Headache Classifications and Treatment Options

By Dr. David Bokermann

One of my goals for starting this blog series is to improve public awareness regarding the many different ailments that physical therapy can help treat. I began with the role PT can play in concussion management. Today, I am here to talk about a very common area of pain known to many that most people may not seek active rehabilitation for and that is HEADACHES. ​

Headaches are experienced by most people but do vary in intensity, severity and frequency. Sometimes they present without pattern, interrupt our daily routines and can wreak havoc on our ability to concentrate, exercise and function at work. I know personally when I don't get a good night's rest, adequately hydrate or get overloaded with the stress and anxiety of life I experience headaches with pain above my eyes. Sometimes I will reach into the medicine cabinet for some pain-relieving medication, or I might try to do some breathing exercises or attempt to shift my focus to stretching or modify my environment. Personally, my headaches may fall into a mild category- quickly resolving with simple fixes, in this blog I want to touch on headaches that are frequent, stop you from doing what you love to do and are moderate to severe that impact quality of life and don’t respond to quick fixes.

When trying to find relief for a headache, knowing what type of headache you are dealing with is crucial to fully alleviating your pain. Our role as a PT in headaches is to identify the exact type of headache you are dealing with to provide the most individualized treatment approach.My personal headaches described above would be considered tension or “stress-related” headaches. There are in fact 10 other common headaches, including: ​

• Sinus.
• Migraine.
• Cluster.
• Rebound.
• Cervicogenic
• Hormone.
• Exertion.
• Caffeine.
• Post-traumatic

PT Evaluation of Headaches
The benefit of seeing a skilled physical therapist for your headaches is to clearly identify your type of headache, to pinpoint the source of pain and provide an individualized treatment plan that targets your deficits. This will create a path for recovery and provide a framework to return you back to a life without pain or difficulty.  At RecoverRx PT our therapists will listen to your headache history looking for patterns, triggers or environmental influences. Following the subjective portion a thorough assessment of the head, neck, thoracic spine, postural system and jaw will help to create a picture of potential contributing factors that influence your headaches. We will also assess the muscle system looking to identify trigger points, areas of tightness or imbalances that have a referral pattern to the area of pain.

PT Treatment for Headaches
I want to provide the highest level of individualized care for our patients utilizing different techniques based upon our findings from assessment. If a patient is dealing with a cervicogenic headache that involves mild feelings of dizziness or feeling off, we will utilize a laser feedback system to improve the connection between our neck and brain which may be impacted by postural deficits. Or we might utilize dry needling into the palpable trigger points we found on assessment that are contributing to your headaches. 
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When seeking care for headaches, please know that physical therapy is an option for all. Physical therapy can be designed and focused on your individual needs. When dealing the headaches, think of getting PT first to pinpoint the problem, identify the headache type and provide comprehensive treatment to improve your symptoms and functioning.

Please don't hesitate to reach out to us your healthcare provider if you have additional questions regarding headaches and/or the types of treatments that you should be receiving. Thanks!