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What the headache!?

If you suffer from headaches, physical therapy can likely help. There are so many different types of headaches that can cause some serious irritations and frustrations in our daily routines.

The first thing physical therapists will do to help you with your headache will be to get a thorough history including, but not limited, to the following questions:

  1. Does it bother you more in the morning or the afternoon or the evening?

  2. Does being on your computer or phone make it worse?

  3. Does reading increase the headache?

  4. Do you feel the headache on top of your head? Behind your eyes? Base of your skull?

  5. Is there anything the helps alleviate the headache? Ice? Heat? Sleep?

  6. Does your headache change with body position? Worse when you lay down? Stand? Look up? Look down?

  7. Are your headaches intense but brief? Are they achy but last a long time?

  8. Have you had any dental work done lately?

  9. Do you have any clicking in your jaw?

  10. Do you grind your teeth at night or wear a night guard?

  11. Does it get worse when you eat or chew foods?

  12. Does sneezing or coughing increase the intensity of your headache?

  13. Do you wear glasses?

  14. Do you have a history of sinus infections?

  15. How would you describe the quality of your sleeping?

When a patient comes to physical therapy with complaints of a headache, I often will ask the above questions and then follow it with a physical exam. The exam will include evaluating your neck range of motion, neck strength, shoulder range of motion, the way you open and close your mouth, and likely your eye tracking skills. Any of these things will help guide my treatment as well as help me give you advice on adjustments to make in your daily routine.

Physical therapy will often perform myofascial release to your neck musculature including upper traps, subocciptals, levator scap and more. We emphasize posture and these days we do a lot of ergonomic assessments. I usually have my patients have someone take a picture of them sitting at their desk so I can see what their workspace setup is like. Small adjustments like screen height or depth can make a huge postural change and thus decrease your headaches.

If your jaw appears to be involved, we can do internal and external work to the TMJ including hands on and dry needling. It's amazing how often we hold tension through the jaw that can be the source of our headaches.

Sometimes we can retrain the stability of our neck muscles by wearing a laser on our head and tracing pictures on a wall! This is a fun training exercise that is surprisingly tiring for a lot of patients considering our neck is responsible for holding our head up all day. When we retrain the smaller stabilizers in our neck, that means we can give whatever muscles have been doing too much work a much-needed break - and this likely can decrease your headaches.

If you're having those nagging and seemingly inexplicable headaches, give physical therapy a try - we are human movement experts and investigators! If we can't help you with the headache ourselves, we will know exactly where to send you!!

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