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What are Headaches?

Headaches, like back pain, are one of the most common of all physical complaints and can be one of the most frustrating to manage. Pain of any type that occurs in any part of the head is called a headache.

Tension-type headaches (also called muscle-spasm headaches) are the most common types of headaches in adults. They may be the result of a neck or jaw problem, poor posture, fatigue, or stress.

A problem in the neck, head, or jaw–such as an injury or arthritis–can lead to tension in the muscles at the back of the head and to increased pressure on the nerves to the face and head. Poor posture can cause these muscles to become overworked, which can trigger a headache.

How Does it Feel?

A tension-type headache typically begins at the back of the head and spreads to the top of the head and the eyes. You might feel an increase in facial pain along the cheeks near the jaw bone (temporomandibular joint dysfunction). People often describe a tightness, a sensation of someone tugging on their hair, or a feeling of wearing a tight cap. These headaches can worsen with specific positions–such as sitting at a desk–and may ease with rest.

How Can a Physical Therapist Help?

Your physical therapist will conduct a thorough examination that includes a review of your health history. Your therapist will ask you questions and will perform tests to determine the most likely cause of your headaches. For example, your therapist might:

Ask you:
to recall any previous injuries to your neck, head, or jaw
the location, nature, and behavior of your pain and other symptoms
to draw your areas of pain on a body diagram
Perform tests of muscle strength and sensation
Examine your posture when sitting, standing, and performing various activities
Measure the range of motion of your neck, shoulders, and other relevant parts of your body
Use manual therapy to evaluate the mobility of the joints and muscles in your neck
If it appears that you do have tension-type headaches, your physical therapist will work with you to design a plan of care to meet your goals. If the evaluation indicates that you may have a different type of headache–such as sinus, migraine, or cluster headache–your physical therapist likely will refer you to another health care professional for additional diagnostic tests and treatment.

Your physical therapist will work with you to correct the problems that are causing your pain and will help you learn to prevent headaches through simple changes in your posture and lifestyle:

Improve neck mobility. Physical therapists use a specialized technique called manual therapy to increase movement and relieve pain and to stretch the muscles of the back of the neck.

Improve your strength
. Your physical therapist will teach you exercises to increase the strength of the muscles that help stabilize your upper back and neck to improve your posture and endurance and make it easier for you to sit or stand for longer periods of time without discomfort.

Improve your posture. Physical therapistswill teach you to ways to improve your posture. Whether it is simply pushing your chest out or pulling your shoulder blades backward and together, slight modifications to everyday living can make a vast improvement in posture.

Modify your workstation or home office. Tips may include:

using a headset instead of a regular phone
adjusting your computer screen so that it is no lower than the level of your eyes
finding an appropriate desk chair
adjusting the position of your computer mouse

Real Life Experiences

Sarah has noticed over the past 2 weeks that she has experienced a “pressure sensation” starting at the base of her head that travels to the front of her forehead when she is sitting at her computer for more than an hour. Her discomfort increases as the day goes on, but is less on weekends.

She decides to consult her physical therapist to see if physical therapy can help. Her therapist discusses her symptoms with her, examines her, and determines that her headache is a tension-type headache resulting from tightness in the muscles of the neck. The therapist works with Sarah to treat her pain, increase her flexibility and strength, and improve her posture.

The physical therapist also offers suggestions for making changes to her workspace. For instance, Sarah makes sure that her computer monitor is directly in front of her and at eye level; she buys a new desk chair; and she now uses a headset for her phone. She quickly notices that her headaches are much less severe and that she can work at the computer for longer periods of time. Soon, Sarah is headache-free.

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