Headaches: The Physiotherapist’s Role

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painkillers_may_cause_more_headaches_12The feeling of pain up the back of the head, across the temples and behind the eyes is a common presenting symptom in this clinic. Frequently it occurs in conjunction with neck pain giving the clue that the problem originates in the neck. It is imperative to rule out other causes which would require referral to your GP. Headaches associated with direct injury or illness need to be identified early. These may require further investigation such as a CT Scan or MRI. A neck headache is the domain of the physio and is one of the most common maladies present in modern society. These headaches will usually arise over a period of time, be associated with aggravating postures and be variable in nature. Such a headache may be one sided and be worse at particular times of the day. Frequently, areas of acute tenderness can be palpated at the top of the neck where the top neck vertebrae meet the base of the skull. Nausea and dizziness are also symptoms of the neck headache but the physio will also be aware that other more serious problems can give rise to such symptoms necessitating a careful and cautious approach.

Physiotherapy treatment for neck headaches aims to address the immediate problem and to give advice and self- treatment strategies which will help the person deal with the problem in the future. Manual therapy techniques will ensure the neck joints are moving smoothly. Specific massage techniques will help clear the muscle spasm from around the neck. Exercises to strengthen the muscles at the top of the neck (the ones that hold the chin in close to the neck) and between the shoulder blades will be part of the daily self-management programme. The physio will also inquire into habitual postures which may be perpetuating the problem. Work postures which may need to be addressed would include a right arm being too far forward on the mouse, asymmetrical sitting positions or a computer screen which is positioned off to one side. Even little habits around the house may lead to neck headaches if they are continually repeated over a prolonged period of time. Certainly, a neck headache can be an extremely debilitating problem which may not be effectively helped just with pain killers. When they exist for a prolonged period, the option of taking pain killers is not ideal hence the value of having the problem thoroughly addressed by a physio so that a long term solution is achieved.

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