How to manage your headache without medication

– Adrien Dannhauser (BPhyst, SPT1)

woman with a headache

People that suffer from chronic headaches struggle to concentrate; and this has a negative effect on their work. Many migraines-suffers take a day off from work to recover. One can just imagine the impact on the economy. Most headache patients take medication to manage their headaches. Some require these daily.

Headaches are a common problem that can have a disabling affect on its sufferers and it can also play a big role in socio-economic problems. The world health organisation (WHO) reports that it is one of the 5 most disabling disorders in Women (WHO – Stovner et all 2007). It is a greater functional limitation than chronic diabetes, hypertension, osteoarthritis or lower back pain (Solomon 1997).

There is hope if you struggle with chronic headaches. Follow these 4 steps to treat and manage headaches without medication.

Step 1: Understand how headaches work.

In order to treat headaches effectively, it’s important to understand how headaches work.

Headaches are classified into the Primary/vascular headaches that include migraine, cluster and tension – type headaches. Or the Secondary/ non vascular headaches that include cervicogenic, exercise related headaches and post traumatic headaches (e.g. whiplash injury)

Primary or vascular headaches are influenced by the arteries going to the brain. The main cause is due to biochemical changes and vaso-dilation and constriction of the arteries in the brain. When there is too much vaso- dilation/swelling in the arteries, it can cause a headache. The secondary group of headaches/cervicogenic headaches are caused by a disorder in the neck.

Symptoms of the vascular headaches normally have a very set pattern, whereas the non vascular group’s symptoms are vaguer and patients normally have a history of associated neck pain.

Please see the table below for the specific symptoms of each headache group:

Primary / Vascular HeadachesSecondary / Non-Vascular Headaches
MigraineClusterTension type headacheCervicogenic headache
  • Attacks that last from 4 – 72 hours
  • With or without an aura symptom (sensitivity to light/sound, tingling in fingers)
  • Unilateral pain that may change sides
  • Moderate to severe throbbing pain
  • Nausea with or without vomiting
  • Photo/ Phonophobia (light and sound sensitive)
  • Lasts for only a certain period of time
  • Unilateral pain that may change sides
  • Begins abruptly and builds up quickly
  • Excruciating pain
  • Goosebumps or tearing of the eye.
  • Headaches lasting 30 min to 7 days
  • Pressing, tightening and non-pulsating pain
  • Bilateral, band-like pain
  • Mild to moderate
  • No nausea or vomiting
  • Mild Photo/ Phonophobia (light and sound sensitive)
  • Prevalent in teenagers and adults
  • Bilateral or unilateral dominant headaches – that don’t shift sides
  • Associated with unilateral neck, shoulder or arm pain
  • Headache aggravated by neck muscle tension or bad posture
  • Restricted neck motion or tenderness to the neck muscles
  • A history of a previous whiplash injury

Vascular types of headaches are best treated with medication. However, chronic headaches are mostly a mixed picture between cervicogenic headaches (headaches that originate from the neck) and migraine /tension headaches. So even if you have a migraine, your neck muscles might still play a role in your pain.

Look at the diagram below. In practice it’s rare to see a patient that ONLY gets a migraine. Most patients have symptoms that are a mix picture between a migraine, tension and cervicogenic headaches.

Fig 1: An Illustration where most people’s headaches originates.

diagram that shows different types of headaches

Step 2: Book an appointment at the physio.

Physiotherapy treatment can help immensely for the acute and chronic headache patient. Physiotherapy will focus on sorting out the neck disorder. Research shows, that patients need less medication to manage their headaches if they do regular physiotherapy treatment.

There are certain factors that will eventually trigger a headache. Factors like stress, sitting in front of your computer and driving. Think about a glass of water. Each “factor/trigger” fills your glass bit by bit. Your glass eventually gets full, and then a massive headache/migraine occurs. Physiotherapy helps to empty the glass. If one regularly empties the glass then one will be able to manage your headache without medication.

At Just Physio we do a thorough evaluation of the neck and jaw. The physiotherapist will start by asking about the history and onset of your headaches, previous trauma and factors that might contribute to the headache. After getting the history, the physiotherapist will do certain tests on the neck and jaw to look for any stiffness and dysfunction in the joints, muscles and nerves. Treatment will focus on mobilization of the cervical joints and jaw, myofascial release of the stiff muscles and neural mobilisation of the cervical nerves.

Physiotherapy can and will make a huge difference in the chronic headaches sufferer’s life! It’s important to understand that physiotherapy is not a quick fix. We recommended that one start by attending a few treatment sessions close to each other. This will help to get the pain under control. When the pain is under control the physiotherapist will start to increase the time between sessions. Eventually patients will only need to come once a month or once every two months. Every patient is different, so a unique treatment program will be worked out specific to each patients needs.

Step 3: Change your posture at work

One can just imagine what effect bad posture has when one sits for 8 hours in front of your computer every day. A study done by Falla et all 2007 showed that most people can’t maintain a proper posture when they are working. Bad posture can put a lot of strain on the neck muscles. A stiff neck can trigger a headache. It’s important to get up every two hours to stretch or walk around. Our bodies are made to move.

Please look at the diagram below on how to set up your work station. The physiotherapist will also educate you on your posture and work station setup.

Fig 2: How to set up your work station.

Correct posture at workstation

Step 4: Do regular exercise

Research shows that regular moderate intensity exercise 3 times a weak can help to decrease stress and increase a general well being (Taylor et all 2002-2005, Bronfort et all 2004). The body release endorphins when we exercise. Endorphins are our “happy hormone” and this will help to decrease stress and also help with muscle spasm. Falla et all 2007 also found that an exercise programme have a beneficial effect on our sitting postures.

Every patient is unique and it therefore important to have a proper evaluation done by a physiotherapist. The physiotherapist will give an exercise program that will address the weak and stiff muscles.

What are the benefits of attending physiotherapy at JUST PHYSIO?

  • We do a thorough evaluation of your problem. A headache can only be treated effectively if the cause of the problem is known.
  • Treatment will focus on:
    • decreasing pain
    • increasing range of motion of the neck
    • decreasing muscle spasm
  • An individualised exercise program will be given.
  • Posture evaluation and ‘correct posture’ advice will be given

Last but not least…

By attending physiotherapy and doing your exercise program you will be able to manage your headaches without medication! Book now and take the first step in managing your headache without medication.

For a limited time only Just Physio will give you the first tool to help you manage your headache without medication. Please fill in your details below to receive your free exercise programme.

Download my FREE Headache Exercise Program Part 1. Please provide us with your name and email address and we will mail the program to you for privacy purposes.

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