Q: My doctor said that there are many types of headaches. What is the difference?

A: Pain of any type that occurs in any part of the head is called a headache. There are many different types of headaches, with just as many causes. The International Headache Society describes several different categories of headache:

Tension-type

Migraine and cluster

Secondary headaches from an underlying condition, such as fever, infectious disease, sinus disorder, or in rare cases, a tumor or more serious illness

Cranial neuralgias, facial pain and other headaches

Most headaches are harmless and resolve on their own, although severe headaches that recur frequently can affect your ability to do your daily activities and can reduce your quality of life.

There is effective treatment for almost every type of headache. The challenge lies in determining the type of headache, its cause, and in developing an appropriate treatment plan that will reduce both its frequency and intensity. Physical therapists can help determine the type of headache you have and are experts in managing pain from tension-type headaches.

Q: What causes a headache?

A: 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.

Q: How does a tension headache feel?

A: 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.

Q: How can a physical therapist help?

A: 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

Ask you the location, nature, and behavior of your pain and other symptoms

Ask you 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 therapists will teach you 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 two 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.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat a variety of conditions or injuries. You may want to consider:

A physical therapist who is experienced in treating people with musculoskeletal problems. Some physical therapists have a practice with a craniofacial focus, meaning that they focus on movement disorders related to the skull and facial structures.

A physical therapist who is a board-certified clinical specialist or who has completed a residency or fellowship in orthopedic physical therapy. This therapist has advanced knowledge, experience and skills that may apply to your condition.

You can find physical therapists who have these and other credentials by using “Find a PT” the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you’re looking for a physical therapist (or any other health care provider):

Get recommendations from family and friends or from other health care providers.

When you contact a physical therapy clinic for an appointment, ask about the physical therapists’ experience in helping people with headaches.

During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.

Source: moveforwardpt.com

Chautauqua Physical & Occupational Therapy is located inside the Riverwalk Center, 15 S. Main St., Jamestown. We are the only outpatient clinic to offer free consultations to our community. Call us at 488-2322 if you are having pain. Celebrating 18 years of serving our community. Check out our new Live Well Center open to the public evidence based wellness programs, individually created to keep you safe as you improve your health. www.chautauquapt.com.