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Can you treat headaches with physiotherapy?

<div class="theconversation-article-body">You might’ve noticed some physiotherapists advertise they offer treatments for headaches and wondered: would that work?</p> <p>In fact, there’s a solid body of research showing that physiotherapy treatments can be really helpful for certain types of headache.</p> <p>Sometimes, however, medical management is also necessary and it’s worth seeing a doctor. Here’s what you need to know.</p> <h2>Cervicogenic headache: when pain travels up your neck</h2> <p>Cervicogenic headache is where pain is referred from the top of the neck (an area known as the upper cervical spine).</p> <p>Pain is usually one-sided. It generally starts just beneath the skull at the top of the neck, spreading into the back of the head and sometimes into the back of the eye.</p> <p>Neck pain and headache are often triggered by activities that put strain on the neck, such as holding one posture or position for a long time, or doing repetitive neck movements (such as looking up and down repeatedly).</p> <p>Unlike in migraine, people experiencing cervicogenic headache don’t usually get nausea or sensitivity to light and sound.</p> <p>Because this is a musculoskeletal condition of the upper neck, physiotherapy treatments that <a href="https://pubmed.ncbi.nlm.nih.gov/12221344/">improve</a> neck function – such as manual therapy, exercise and education – can <a href="https://pubmed.ncbi.nlm.nih.gov/27497890/">provide</a> <a href="https://pubmed.ncbi.nlm.nih.gov/38902195/">short- and long-term benefits</a>.</p> <h2>Can physio help with migraine?</h2> <p>Migraine is a neurological disorder whereby the brain has difficulty processing sensory input.</p> <p>This can cause episodic attacks of moderate to severe headache, as well as:</p> <ul> <li>sensitivity to light and noise</li> <li>nausea and</li> <li>intolerance to physical exertion.</li> </ul> <p>There are many triggers. Everyone’s are different and identifying yours is crucial to self-management of migraine. Medication can also help, so seeing a GP is the first step if you <a href="https://headacheaustralia.org.au/migraine/">suspect you have migraine</a>.</p> <p>About <a href="https://pubmed.ncbi.nlm.nih.gov/35166137/">70-80%</a> of people with migraine also have neck pain, commonly just before or at the onset of a migraine attack. This can make people think their neck pain is triggering the migraine.</p> <p>While this may be true in some people, our <a href="https://pubmed.ncbi.nlm.nih.gov/34214181/">research</a> has shown many people with migraine have nothing wrong with their neck despite having neck pain.</p> <p>In those cases, neck pain is part of migraine and can be a warning (but not a cause or trigger) of an imminent migraine attack. It can signal patients need to take steps to prevent the attack.</p> <p>On the other hand, if the person has musculoskeletal neck disorder, physiotherapy neck treatments may help improve their migraine. Musculoskeletal neck disorder is what physiotherapists call typical neck pain caused by, for instance, a sports injury or sleeping in a weird way.</p> <p>You may have heard of the Watson manual therapy technique being used to treat migraine. It involves applying manual pressure to the upper cervical spine and neck area.</p> <p>There are currently no peer-reviewed studies looking at how effective this technique is for migraine.</p> <p>However, recent studies investigating a combination of manual therapy, neck exercises and education tailored to the individual’s circumstances <a href="https://pubmed.ncbi.nlm.nih.gov/36739510/">show</a> some <a href="https://www.researchgate.net/publication/342117351_Neck_treatment_compared_to_aerobic_exercise_in_migraine_A_preference-based_clinical_trial">small effects</a> in improving the number of migraine attacks and the disabling effects of headache.</p> <p>Manual therapy and neck exercises can also give short-term pain relief.</p> <p>However, in some cases the neck can become very sensitive and easily aggravated in <a href="https://pubmed.ncbi.nlm.nih.gov/15907257/">migraine</a>. That means inappropriate assessment or treatment could end up triggering a migraine.</p> <p>Physiotherapy can help with migraine but you first need a comprehensive and skilled physical assessment of the neck by an experienced physiotherapist. It’s crucial to identify if a musculoskeletal neck disorder is present and, if so, which type of neck treatment is needed.</p> <p>It is also important people with migraine understand how their migraine is triggered, what lifestyle factors contribute to it and when to take the appropriate medications to help manage their migraines.</p> <p>A trained physiotherapist can provide some of this information and help patients make sense of their condition and recommend the patient see their GP for medication, when appropriate.</p> <h2>What about tension headaches?</h2> <p>Tension type headache is the most common type of headache, characterised by a feeling of “tightness” or “band-like” pain around the head.</p> <p>Nausea and sensitivity to light and noise are not usually present with this type of headache.</p> <p>Like migraine, tension type headache is often associated with neck pain and also has different aggravating factors, not all of which are due to the neck.</p> <p>Again, a detailed assessment by a trained physiotherapist is needed to identify if the neck is involved and what type of neck treatment is best.</p> <p>There is some evidence a combination of <a href="https://pubmed.ncbi.nlm.nih.gov/35236143/">manual therapy and exercise</a> can reduce tension type headache.</p> <p>Physiotherapists can also provide education and advice on aggravating factors and self management.</p> <h2>Seeking help</h2> <p>There are many types and causes of headache. If you suffer frequent headaches or have a new or unusual headache, ask a doctor to investigate.</p> <p>There is good evidence physiotherapy treatment will improve cervicogenic headache and emerging evidence it might help migraine and tension type headache (alongside usual medical care).</p> <p>If you are wondering if you have cervicogenic headache or if you have bothersome neck pain associated with headache, ask your doctor to refer you to a skilled physiotherapist trained in headache treatment. A careful assessment can determine if physiotherapy treatment will help.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/256581/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By </em><a href="https://theconversation.com/profiles/zhiqi-liang-2392952"><em>Zhiqi Liang</em></a><em>, Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/julia-treleaven-2393094">Julia Treleaven</a>, Associate Professor in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/lucy-thomas-2392963">Lucy Thomas</a>, Teaching and research academic in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-you-treat-headaches-with-physiotherapy-heres-what-the-research-says-256581">original article</a>.</em></p> <p><em>Image: Marcus Aurelius / Pexels</em></p> </div>

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5 signs you should see a physiotherapist

<p><em><strong>James Norwick is a sports enthusiast, fitness lover and a healthy lifestyle promoter. He is also a blogger and a part of the team behind <a href="http://www.bendandmend.com.au/" target="_blank"><span style="text-decoration: underline;">Bend + Mend</span></a> – Physiotherapy and Pilates Studio.</strong></em></p> <p>Many people who need a physiotherapist often don’t know it. Physiotherapy can help many people, but unfortunately, a significant percentage of individuals don’t seek that help until it’s too late. It’s best to see a physiotherapist before a problem gets worse. Learning to recognise the signs will allow you to intervene early, putting you on the fastest possible track to recovery.</p> <p><strong>1. Pain that’s lasted a long time</strong></p> <p>It’s normal to feel sore for a few days after a minor injury or some overexertion. It’s when that soreness or swelling persists for an unusually long time that signifies something is seriously wrong. If you got hurt a week ago and the area is still tender, a physiotherapist will be able to help you. This also applies to old injuries that “flare up” every once in a while. If you hurt your back last year, but it still gives you trouble once in a while, you need to have it checked out as soon as possible.</p> <p><strong>2. Issues with mobility are beginning to develop</strong></p> <p>We all lose a little flexibility or mobility as we age, but it isn’t normal for that loss of motion to affect our everyday lives. If you have trouble bending over or walking upstairs, this is a problem. You may have weak tissue or tense muscles that are preventing you from being as mobile and flexible as you need to be. A physiotherapist will identify the source of the problem, and help you strengthen the affected muscles until they’re working the way they should be.</p> <p><strong>3. Your medicine doesn’t seem to be working</strong></p> <p>If you’ve been prescribed anti-inflammatory drugs or pain medication to treat lingering symptoms after an injury and they don’t seem to be doing their job, you probably need to explore recovery from a different angle. In most cases, these medications are only masking underlying symptoms. They don’t stop the source of the pain or inflammation – they only prevent you from feeling it. Physiotherapists target the actual issue, rather than the symptoms. You may need a combination of both physiotherapy and medication.</p> <p><strong>4. It hurts to sit for a long time</strong></p> <p>Plenty of people need to sit for long periods of times, especially if its required by their jobs. Office workers and Uber drivers, for example, spend most of their days sitting. This is also common among people over the age of 60, as retirement tends to encourage sedentary behaviour. The human body is built to move, and it won’t work correctly unless it’s getting enough movement. A physiotherapist can help you design a plan to incorporate move movement into your life, as well as help you adopt better posture that will reduce pain from slouching.</p> <p><strong>5. You’ve been told you may need surgery</strong></p> <p>In rare cases, physiotherapy can prevent the need for surgical intervention. Even if it can’t, there’s never a bad time to start physiotherapy. Your physiotherapist can help you prepare your body for surgery, which will make it easier for you to recover later on down the road. After you’ve healed from your surgery and are approved to return to your physiotherapy regimen, the therapist can help you build back stronger muscles, reducing the potential for a recurring injury and helping you return to full operating capacity much faster than you would have without intervention.</p> <p>If you think you may benefit from physiotherapy, talk to your doctor about what’s right for you. Many doctors support the use of physiotherapy to treat a wide variety of conditions. Even when used as a supplement to a more complicated healthcare plan, physiotherapy has the potential to be one of the most beneficial things you can do for your health.</p>

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