How to Treat Chronic Headache Disorder

physical therapy modalities for chronic headache pain

Chronic headaches can be incredibly debilitating. Headache disorders are the most under-recognized and under-treated issue in rehabilitation. However, headache disorders are the most common disorder of the nervous system. From painful to disabling headache disorders are known as: migraine, tension-type headache, and cluster headache. Additionally, headaches can also be a secondary issue to another disorder which can lead to a heavy reliance and overuse of medication.

Migraines are caused when an area deep in the brain is activated which leads to the release of pain-producing inflammatory chemicals effecting the nerves and blood vessels of the head. Chronic headaches can be caused by myriad circumstances including these most common events:

• Eye fatigue from computer overuse
• Poor posture
• Nerve Impingement
• Inadequate sleep
• Overexertion in physical activity

Headache disorders are a public health issue leading to lost working hours and lowered productivity for headache sufferers. Unfortunately, only half of chronic headache sufferers seek treatment from a professional. Oral pain medication is the most common treatment for headache sufferers, however overreliance on medication can create future problems for patients. Therefore, it’s important that chronic headache patients understand that physical therapy and rehabilitation can make a significant impact on the chronic headache pain, lowering their need for oral analgesics.

Treating Chronic Headache Pain with Physical Therapy

1. Cold Compression Therapy: A combination approach is best when treating chronic headaches. The cold compression device with the neck wrap combines the anaesthetizing effects of cold with the inflammatory reducing benefits of compression. Another great way to treat chronic headache pain is with contrast therapy, alternating between hot and cold compression packs. This adds the deep penetrating benefit of heat therapy which helps release tight or tense muscles.
2. Ultrasound Therapy: Ultrasound therapy machines are also great for treating chronic headache pain. The soundwaves of ultrasound therapy are able to help release impinged nerves and tight muscles. With the ability to use different size soundhead applicators, ultrasound therapy can be used to treat the all areas of the neck and shoulders (common problem areas for headache sufferers).
3. Transcutaneous Electrical Nerve Stimulation (TENS): TENS units are FDA approved for treating chronic headaches and migraine pain. Whether used in a clinical setting or as a portable device for patient’s home use, TENS delivers small bursts of electrical impulses which help block the body’s pain signals to the brain.
4. Biofeedback: Since chronic headaches can be triggered by overexertion and stress, biofeedback is a good addition to treating headache disorder symptoms. Biofeedback uses information about the body (feedback): muscle tension, skin temperature, brain waves, and other body signals in order to help patients reduce the stress response.
5. Therapeutic Exercise & Postural Training: When a patient has poor posture it can contribute to the recurrence of headaches. Therapeutic exercise and postural training can help patients gain strength and stamina to holding good posture, while also giving them valuable education as to what posture is healthy for their work environments.

The good news is there are many modalities beyond oral pain medication which can successfully treat the often debilitating pain of chronic headaches. As always, education plays an integral role in informing patients with headache disorders about their treatment options.