Headaches
Headaches are a common problem in many developed countries. The National Headache Foundation in the USA has reported in 1999 that over 45 million Americans suffer from chronic (long-standing) recurring headaches severe enough to seek medical intervention. One must realize that there are many sources and causes of headaches. Headaches of musculoskeletal origin, if treated appropriately, can respond well to manipulative physiotherapy intervention. It is the role of a musculoskeletal physiotherapist to treat headaches of mechanical origin and to refer cases of non-mechanical origin back to the doctors. We rely very much on doctors to exclude headaches of non-mechanical origin or of other sinister condition before referring for manipulative physiotherapy. In some cases however, manipulative physiotherapy may be used by doctors as a differential diagnostic test to see if the spine could be the source of the headaches.
Some common names given to headaches of mechanical musculoskeletal origin are tension headaches, stress headaches, tension-migraine, or even just migraine as patients often regard all headaches as migraine headaches. While true migraine is more appropriately treated with medical intervention, the other musculoskeletal headaches often respond well to manipulative physiotherapy. We often regard these headaches as cervical headaches (headaches referred from the neck). Some common sources are C0-1, C1-2 and C2-3 at the upper neck region, occasionally at a lower level or even to the upper thoracic spine (upper back); neural (nerve) "tension" or irritation; muscular as at the trapezius, sternomastoid, occipitalis. Common causes are trauma such as neck strain, whiplash; postural especially poke chin and forward head postures; stress and tension. Manipulative physiotherapy treatment should include full assessment of all possible mechanical dysfunctions including detail palpation of the joints, muscles and other soft tissues. Quick thrust type of joint manipulations may be required in some cases but we fully aware of the risks and contraindications of such technique especially the possible impairment of the vertebral artery. Gentle specific joint mobilizations, soft tissue massage, postural, mobility, stretching and appropriate strengthening exercises are generally very effective in alleviating headaches of mechanical musculoskeletal origin.
As a general rule, the more chronic the headaches are the longer it takes for them to respond to treatment and the more difficult it is to clear all symptoms. In most cases, certain degree of response to treatment should be apparent within a few weeks no matter how chronic the condition is. The smiles on patients' faces make treating headaches very rewarding.
Luck LI
Musculoskeletal Physiotherapist
Some common names given to headaches of mechanical musculoskeletal origin are tension headaches, stress headaches, tension-migraine, or even just migraine as patients often regard all headaches as migraine headaches. While true migraine is more appropriately treated with medical intervention, the other musculoskeletal headaches often respond well to manipulative physiotherapy. We often regard these headaches as cervical headaches (headaches referred from the neck). Some common sources are C0-1, C1-2 and C2-3 at the upper neck region, occasionally at a lower level or even to the upper thoracic spine (upper back); neural (nerve) "tension" or irritation; muscular as at the trapezius, sternomastoid, occipitalis. Common causes are trauma such as neck strain, whiplash; postural especially poke chin and forward head postures; stress and tension. Manipulative physiotherapy treatment should include full assessment of all possible mechanical dysfunctions including detail palpation of the joints, muscles and other soft tissues. Quick thrust type of joint manipulations may be required in some cases but we fully aware of the risks and contraindications of such technique especially the possible impairment of the vertebral artery. Gentle specific joint mobilizations, soft tissue massage, postural, mobility, stretching and appropriate strengthening exercises are generally very effective in alleviating headaches of mechanical musculoskeletal origin.
As a general rule, the more chronic the headaches are the longer it takes for them to respond to treatment and the more difficult it is to clear all symptoms. In most cases, certain degree of response to treatment should be apparent within a few weeks no matter how chronic the condition is. The smiles on patients' faces make treating headaches very rewarding.
Luck LI
Musculoskeletal Physiotherapist