Headache Treatment & Migraine Relief Therapy

What are Headaches?

A headache is characterized as any pain that occurs on the head. There are several types of headaches, each with its own cause.

Following are the main categories of common headaches and their separate causes:Headache Pain Therapy

  • Tension and cervicogenic headaches
  • Migraine and cluster headaches
  • Secondary headaches resulting from another underlying illness, such as sinus infection,  infectious disease, tumor or other serious illnesses.

Most headaches are acute and temporary, though if symptoms last for longer than a day, can disrupt a patient’s ability to function in daily life due to its proximal nature on the body.

There are effective treatments for most headaches, but the key to finding the appropriate intervention lies in the evaluation and classification of type of headache that the patient is experiencing. Headache treatments are different for the different types of headaches and a physical therapist can help distinguish them and create effective headache relief plans both in the clinic and at home that would help reduce the frequency and intensity of headache pain.

What are Tension Headaches?

Tension headaches have a muscle spasm origination and are the most common types of headaches seen in adults. These muscle spasms may result from neck injuries or jaw issues, stress and fatigue, or from poor posture. Physical therapy is the most effective in treating tension headaches by way of correcting poor postural habits, improving strength and range of motion of joints of the jaw, neck and shoulders.

Oftentimes, an inherent neck or jaw issue such as from injury or degenerative causes can lead to tension in the muscles in the back of the neck that extend to the base of the skull. This increased tension propagates a feeling of compression and tightness on the facial nerves and muscles of the cranium. Poor posture can be a leading cause to this increased tension as well because posterior neck muscles become overworked and strained, later triggering a headache.

A tension headache generally starts as a muscle spasm that starts either at the back of the neck or at the base of the skull. The pain may radiate to the sides of the head and up to the top of the eyes. The patient may even feel increased tension by the jaw bone that radiates to the sides of the neck and behind the ears. Patients oftentimes feel tightness, ache, and sometimes burning from stretching or moving a tight muscle. Tension headaches may worsen with poor computer desk posture and may ease with rest and sleep. Tension headache relief can be achieved with property physical therapy techniques.

How a Physical Therapist Can Help with Tension Headaches

A physical therapist conducts a thorough evaluation to determine the cause of the headache. If a tension headache is suspected, their goal is then to hone in on the anatomical and biomechanical causes of the tension headache. The physical therapist would ask about daily habits and activities, and perform tests to analyze the likely culprits that are the cause of the headache.  

Following are subjective and objective data that would help a physical therapist hone in on the causes and remedies to acheived headache relief:

    • History of previous injuries to the neck, head, or jaw – such as from sports, trauma or a car accident.
    • The locations, intensity, frequency and nature of the pain experienced.
    • Muscle strength tests of the neck, shoulder, and arm.
    • Sensation tests of the neck, shoulder and arm.
    • Postural examination during sitting, standing and while performing daily activities required for sports, work and/or living.
    • Range of motion measurements of the the neck, shoulder, arm, thoracic spine.
    • Palpation and assessment of joint mobility and muscle soft tissue flexibility in the muscles around the head and neck.

If the origination of headache pain is truly stemming from the jaw or cervical spine, a physical therapist can then form a plan of care that would encompass improving strength , mobility and posture. If the physical therapist’s’ evaluation determines another causative factor, such as migraine or a secondary headache from a systemic illness, he/she will refer the patient out to another healthcare professional for more diagnostic tests and treatment.

Following is an example of a physical therapist’s treatment plan for solving tension headaches:

  • Manual mobilization of muscles and joints to improve segmental mobility in the cervical and thoracic spine. Stretching tight muscles in the back of the skull and neck. Manually treating trigger points, or “hot” areas of pain and tension.
  • Improve strength and endurance of anterior stability muscles of the neck and upper back muscles that would in turn improve posture, allowing the patient to hold a healthier posture for longer periods of time while they perform daily activities.
  • Posture re-education by verbal instructions, and self-correction tools like using mirrors. Guided modification of computer workdesk parameters to ensure a comfortable and healthy sitting environment for work.  This may involve use of a headset instead of a handheld phone; adjusting the tilt angle of the computer screen; changing the desk chair’s parameters so the arms are resting in a comfortable and appropriate position; adjusting the location and position of the computer mouse and keyboard.

Physical Therapy and Migraine Headaches

Migraine headaches are a more complicated condition that can be a severe, and disabling. Patients generally experience an intense period of pain whereby they are unable to function or do anything in the presence of light or sound. Migraine headaches typically begin with the presence of an ‘aura’ – a visual disturbance or an usual olfactory experience that is unrelated to the external environment. The patient may also feel nauseous before the migraine occurs. Cures for migraines are elusive and typically remedies other than medication usually involves the patient shutting himself into a quiet and dark room for a long period of time to wait it out.

Migraines are a disorder of the central nervous system, the brain and the spinal cord. It involves the nerves and blood vessels and may be linked to epilepsy. Migraines can be triggered by stress, at random, or by mechanical injury/strain to the neck muscles and joints. When the trigger is more centralized, medications are useful in abating the symptoms; and when the trigger is more peripheral and mechanical in nature a physical therapist may be helpful in reducing the noxious stimuli. A physical therapist is able to educate the patient on relaxation techniques and on modalities to help reduce the intensity of the headaches, but most sufferers of classic cases of migraine headaches would find physical therapy benefits limited and would need more extensive healthcare intervention.

If you suffer from headaches, contact one of our Clinics in Portland for headache relief today!

Follow Me @

Alice Holland, DPT

Doctor of Physical Therapy, Director at Stride Strong Physical Therapy
Alice earned her Doctorate of Physical Therapy from USC in 2007, and have practiced Physical Therapy for 12+ years in the Outpatient Orthopedic Setting. Certified in ASTYM, she also has been a featured expert on Physical Therapy on numerous publications including health.com, healthline.com and yahoo.com.
Follow Me @

Latest posts by Alice Holland, DPT

Ana Lucia Pinheiro
Ana Lucia Pinheiro
02:18 20 Oct 17
This place is amazing. I am so happy I found Stride Strong PT. Alice pays attention to all of the details, she watches every single move I make, my posture, and the way I move through every exercise. She is very knowledgeable, she was able to pin-point the problems in my back and she has a plan to help me become stronger where I need. The place is brand new, huge, and has nice exercise machines. I tried a few physical therapists in the area, and Alice is TOP, second to none, and I feel super lucky to have found her. Highly recommended!!
Prashant Gupta
Prashant Gupta
01:00 02 Oct 17
Dr. Alice at Stride Strong is one of the best PTs I have come across. Her attention to detail and assessment of the root cause of injury is very good. She is excellent in evaluating pain patterns and giving a training schedule for a rehab & injury prevention, she is extremely knowledgeable. I would strongly recommend Stride Strong to anyone looking for PT. It is easily the best PT clinics in Hillsboro area.
steven zollin
steven zollin
20:57 14 Sep 17
Highly recommend Stride Strong Physical Therapy , Alice showed me proper form to assist in recovery with my shoulder and is very knowledgeable.
Lindsay Nied
Lindsay Nied
23:33 18 Dec 17
I recently had a massage from Joel at the Hillsboro location. He was able to work on an ongoing issue I have been experiencing with my back after a sports injury, and I left feeling so much better. The whole facility looked incredible, and everyone I met was friendly and welcoming. I would highly recommend Stride Strong for massage and physical therapy.
JoAnn Hatch
JoAnn Hatch
08:20 08 Nov 17
Dr. Sydney is by far the absolute best physical therapist I've worked with ever! Her expertise in designing highly effective and efficient exercise plans is beyond compare. I feel so much better as my strength and function increases. She comes up with the most brilliant and fun ideas to motivate. To my delight she even offered to come to my home in Vancouver and work with me on my own equipment including a Stott Pilates Reformer. Talk about going above and beyond! Couldn't be more grateful I found her!!!
Clare Perry
Clare Perry
21:58 23 Oct 17
A full hour of a dedicated PT professional's time without aides or techs? That's just one of the things that sets this clinic apart from others. Competent, professional, and amiable, Dr. Alice Holland and her team are the best in the area. While I generally see them at the Cedar Mill Clinic on Cornell, situational constraints took me to their new Hillsboro clinic today near Intel Jones Farm. Beautifully furnished, spacious with easy parking and access. May you continue to grow and thrive, Stride Strong!
Joyce Heideman
Joyce Heideman
08:28 11 May 18
After foot surgery I went to Stride Strong for therapy with Alice Holland. She helped me reach my full mobility again by continuously introducing new and challenging exercises. The entire staff is friendly and professional. They are always on time and do not rush. I look forward to doing 1/2 marathons again and riding my recumbent trike. Thank you Stride Strong for your care and high level of expertise.
Suad Daher
Suad Daher
20:48 28 Feb 18
The best physical therapy ever. Both JP and Sydney were a great PT, they helped me understand how I can help treat my injury and how it may have caused. And also they informed about so many techniques that I can use to help my injuries or any other injuries I get in the near future. They are both friendly and nice to talk too, and verbunformative. And there is also Krystal, she is the best front desk receptionist ever, she is nice and friendly and can easily manage your schedule based on the patients comfort if they want to schedule or not. She can help and she replies fast to any patients email. And she is easy to talk to. Thank you Stride Strong Physical Therapy.
Amanda O'Rourke
Amanda O'Rourke
21:38 15 Jun 18
In just a month I've seen great progress! I've been incorporating the exercises taught to me into my daily workout routine. Im very happy with my continued results.
Albert Szal
Albert Szal
23:43 10 Jun 18
Mary Szal here: I've had three sessions with Brittany at the Hillsboro location. I can say that she has been the most effective and instructive physical therapist I've ever experienced. Her personality, energy, knowledge and results are top notch.
Osa Phiangdae
Osa Phiangdae
00:05 22 Mar 18
Awesome place for PT. Hillsboro location has plenty of parking and very spacious. I had the pleasure to work mostly with Dr. Alice Holland and JP. I came in with a shoulder injury and thank goodness they understood what I was going through. They are the best of what they do, I would recommend Stride Strong to anyone who needs PT.
See All Reviews

© Copyright 2019 STRIDE STRONG