By: Bhavika Shah, BPT, MPT, Physiotherapist
Headaches can be present for days, affect your quality of life and make you irritable. The good news is that many headaches can be managed or even prevented with the right approach—focused on posture, movement, and muscle balance. The key is skilfully diagnosing where the pain originates. Let’s explore three of the most common types of headaches. We’ll go over how physiotherapy can help reduce symptoms, cut down reliance on medication, and improve overall quality of life.
1. Tension-Type Headaches
What it is: The most common type of headache, often described as a tight band or dull ache across the forehead, temples, or back of the head.Physio Insight: Tension headaches are frequently linked to muscle tension in the neck and shoulders, poor posture (slouching - especially with screen use), desk work and stress-related clenching of jaw or neck muscles.
What Helps:
● Manual therapy, dry needling and fascial release as indicated to release tight muscles in the neck and upper back
● Postural re-education to reduce strain (especially for desk workers)
● Stretching and mobility exercises for the neck, shoulders, and upper spine
Few Stretches to ease the pain:
| Levator Scapulae Stretch: | Trapezius Stretch: |
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Prevent It: Ergonomic setup, regular movement breaks, and strengthening postural muscles.
2. Cervicogenic Headaches
What it is: A headache that actually originates from the neck, usually felt on one side of the head and often worsened by certain neck positions.Physio Insight: These headaches are caused by dysfunction in the joints, discs, or muscles of the upper neck. They’re commonly misdiagnosed as migraines or tension headaches.
What Helps:
● Joint mobilisation of the cervical spine
● Targeted neck strengthening (e.g. deep neck flexor training)
● Education on movement and posture to avoid aggravating positions
● Dry needling or soft tissue release to improve flexibility and muscle tension
Prevent It: Ongoing neck and upper back exercises, good desk ergonomics, and early treatment of neck stiffness or injury.
3. Migraine (with muscular/joint issues)
What it is: Migraines are a neurological condition, but they often have physical triggers such as neck tension, poor sleep posture, or jaw clenching.Physio Insight: While migraines are complex, physiotherapy can help reduce the frequency and intensity by addressing physical triggers like muscle imbalances, joint stiffness, and poor postural habits.
What Helps:
● Gentle neck mobilisation
● Postural retraining and ergonomic advice
● Breathing and relaxation techniques to manage stress
● Education on pacing and movement habits to avoid flare-ups
Prevent It: Recognising and avoiding physical triggers, staying active, and maintaining good sleep and movement routines.
General Physio Tips for Headache Prevention:
● Move regularly – avoid holding any position (especially sitting) too long.
● Strengthen postural muscles – especially your deep neck flexors and upper back.
● Stay hydrated and manage stress with movement or mindfulness, provided your schedule allows.
● Use proper ergonomics at work and home.
As a physiotherapist with a background in headache management, my thesis focused on the intricate relationship between musculoskeletal dysfunctions and headache symptoms. I’m passionate about providing effective evidence-based solutions to alleviate headache pain and improve overall well-being.
If you have headaches, let's work together to find a solution and improve your quality of life. You can read more about my training and qualifications here.
-Bhavika Shah, BPT, MPT
Book your appointment now.
www.ottawaosteopath.com
References:
● La Touche, Prescription of therapeutic exercise in migraine, an evidence-based clinical practice guideline. J Headache Pain 24, 68 (2023). https://doi.org/10.1186/s10194-023-01571-8
● Bini, P.,The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis. Chiropr Man Therap 30, 49 (2022). https://doi.org/10.1186/s12998-022-00459-9
● Wang R. Myofascial Release for the Treatment of Tension-Type, Cervicogenic Headache or Migraine: A Systematic Review and Meta-Analysis. Pain Res Manag. 2024 Mar 31;2024:2042069. doi:10.1155/2024/2042069.
