A Physical Therapist’s Headache Experience

Jul 15, 2020

Are you experiencing regular headaches?

If so, have you ever considered PT for treatment?  

Hear from one of RPT’s physical therapists about her experiences with headaches and how physical therapy has helped her.

By Katherine Partyka, DPT

Growing up my mom struggled with chronic headaches. She would get day-ending migraines with auras and sensitivity to light. So when I started having headaches with pressure behind my eyes and splitting pain above my left eye, I assumed I was starting to get migraines similar to my mom. My headaches would start sometime in the mid to late afternoon progressively getting worse throughout the day to a full-blown sharp pain above my left eye, pressure in my head behind my eyes, and light sensitivity. The headaches would only go away with sleep causing me to barely function once I would get home. If this story sounds familiar, you might find yourself as I did, are these migraines or just really bad headaches? What’s the difference between the two? 

Although the exact etiology of migraines is not known, there are many triggers identified such as hormonal changes, foods, food additives, stress, medications, and weather changes just to name a few. Migraines often occur in four phases which include prodrome, aura, attack, and post-drome; however not everyone experiences all four phases. The prodrome phase may last for 1-2 days with subtle changes in muscle stiffness and fatigue. The aura phase may happen during or before the migraine and last up to an hour with bright lights, vision changes, and extreme sensitivity to light or sound. The attack phase is the phase in which the headache is most severe with throbbing often one-sided pain in the head and sometimes neck. Migraines can last up to 72 hours. The post-drome phase is the phase after the head pain recedes often leaving individuals fatigued for up to a day after the headache ends. Migraines can be diagnosed by a neurologist and many medications for treatment and prevention are now available. If you believe you are having migraines, schedule an appointment with your primary care physician.

Not all headaches are migraines although some of the symptoms of migraines are found in individuals with headaches stemming from other sources. For example, I have light sensitivity, but no aura. Within the last year, I have been able to trace my headaches to neck pain and when I have one of my colleagues work on my neck, my headaches improve. If I feel a headache coming on, I can mitigate it with physical therapy treatment! So, how can physical therapy help determine if you have migraines or if you are actually having really bad headaches called cervicogenic headaches? A licensed physical therapist can assess the motion of your neck and back, the tension through muscles in your spine and neck which might indicate headaches stemming from problems in your neck or spine referring pain and causing headaches. In fact, there are common muscles that refer pain into your neck and head that might be the culprit.

The first, and most recognizable, is the upper trapezius. Tight spots or “knots” in the muscles at the base of the neck/shoulders often cause pain into the back of the neck/head and often in a “ram’s horn” pattern up the back of the neck into the sides of the head. If you are a person that carries their stress in their neck or shoulders, this muscle might be contributing to your headaches. A second muscle, and the trigger for my headaches!, is named sternocleidomastoid or SCM. This muscle attaches from your collar bone to the back of your head just behind your ear. It helps rotate and bend the neck. This muscle commonly refers pain into the top of the head, jaw, and into the forehead just above or around the eye. Lastly, a muscle named levator scapulae connects from the top of the shoulder blade into the back of the neck. It also helps bend and rotate the neck and can often refer pain into the back of the neck and down into the shoulder blade or mid-back. 

If any of these symptoms sound familiar, or you are having headaches and would like a physical therapist to assess your neck and surrounding muscles to see if your chronic headaches might be lessened with physical therapy treatment, please reach out to us at Robinet Physical Therapy to schedule a free consultation.