A headache can be defined as pain in any region of the head. The cause, duration and intensity of the pain can vary according to the type of headache. Some people suffer from them monthly, weekly and sometimes even daily. Headaches can range from being a nuisance to being completely debilitating, disrupting your ability to drive, work, concentrate, do daily chores or even stand upright. The most frustrating thing about headaches is that there is so much variety between individuals with different headache types, symptoms and triggers. This makes it very hard to diagnose headaches correctly, and therefore treatment them successfully.
Headaches affect around 47% of the global population on a regular basis. The International Headache Society has identified over 130 distinct headache types and over 300 causes of headaches. The pain you feel during a headache comes from a mix of signals between your brain, blood vessels, and nearby nerves. Specific nerves in your blood vessels and head muscles switch on and send pain signals to your brain. But it isn’t clear how these signals get turned on in the first place.
Some of the common causes of headaches include
In a very small percentage of patients there may be a sinister cause of your head pain. This is extremely rare. Read the list below and if you experience any of the following symptoms, please seek the advice of your doctor. Your headache can then be thoroughly investigated to rule out any underlying issues.
Fortunately, the vast majority of headaches do not require urgent medical investigation and should respond positively to treatment, depending upon an accurate diagnosis.
Most headaches can be diagnosed as:
These are the most common headache types and interestingly (or frustratingly), they can also co-exist. You can simultaneously suffer one, two or more types of headache or a migraine at the same time. One may cause another or overlap with each other. These are known as mixed or multi-source headaches. They can take longer to resolve as your physiotherapist works through treating the different causes. For example, a dysfunctional painful neck can cause an increase in surrounding muscle spasm.This in turn increases your blood pressure. In this scenario, you could have a cervicogenic (neck) headache, with a tension headache and a resultant migraine!
The table below will help you to differentiate between common headache types and help you understand which headache you might have. This will better help you understand and manage your headache as well as seek the right treatment. If you don’t feel you fit exactly into any one of these categories, get diagnosed by your GP. They will be able to assess you and your history and symptoms and may identify where you ‘fit’. Remember every person and every headache is individual and may vary or present slightly differently from the norms.
Once you get your headaches diagnosed correctly, you can then start the right treatment plan for your symptoms.
Physiotherapy has been shown over the years, both clinically and through research, to have beneficial effects for headaches. Especially those of cervicogenic origin. Contributing factors to these types of headaches have been shown to include sustained postures and repetitive movements that irritate the neck soft tissues. Think about your desk or computer set up and your studying or working habits. Do you constantly turn to one side, look up for long periods or similarly, constantly look down? It is not necessarily the particular way you are sitting that may be influencing your headaches- but the amount of time you spend in that posture that doesn’t help. Without sufficient breaks, sustained postures can cause muscle spasm, muscle imbalance and weakness as well as strain the joints in your neck. All of which can refer pain to the head and result in headache.
Physiotherapists can use manual, hands-on therapy, manipulating or mobilising your neck. This can be hugely beneficial in eliminating your headache; or at least reducing the intensity and duration of the headache. Soft tissue work including trigger point therapy and massage too can be effective in relieving spasm in the head and neck muscles possibly contributing to your headache. Massage and acupuncture can reduce associated stress and help people cope better with headaches.
Importantly, Physiotherapists can identify muscle weakness and assess your work or home space and daily activities. They can give advice on making changes to your headache causing habits and show you how to perform corrective exercises. Exercises are particularly important to help strengthen weak muscles to manage and prevent future headaches. Recent research has shown that neck exercises are likely to reduce future pain by 60%.
The following exercises may provide some headache relief if it is related to your neck. You could also try simple decompression in supine lying with a pillow beneath your knees and head support on a pillow. Focus on your diaphragmatic breathing so that you can let the head and neck muscles relax.
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Your physiotherapist can assess and prescribe specific strengthening exercises for your neck muscles. The exercises could include isometric neck exercises, bering sorenson neck exercises, bird dog exercises in 4 point kneeling. You need good trunk support to sit your head effectively on your shoulders, so core exercises should also be included. Similarly, improving upper body strength often helps with headaches that are related to neck issues. If the limbs are strong there is less strain on neck muscles and joints.
If you have any questions about the role physio can play in decreasing headaches or need more detailed advice please feel free to contact us.