congestion in the sinus passages, and the pain is usually felt around the forehead, eyes, and cheeks.
5. Rebound headaches: Also known as medication-overuse headaches, these occur when pain medications are overused or misused, leading to a cycle of recurring headaches.
6. Hormonal headaches: Some individuals experience headaches related to hormonal fluctuations, such as those associated with menstruation or hormonal therapy.
7. Exertional headaches: These headaches are triggered by physical activity or exertion.

‍

For occasional headaches that are not severe and not accompanied by other concerning symptoms, over-the-counter pain relievers, rest, and lifestyle adjustments may help alleviate the pain. However, if headaches are severe, recurrent, or accompanied by other worrisome symptoms, it is advisable to seek medical attention for proper evaluation and management.

‍

What causes a headache?

‍

Headaches can have various causes, and the underlying mechanisms differ depending on the type of headache. Here are some common causes and triggers for different types of headaches:

‍

1. Tension headaches:

   - Stress and anxiety

   - Muscle tension in the head, neck, and shoulder regions

   - Poor posture

   - Eye strain from extended screen time or reading

   - Fatigue

   - Dehydration

‍

2. Migraine headaches:

   - Genetics and family history

   - Hormonal changes in women (e.g., menstruation, pregnancy, menopause)

   - Certain foods and beverages (e.g., aged cheese, alcohol, caffeine, processed meats)

   - Environmental factors (e.g., strong odors, bright lights, loud noises, air pressure changes,  temperature)

   - Changes in sleep patterns

   - Emotional stress

   - Physical exertion

‍

3. Cluster headaches:

   - The exact cause is not fully understood, but they may be related to abnormalities in the hypothalamus (a part of the brain that regulates body rhythms)

   - Alcohol consumption

   - Smoking or exposure to smoke

   - Changes in sleep patterns

‍

4. Sinus headaches:

   - Sinusitis or inflammation of the sinuses due to allergies or infections

   - Pressure changes in the sinuses (e.g., during air travel or diving)

‍

5. Rebound headaches:

   - Overuse or misuse of pain medications (e.g., over-the-counter pain relievers or prescription drugs)

   - Regular use of headache medication for more than a few days per week

‍

6. Hormonal headaches:

   - Fluctuations in hormone levels during the menstrual cycle

   - Hormonal medications or therapies (e.g., birth control pills, hormone replacement therapy)

‍

7. Exertional headaches:

   - Strenuous physical activity or exercise

   - Straining during activities like weightlifting or heavy lifting

‍

It's important to note that some headaches can also be secondary to underlying medical conditions, such as head injuries, infections, high blood pressure, tumors, or vascular disorders. These cases require medical evaluation and treatment to address the root cause.

‍

If you experience frequent or severe headaches or if your headaches are accompanied by other concerning symptoms, it is crucial to consult a healthcare professional for a proper diagnosis and appropriate management plan. Identifying and addressing the underlying cause can lead to more effective headache relief and prevention.

‍

How can physical therapy help?

‍

Physical therapy can be beneficial in managing and reducing headaches, especially those caused by tension, musculoskeletal issues, or poor posture. Physical therapists are trained to assess and address various factors that can contribute to headaches. Here are some ways physical therapy can help with headaches:

‍

1. Muscle tension and trigger point release: Physical therapists can identify areas of muscle tension and tightness, especially in the neck, shoulders, and upper back. Through manual therapy techniques, such as deep tissue massage and trigger point release, they can help relax these muscles, reducing headache-inducing tension.
2. Posture/kinesthetic training: Poor posture, particularly in the neck and upper back, can contribute to tension headaches. This type of training aims to develop patient awareness of safe spinal position and movement as well as the effects of positions (e.g. lying, sitting, standing) have on the spine. Awareness of what posture makes the symptoms better or worse and identifying the neutral spine position are important in helping patients manage their symptoms. Physical therapists can provide exercises and guidance to improve posture. 
3. Mobility and flexibility exercises: Tight muscles can lead to headaches. Physical therapists can prescribe specific manual and safe self-stretching exercises to improve flexibility of the restricting tissues and reduce muscle tension, thereby alleviating headache symptoms.
4. Stabilization and strengthening exercises: Physical therapists will utilize cervical and scapular stabilization exercises to develop control and stability, emphasizing tonic holding of the deep segmental muscles in isolation with global muscles and train the lower trapezius, rhomboids and serratus anterior muscles (scapular muscles) in tonic holding postures. Once the patient learns effective cervical as well as scapular stabilization and management of symptoms, dynamic neck, shoulders and upper back strengthening exercises are initiated to improve strength, endurance and performance of the surrounding muscles on the said areas. 
5. Joint mobilization: Dysfunction in the cervical spine or temporomandibular joint (TMJ) can contribute to headaches. Physical therapists can perform joint mobilization techniques to improve joint function and relieve headaches associated with these issues.
6. Postural stress management and relaxation techniques: Stress and anxiety are common triggers for tension headaches and migraines. It is also common that a patient’s symptoms are exacerbated with sustained postural stresses such as prolonged sitting at a computer, talking on a phone (head tilted), or repetitive forward motions. Physical therapists can teach relaxation techniques, such as deep breathing and how to consciously relax tension in muscles, to help manage stress and reduce the frequency and intensity of headaches.
7. Environmental adaptations: Ergonomic assessment and modification of the home and working environments are necessary to correct stresses as well as prevent future recurrence of symptoms.
8. Education and lifestyle modifications: Physical therapists can educate patients about headache triggers as well as the role and importance of the rehabilitation program in managing the symptoms. They also advise patients on lifestyle modifications to avoid or minimize these triggers. This may include guidance on proper sleep habits, hydration, and diet.
9. Home Exercise Program: Physical therapists provide a specialized home exercise program for each patient and teach how to safely and effectively incorporate it into their daily routine to reinforce the interventions and promote optimal recovery.
10. Biofeedback: Some physical therapists use biofeedback techniques to help patients become more aware of their body's response to stress and tension. By learning to control certain physiological responses, patients may be able to reduce the occurrence and intensity of headaches.

‍

It's essential to note that physical therapy is most effective when tailored to an individual's specific needs and headache triggers. Therefore, a thorough evaluation by a physical therapist is crucial to create a personalized treatment plan. Additionally, for headaches caused by underlying medical conditions, physical therapy may be part of a comprehensive treatment approach, working in collaboration with other healthcare providers to address the root cause of the headaches.

‍

Trust PeteHealth for treating headaches 

Looking for a physical therapist to help you manage and treat headaches? PeteHealth is the trusted physical therapy solution that you can access on your schedule, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

‍

Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth.

‍