Headaches

There are multiple causes of headaches and Pure can help diagnose and treat your headaches to help manage and alleviate your symptoms. The first step is identifying which kind of headache you have, this can be done quickly and accurately through a Physiotherapy assessment. Your Physiotherapy session will include specific exercises, education on management and manual therapy.

Common Types of Headache

• Musculoskeletal – accompanied by neck pain, aggravated with prolonged sitting/driving & typically located in the back or side of the head, one-sided usually.

• Tension – pain and pressure at the front of the head which can exacerbate with stress.

• Migraine – can be accompanied with dizziness or nausea and light sensitivity, most severe and may require being in a darkened room.

The spinal muscles either side of the cervical spine (neck) are often causes of pain in the back or the side of the head. These muscles attach to different areas of the head/neck and insert further down the neck/shoulder therefore pain can be ‘referred’. Stiffness or inflammation in the upper vertebrae of the neck and the jaw are other culprits to headaches, but these can all be addressed by a Physiotherapist.

Muscle imbalance or poor posture can often result in weakness in the frontal muscles of the neck and mean the muscles at the back of the neck can be overworked. Tightness is often a result of weakness, so you can’t go wrong with getting strong!

There are other factors that contribute towards more short-lived headaches for example: dehydration, sinusitis, electrolyte imbalance, certain medications, stress, excessive screen time and fatigue.

Your Physiotherapist at Pure will give your the opportunity to explain the history and behaviour of your symptoms. This will help your clinician gain a better understanding of the nature of your condition and will help direct your physical examination so an accurate and rapid diagnosis can be provided. With a precise diagnosis in place, your Physiotherapist will work with you – directed by your goals, to design a personalised self-management and treatment plan.

Most headaches can be treated by a multi-angled approach, but tension and migraine headaches can be more stubborn and take time. A deeper look at triggers for stress or general health i.e. sleep levels or diet may need to be explored. Based on your physical abilities, occupation, daily activities and goals – to name a few factors that are taken in to account, your Physiotherapist will offer personalised strategies to help you manage your symptoms.

For the neck and other musculoskeletal problems, if you are in a sustained position for too long it is likely to result in pain and dysfunction. The body is nourished with nutrients and healthy blood flow through movement and gets less of this when you’re in static positions. Although posture is important, it’s less about the position but more about how long you’re in that position for. It is recommended to take regular breaks from sitting – every 20-30 minutes and to take a small walk or stand up and stretch for postural variation which, at Pure Physiotherapy, our skilled clinicians will help address with you. Desk based exercises can be a great strategy to repeat regularly throughout the day to reduce and prevent neck and head pain.

That said, forward head posture can have some influence on the neck and cause head and neck pain; every inch your chin pokes forward it doubles the weight of the head through the neck and the load it has to support putting a lot of stress through the neck and back. A good desk set up can be helpful and to alternate between sitting working position and standing working position is ideal.

The ideal sleeping position for your spine is lying on your side with good support for your head and neck. This includes your pillow being tucked close into the chin and ensuring your head is neutral i.e. not too much or too little support. An orthopaedic pillow can be helpful for comfort and specific support. Trying not to sleep on your front with your head towards one side can reduce the torsion through your neck and reduce the chance of waking up with headaches or neck stiffness.

Your Physiotherapist can teach you self-massage techniques which can be helpful to relieve pain and muscle tightness. Some good areas to apply pressure is just below the skull and approximately 3 inches in the left or right of the spine. It is also an acupressure point which can help with relaxation among other health benefits.

Exercise prescription forms a key element of Physiotherapy. Through regular re-assessment, we ensure that you are working towards the goals you have set and this also makes certain that your treatment remains optimal. Below are some of the examples of Physiotherapy treatments that Pure specialise in:

• Trigger point therapy

• Joint mobilisations

• Acupuncture

• Soft tissue massage

• Tailored home exercise program to strengthen/lengthen the neck muscles

Please see the patient resources section where we have created a series of recommended exercise programmes to help with headaches. We advise consulting with your Physiotherapist prior to trying any of these exercises.

As you progress through your recovery, we provide progressed exercises and ongoing support to make sure you can effectively manage your condition and prevent re-occurrence.

If you experience any of the following symptoms after neck or head trauma, or if you have neck and head pain:

• Dizziness.

• Double vision.

• Loss of consciousness.

• Speech or swallowing problems.

• Pins and needles or numbness.

National Institute of Health and Care Excellence. (2019). Headache – assessment. Retrieved from https://cks.nice.org.uk/headache-assessment#!scenario. [Accessed 13/7/2020].