Headaches are a common complaint, and there are many different types. One method for treating headaches is physical therapy.
Depending on the type of headache a person experiences, physical therapy may consist of soft tissue mobilization, hot and cold therapy, or exercises to improve muscle strength, flexibility, and posture.
This article describes how physical therapy works for different types of headaches, and discusses the potential benefits of this treatment. We also discuss whether physical therapy is suitable for all types of headaches, and outline some of the other treatments available.
Below are some examples of how physical therapy can help to reduce the frequency and severity of different types of headaches.
Physical therapy for cervicogenic headaches
Cervicogenic headaches are those that originate in the neck area and radiate up to the head. Factors that can contribute to cervicogenic headaches include:
- stiff neck joints
- nerve irritation
- muscle tightness
A physical therapist can work with a person to devise a set of exercises that will help with the following:
- strengthening the muscles of the neck and upper body
- increasing range of movement
- decreasing pain
The ultimate goal of physical therapy for cervicogenic headaches is to reduce the severity and frequency of this type of headache. This is typically done by strengthening the deep muscles of the neck and upper back, as well as stretching the chest and tight muscles.
Physical therapy for migraine
Migraine is a neurological condition characterized by migraine attacks, which typically present as
According to the
The National Headache Institute (NHI) notes that physical therapy is emerging as a promising treatment option for migraine. They add that, unlike certain drug treatments for migraine, physical therapy does not increase the risk of worsening migraine in the long term.
According to the NHI, there are two types of physical therapy for migraine: passive and active.
Passive physical therapies include:
- massage
- application of hot and cold packs
- transcutaneous electrical nerve stimulation (TENS)
Active physical therapies include:
- stretching
- exercises for strengthening muscles, improving range of motion, and alleviating pain
- low impact aerobic conditioning
Tension headaches
A tension-type headache is a type of headache characterized by a sensation of a tight band around the head or a dull ache on both sides of the head. According to the American Migraine Foundation (AMF), it is the most common type of headache, affecting around 2 in 3 adults in the United States.
Although medical professionals do not know the exact cause of tension-type headaches, contributing factors likely include:
The AMF notes that regular exercise and relaxation techniques can reduce the frequency of tension-type headaches.
The NHI also suggests that both passive and active physical therapy approaches may help in the treatment of tension-type headaches.
Physical therapy may help to reduce both the intensity and frequency of certain headaches.
- a reduction in the intensity of cervicogenic headaches
- improved blood flow
- increased oxygen supply to the tissues
- an increase in pain-relieving chemicals called endorphins, which lead to a reduction in pain
While this review found these techniques to be effective, each therapist has their own unique approach.
A 2021 study investigated the effects of yoga and physical therapy in addition to standard pharmacological treatments for migraine. The researchers divided participants into three groups. One group received the standard pharmacological migraine treatment (SPMT) only, while the other groups received SPMT and yoga, or SPMT and physical therapy.
After 3 months, all three groups reported a reduction in headache frequency. However, the groups that practiced yoga or physical therapy in addition to receiving the SPMT reported an overall greater reduction in headache frequency and severity.
According to the NHI, physical therapy is a suitable treatment for many different types of headaches, including:
- cervicogenic headaches
- migraine episodes
- tension-type headaches
An older review from 2016 investigated the effect of physical therapy on cervicogenic, migraine, and tension-type headaches. The review noted that not all types of physical therapy are equally effective for all types of headaches.
According to the 2016 review, physical therapy appears less effective for migraine than for tension-type headaches. This is because the underlying factor of migraine is a neurological disorder whereas tension-type headaches are more related to issues with the musculoskeletal system. As such, the latter appears more responsive to physical therapy.
The review concludes that all three headache types appear to benefit from a treatment approach that combines physical therapy with other types of treatment.
A person who experiences headaches should talk with a doctor or physical therapist about their individual treatment options.
Diagnosing a headache is an important step toward finding an appropriate treatment.
Besides cervicogenic, migraine, and tension-type headaches, some other headache types include:
- temporomandibular joint (TMJ) headache
- cluster headache
- sinus headache
- allergy headache
- caffeine withdrawal headache
- hormonal headache
- thunderclap headache
A person should visit a doctor if they experience a new onset of headaches or an increase in the frequency or severity of headaches. A doctor will work to diagnose the cause of the headaches and recommend an appropriate treatment plan.
Some headaches may respond to lifestyle changes, such as dietary changes, avoiding headache triggers, or practicing physical therapy exercises. Others may require medical treatment, such as over-the-counter (OTC) or prescription pain relievers.
Anyone who experiences a sudden and severe headache known as a “thunderclap headache” should seek immediate medical attention. In some cases, this type of headache can indicate an underlying medical emergency, such as a stroke. Generally, the sooner a person receives treatment for a stroke, the
Besides physical therapy, the following treatments may help to reduce headache frequency and severity:
- taking OTC or prescription pain medications
- avoiding certain medications with side effects that can trigger headaches
- avoiding foods that may trigger migraine or headaches
- avoiding lights and sounds that may trigger or worsen migraine or headaches
- managing stress
- getting enough sleep
- eating a healthy diet
A person will need to have a consultation with a doctor in order to determine the best course of treatment for their particular headache type.
Below are some answers to frequently asked questions about physical therapy for headaches.
What do physical therapists do for headaches?
A physical therapist will make recommendations according to the type of headache a person experiences.
Some possible physical therapy treatment options include:
- muscle stretching and strengthening exercises
- massage
- hot and cold therapy
- postural retraining
What exercises get rid of a headache?
Cervicogenic and tension-type headaches may both respond favorably to muscle stretching and strengthening exercises.
Stretching exercises help reduce muscle tension and stiffness in the neck and upper body while strengthening exercises improve muscle strength and posture. Both may help to reduce the frequency and severity of these types of headaches.
Can physical therapy help with head pressure?
Tension-type headaches, sinus headaches, and certain other types of headaches may cause a sensation of pressure in or around the head. According to the AMF, physical therapy may help to alleviate this sensation.
However, a feeling of pressure in the head can sometimes signal a more serious underlying health condition, such as high blood pressure or an aneurysm. Therefore, anyone who experiences this sensation should see their doctor for a diagnosis, and to rule out other issues.
Can physical therapy help neck pain and headaches?
Neck pain and stiffness can trigger certain types of headaches, such as cervicogenic headaches. Physical therapy can help reduce nerve irritation and tightness in the neck, decreasing the intensity and frequency of these headaches.
Headaches are a common condition and there are many different types. They can range in severity from mild to severe.
Research indicates that physical therapy may be a beneficial add-on or “adjuvant” therapy for certain types of headaches, particularly cervicogenic and tension-type headaches. However, some research suggests that physical therapy may be less effective for migraine.
Physical therapy may consist of various treatments, including massage, hot and cold therapy, and exercises to improve muscle strength and flexibility, and posture.
A person should consult their doctor if they experience new or worsening headaches. The doctor will work to diagnose the cause and recommend an appropriate treatment plan, which may incorporate physical therapy.