Pang Physical Therapy

Migraine & Headaches

Comprehensive care and support for headache disorders 

How does Physical Therapy Help with Migraine & Headaches?

Migraine is the second leading cause of disability in the world after low back pain. More than just a headache, migraine is a neurological disorder with a myriad of symptoms and can have many different clinical presentations. When someone has more than 15 migraine headaches per month, they are said to have chronic migraine. 

It is not uncommon for migraines to be caused or exacerbated by tight muscles around the head and neck. Therefore, people with migraine often also present with symptoms like jaw pain, neck pain, and even dizziness. Physical therapy can be effective at addressing the aforementioned issues to reduce migraine symptoms thereby decreasing disability and improving quality of life. Vestibular rehabilitation has been found to be particularly effective for treating vestibular migraine variants that include symptoms of dizziness, nausea, and motion sensitivity. Click here for more information on how physical therapy can address dizziness for vestibular migraine variants. 

Other headache disorders that can be effectively addressed through physical therapy intervention include concussion, cervicogenic headaches, tension type headaches, and temporomandibular headaches. Chronic pain disorders such as fibromyalgia or chronic fatigue syndrome often also include a secondary headache component.  

Common Symptoms of Migraine

  • Headache
  • Neck pain
  • Jaw pain 
  • Facial pain
  • Dizziness
  • Nausea/vomiting
  • Fatigue
  • Difficulty sleeping
  • Aura
  • Brain Fog 
  • Difficulty Concentrating
  • Irritability 
  • Anxiety/Depression
Neck muscle assessment for headaches

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Graphic showing different headache types

Headache Types

There are many different forms of migraine and headache. It is crucial to determine your headache classification with a thorough physical therapy evaluation to ascertain root cause and direct treatment. 

Migraine headaches can take on many different forms necessitating highly individualized care plans. Besides headache, migraine can also cause dizziness as well as facial pain. 

Treatment techniques can include manual therapy, strengthening, normalizing of neck motion, and vestibular therapy to address dizziness. 

Discussion of lifestyle factors such as general exercise habits, sleep hygiene, relaxation techniques, and diet are also part of a comprehensive treatment plan. 

Cervicogenic means originating from the neck. Many people do not realize that neck dysfunction is one of the leading causes of headache. 

While disabling, there is ample evidence that physical therapy can help resolve cervicogenic headaches. Any dizziness or pain in the face can also often be of neck origin. 

Treatment will include addressing of musculature imbalances, normalizing of neck motion, manual therapy/massage, and other modalities. 

Tension-type headache is a neurological disorder that involves a dull aching pain around the temporal region of the head. People often describe the pain as a tightening band around the forehead, neck, or even shoulders.

Treatment will involve neck exercises, postural restoration, relaxation techniques, joint mobilization, stretching, and massage. 

Concussion is a mild traumatic brain injury that results from an impact injury to the head. The field of concussion rehabilitation is rapidly developing and it is well accepted that physical therapy is the gold standard intervention.

Treatment includes neck exercises, vestibular rehabilitation, and vision therapy. Click here to learn more about how physical therapy can help with concussion.  

The temporomandibular joint (TMJ) refers to your jaw. When someone has jaw pain or issues with their chewing muscles they are said to have a temporomandibular disorder (TMD). 

People with TMD often experience a “clicking” sensation with opening/closing of the mouth. TMD is intricately related with headache as well as migraine. Issues at the jaw can often trigger headaches/migraine as well as vice versa.

Treatment will include normalizing jaw motion, neck motion, manual therapy, stress management, and therapeutic exercise. 

A secondary headache refers to a headache that is due to an underlying medical condition. Chronic pain syndromes such as fibromyalgia, chronic fatigue syndrome, and complex regional pain syndrome (CRPS) are all often accompanied by headaches. 

Physical therapy is an integral part of managing chronic pain disorders. Treatment involves pain desensitization, stress management, stretching, and strengthening to address stiffness and fatigue. 

Reviews

I would highly recommend Jimmy Pang as a physical therapist. His professionalism, knowledge and flexibility made my knee replacement surgery a safe, effective and positive experience. He made the best use of our time together and created an exercise plan that allowed me to recover fully in my home environment, making adjustments as I improved, and successfully helped me regain my flexibility, mobility and strength. Jimmy is also a great listener and just a pleasure to be around! I look forward to seeing him again after my next knee replacement surgery.

I worked with Jimmy over the course of several months. I was lucky enough to find someone knowledgeable in treating sciatic nerve pain. Several months into my pregnancy, I started to experience severe sciatic nerve pain rendering me unable to walk at times, and unable to find relief on my own. When I started working with Jimmy, he took the time to get to know me and my situation. I could tell the care plan was tailored to my needs. During our sessions, he focused on identifying activities that showed the best results. He also took the time to show me exercises to do on my own. As my belly continued to get larger, I expected my back to get worse. However, the table stretches, and exercises Jimmy put together for me improved my back. I was more ambulatory and comfortable further into my pregnancy thanks to his knowledge and personalized care. If I had not received the level of care he provided I would have been unable to continue working. I highly recommend him if you’re looking for a knowledgeable physical therapist who genuinely cares about the outcomes of his patients.

Jimmy took my pain seriously, both physical and emotional, and utilized a variety of strategies to address it. He is a gem when it comes to sharing new resources and has introduced me to so many new treatment approaches, particularly at the forefront of pain management research. From his own experiences with chronic pain, he delivers insightful comments of empathy and support that really stuck with me, validated my experience, and served as a mantra helping make the hard times easier to get through. I've gone to Jimmy with instances of both acute and chronic pain. Jimmy has helped me through the acute instances, and reframed my relationship with lifelong pain as a journey with trial and error, peaks and valleys, mindfulness, and acceptance.

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