PTs Effective for Treating Headaches

PTs Effective for Treating Headaches

This 2016 systematic review included 10 RCTs and basically concluded that mobilizations or manipulations of the cervical spine may be beneficial for those who suffer from cervical headaches.

However…

“The single most important factor which determines the potential effectiveness of Physical Therapy treatment for headaches, is accurately diagnosing if the patient actually suffers from cervical headaches….because we cannot treat headaches related to MSG, monthly cycle, meningitis, high blood pressure, migraine, tension, etc. ” B. Jam

It has been shown that cervical headaches can be differentiated from migraine or tension headaches with 100% sensitivity, if 7 criteria are present. The top 3 important/sensitive signs for cervical headaches include:

1) Unilateral headache with side consistency

e.g. If a patient reports one day my headache is on the right side and the next day it is on the left, headaches are less likely of cervical origin.

(A patient with a sore right knee due to OA or MCL sprain will not suddenly have their pain switch into the left knee!)

2) Headaches precipitated and aggravated by certain neck postures

e.g. Prolong reading, looking down, keyboarding, turning to look behind, looking up to the top shelf of a cupboard, etc.

3) Restricted range of motion in the neck

e.g. C0-C1 and/or C1-C2 and/or C2-3 are commonly involved with cervical headaches, hence rotation is the most obvious movement that is restricted and may be painful.

References:

Garcia JD et al Mobilization and Manipulation of the Cervical Spine in Patients with Cervicogenic Headache: Any Scientific Evidence? Front Neurol. 2016 Mar 21;7:40.

Vincent MB, Luna RA 1999 cerviogenic headache: a comparison with migraine and tension type headache. Cephalgia 19 (25);11-16