The head, neck, and jaw have many anatomical structures that can contribute to headaches. One particular area is the upper cervical spine, which contains the first three (cervical) vertebrae. Irritation of these structures can lead to various types of headaches.
Physical Therapy is effective in reducing migraine, cluster, and tension-type headaches. Click here at https://saunders-therapy.com/ to talk to an experienced physical therapist who can help with headache symptoms.
X-Rays
A physical therapist will examine your neck and upper back to determine if any joint stiffness or muscle tightness is contributing to your headaches. They will also want to know your general health, the medications you take, your family history of headaches, and your recent activities (like work and hobbies) that may have triggered the headaches.
Once they have a clear understanding of your symptoms, they will use several treatment techniques to help reduce your headaches. These techniques will include hands-on treatment to stretch out contributing neck muscles, mobilize stiff joints in your upper back and cervical spine, and give tension-relieving massages to trigger points that can contribute to headaches. They will also teach you exercises to improve your posture, strength, and neck mobility to avoid the recurrence of your headaches.
While there are many different types of headaches, some of the most common are tension headaches, cluster headaches, and cervicogenic headaches. Tension headaches are the most common and involve a dull, persistent pain that feels like a tight band around your head. They usually affect both sides of your head and can cause throbbing.
Cervicogenic headaches are caused by tight muscles in your neck that can lead to decreased blood flow and irritation of nerves in the area. These headaches can also be accompanied by dizziness or vertigo. To alleviate these headaches, a physical therapist will use massage and neck mobilization techniques as well as balance and vestibular therapy exercises to improve your balance. These exercises will be individualized to your specific needs.
CT Scan
Most headaches are not life-threatening but for some people, they cause enough discomfort that a medical professional will recommend brain imaging to help make a diagnosis. CT scans use X-rays to create images of the skull and brain and are an excellent initial imaging study for detecting bleeding, skull fractures, and space-occupying lesions such as tumors. The downside of a CT scan is that it exposes the patient to radiation and should be used sparingly, especially for patients with preexisting medical conditions like high blood pressure or a history of previous head injuries.
Magnetic resonance imaging (MRI) uses radio waves and magnets to produce images of the head and brain. This test is less invasive than a CT scan but takes longer to complete. The benefit of an MRI is that it provides much more detail than a CT scan, making it a good choice for diagnosing certain types of headaches. MRI scans are more expensive than CT scans, and are only recommended for headache assessment in patients with a specific diagnosis or who have already undergone a CT scan.
The occipital nerve, also known as the 7th cranial nerve, is a major sensory input to the face and head. When this nerve is involved in a headache, it can feel like a tight band around the head and may irritate other structures including the eyes, ears, sinuses, muscles of the jaw, and temporomandibular joint (TMJ). A TMJ dysfunction can result from neck problems such as a stiff or misaligned TMJ or from sedentary lifestyle habits such as “text neck.” Your physical therapist will assess your cervical spine to determine whether any muscular or fascial tension in this area could be contributing to your symptoms.
MRI
A physical therapist who specializes in headaches will assess your neck to see whether tight muscles or abnormal alignment of your head and spine are contributing to your symptoms. Your therapist will look for movement restrictions in the joints of your cervical spine (C1-C3), your thoracic spine (T5-T8), and your temporomandibular joint (TMJ), which is located in the lower part of your jaw.
The physiotherapist will ask you to discuss your pain history with him or her, including how long the symptoms have lasted and when they occur. They will also ask you about the medications you take, including over-the-counter drugs and prescriptions. A complete medical and family history will help identify potential triggers of your symptoms. They will also ask about your work and lifestyle to help pinpoint any stressors that may cause or aggravate your symptoms.
For some patients with IIH, brain MRI can reveal a spinal cerebrospinal fluid leak. This is usually the result of a spontaneous spinal dural tear due to a herniated intervertebral disc or endplate osteophyte. It can be classified as a type 1 ventral dural tear, a lateral dural tear at the proximal nerve root sleeve, or a CSF-venous fistula at the distal nerve root sleeve.
For other headache patients, MRI can detect an intracranial mass or a herniated disc that could be causing the pain. A CT scan can rule out these problems.
Blood Work
Several different factors can cause headaches. Your Physical Therapist will ask you questions about your symptoms and perform tests to help determine the cause of your headaches. If your headaches are caused by a condition that is not amenable to Physical Therapy treatment they will refer you on to your doctor.
The first thing your Physical Therapist will assess is your neck and the associated muscles that may be contributing to your headaches. The trapezius muscle is the large muscle of your neck and extends from both cervical vertebrae down to the thoracic region and attaches to the head, ear, eye, and jaw bones (temporomandibular joints).
These structures have an extensive network of nerves that supply them with blood. Your therapist will check your neck motion and the associated muscles for tightness, stiffness, or joint irritation. Your therapist will also assess your temporomandibular joints to determine if they are the source of your headache pain (these are located in front of your ears).
Your therapist may use a technique called suboccipital release to loosen the muscles at the base of your skull, which can improve your neck mobility and decrease nerve irritation. In addition, your therapist may use heat or cold to decrease pain or swelling, kinesiology tape to increase tactile awareness of your back and neck position, or electrical stimulation (TENS) on the muscles in your neck to improve their flexibility.
In most cases, a Physical Therapist can treat the causes of your headaches and decrease your frequency and severity of them. If your headaches are being exacerbated by your work environment or a medication you are taking, your therapist can teach you strategies to modify these activities so they don’t contribute to your symptoms.
Electromyography
Headaches are a common complaint affecting nearly everyone at one time or another. Some people experience regular, recurring headaches that are not related to any trauma or injury and can be called “primary” headaches. Others have headaches as a result of other conditions, such as a neck injury from whiplash or an underlying chronic illness like high blood pressure or diabetes. The second type of headache is known as a “secondary” headache and this can be caused by a wide variety of reasons, from stress to dehydration. Fortunately, there are many effective treatments for these types of headaches, including physical therapy and medication.
Before starting treatment, your therapist will ask you several questions about when the headaches first started, what triggers them, how intense they are, and where is the pain located. Then your therapist will do a full examination of the head, neck, jaw, and surrounding structures to determine whether there is any dysfunction that can be assisted by Physical Therapy treatment.
Depending on the type of headache you have, your therapist may recommend a combination of passive (massage, heat/cold therapy, steroid cream) and active therapies. Passive therapies help to relax the muscles and reduce tension, while active therapy is used to strengthen weak muscles and improve posture and movement to relieve your pain.
For example, if your headaches originate in the back of your neck, your physical therapist may perform a special technique called cervical manipulation or mobilization to improve the motion of your neck joints. The therapist can also massage the tight muscles in your neck to improve muscle function and decrease irritation of nerves in this area. For cervicogenic headaches, your therapist may perform exercises to improve the function of the deep muscles in your neck that attach to the skull to reduce your symptoms. In some cases, your therapist may also perform vestibular therapy to treat dizziness or vertigo associated with these headaches.
