Headaches

Headaches can disrupt your daily life, making it difficult to focus, work, and enjoy activities. At Pinnacle, we provide a comprehensive physiotherapy assessment and treatment designed to take into account many factors that can contribute to your headache. We also realise that managing headaches can take a team approach and may help you to involve other professional such as a GP, neurologist, ENT, massage therapist, dietician/nutritionist, psychologist, optometrist or other health care professional to manage your specific headache.

Cervicogenic headaches

‘Cervicogenic’ literally means ‘originating in the neck’. Structures such as muscles, joints and discs all have the capacity to cause headaches. A dense nucleus of nerves (the trigeminocervical nucleus) situated high in the neck shares sensory information between the head, face and neck. In this way, structures in the neck can refer into the face, mimicking tooth pain for example.

At Pinnacle we have physios that have trained at the Watson Headache Institute. This internationally recognised approach is focused on very specific assessment and treatment of the neck to desensitise the trigeminocervical nucleus to manage head and facial pain in multiple headache types.

Read about the Watson Headache Institute

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Diagram of a head showing neural pathways converging at the trigeminal cervical nucleus, with arrows indicating nerve directions and labeled areas.

Tension headache

As the name suggests these headaches have a background of tension or stress. It is common for people to ‘hold’ their tension in muscles, most commonly neck muscles such as the upper trapezius. Hands on techniques such as soft tissue massage and dry needling are typically utilised. Just as importantly, the factors that lead to these ‘tensions’ are addressed aiming for a long term resolution to your headaches.

Migraine

Migraines are divided into those with and without aura. An aura is a disturbance that is felt either prior to or at the onset of migraine. Visual disturbance, such as flashes of light and blind spots are the most common type of aura. Less common auras included sensations such as tingling in the face and speech abnormalities. Migraines can be particularly debilitating with many sufferers finding themselves unable to function and often sensitive to sounds/light/motion.

Managing migraines is very complex. Some people respond very well to medications. There are preventative medications as well as those taken once a migraine or its aura comes on.

Unfortunately, these headaches typically have many recurrences and sufferers do well to work out what triggers them. Common triggers include fluctuation in hormones, flashing light, certain foods/drink, over tiredness and stress to name a few. Strategies such as a headache diary or eliminating certain things can help to work out what specifically triggers your migraine. As mentioned above, the Watson Headache approach considers that the neck may be treated to reduce the severity and frequency of migraines. Your physio may help to manage your migraines in conjunction with a GP or neurologist.

TMD / TMJ

For more infomation on Temporomandibular disorders or issues with the temporomandibular joint please see our TMJ Page.

Other Headache Types

These types include exercise induced headache, headaches related to caffeine/sleep, eye strain and sinus related headaches. Suspicion of some of these will obviously lead to referral on for further help, often via your GP. We will also refer on to your GP if there is suspicion of serious pathology such as brain tumour or other neurological condition.

Management of Headaches

Certain headache types are likely to be treated with hands on techniques such as joint mobilization, massage and dry needling. Posture correction is often addressed, especially in those with more sedentary roles such as students or office based workers. Exercise prescription may include those aimed at reversing certain postural abnormalities or very specific self mobilisations (some of which empower you to reduce your headache independently).

Sleep hygiene is often very important in managing chronic conditions (low back pain for example). However, it is particularly relevant with headaches. Please click here for tips to help you improve your sleep.

If you or someone you know is suffering headaches, please come and see one of our physios so that we can help you to make them less of an impact on your life.