Tension Headaches: What can Physical Therapists do to relieve them?
The majority of headaches are tension type (up to 90%). Tension type headaches are caused by trigger points in the muscles of the neck and head. Tension type headaches are generally bilateral, of mild to moderate severity and generally described as achy, tight or pressure type pain. Pain can be at the base of the skull, radiate from the neck, back, into the eyes, on top of the head or the face. They are generally not associated with nausea, vomiting or auras; which can be related to cervicogenic or migraine headaches.
General factors that increase symptoms of tension headaches include: stress, sleep deprivation, bad posture, eyestrain, hunger and fatigue. Stress can increase holding patterns and muscle tension leading to increased headaches. Sleep deprivation can cause decreased healing of tissues in the body leading to chronic inflammation. Poor posture is almost always associated with headaches and can lead to increased stress and strain of tissues and joints in the body. Eyestrain can lead to increase of muscle tightness at the base of the skull due to common nerve pathways.
Treatment of headaches:
Physical therapists with training in manual physical therapy can assess and treat dysfunctions of joints, muscles, fascia and nerves of the cervical spine. Improving balance and mobility of the cervical and cranial joints and soft tissues can significantly improve symptoms. Therefore tension type headaches can be treated with soft tissue mobilization of trigger points in the muscles of the head and neck. Joint mobilization can be used to improve alignment of the spine and improved mobility of the cranial sutures. Nerve tension can be treated to improve function of nerves. Relaxation techniques can be taught to patients. Exercise for the cervical spine is used to improve overall strength and stability. Education on proper posture and body mechanics can also be included. These are all important components of treatment of tension headaches.