Can Physical Therapy Help My Headaches and Migraines?

If you suffer from headaches or migraines, you may have tried many methods for relief. Common techniques that can often be successful include medications, caffeine, supplements or rest and sleep.

Some forms of migraines and headaches however can be very chronic in nature and not respond to some of these go to home approaches, or the headache can come back very quickly and repetitively if not addressing other contributing factors. Oftentimes we find ourselves discussing these conditions and symptoms with primary care physicians or neurologists, who can be very helpful in the diagnosis and treatment of headaches and migraines. Often overlooked when it comes to the clinical treatment of headaches is Physical Therapy.

In this post, we will review some of the varying types of headaches and migraines and how Physical Therapy can help resolve or improve these conditions.

Musculoskeletal Headaches

These types of headaches can be either tension or cervicogenic headaches. Tension headaches are caused by muscle spasms or tightness that refer pain to locations of the head and face. Tension headaches feel like a pressing or tightening sensation around the head or face and are usually reported with a mild to moderate intensity on a pain scale and are often reported as being on both sides of the head with one side being more intense.

Cervicogenic headaches are caused by dysfunction or pathology of the upper cervical spine where nerves that refer pain to the head become irritated. Cervicogenic headaches typically are reported as moderate to severe in intensity and usually last greater than 2 hours. These headaches also increase with neck movements or poor posture and will present with a limited range of motion of the neck.

Non-Musculoskeletal Headaches

Non-Musculoskeletal headaches can be classified as migraines, cluster headaches or secondary headaches. Migraines are typically vascular-related headaches and involve symptoms such as nausea, photophobia and sound sensitivity that accompany the pain. Migraines usually present on one side of the head, have a pulsing sensation and are severe in intensity. Migraines often last from 4 to 72 hours and will cause the person to avoid activities of daily living.

Cluster headaches do not have an exact known cause but research shows it is most likely due to abnormalities of the hypothalamus. Cluster headaches present with clock-like regularity throughout a 24-hour day with pain that presents around the eye and radiating to other areas of the face. This pain is described as sharp, penetrating and burning with a common descriptor of a hot poker being stuck in the eye or intense pressure behind the eye. Cluster headache pain can last from 15 minutes to 3 hours followed by completely pain-free periods.

Lastly, secondary headaches include medication-related headaches, caffeine and dehydration. Medication headaches can be triggered by recent changes in blood pressure medications or withdrawals from other medications. Caffeine can also cause withdrawal headaches that can last one or two days. Dehydration headaches can be aggravated by exercise, high altitude exposure or other strenuous activity. Drinking enough water/fluids prior to and during activity can help prevent dehydration headaches.


Medication, rest, hydration and other techniques can be used to alleviate and manage headache symptoms. In addition, Physical therapy can be a great course of treatment of acute and chronic headaches or migraines of any variety.

Tension headaches can often be completely resolved through physical therapy. A trained therapist can identify which muscles are the primary cause of referred headache pain and then provide relief through techniques such as myofascial release, cupping, stretching and trigger point dry needling. Along with alleviating the source of pain that is the cause of these headaches, your therapist can develop a specific program of stretching and strengthening exercises to improve your flexibility along with postural stability to help prevent these headaches from starting in the first place.

With cervicogenic headaches, physical therapy can evaluate the overall mobility of your cervical spine, and through joint mobilization or traction, re-establish full pain free range of motion in the neck that was once restricted and causing headaches. Although non-musculoskeletal headaches may have a primary cause that requires a team approach such as seeing a neurologist or other specialized physician, physical therapy can still help reduce the frequency and intensity of these types of headaches. All migraines and cluster headaches have tension components that can be relieved with hands-on manual techniques, complemented by a regiment of stretching and exercising.

If you or anyone you know are experiencing acute or chronic headaches, reach out to see if physical therapy may be an appropriate treatment approach for you.