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  • Writer's pictureSam Kelokates

Physical Therapy for Tension Headache and Migraine

Tension-type headache and migraine of the most prevalent headache disorders that affect millions of people worldwide. Headaches are characterized by pain and discomfort in the head, scalp, or neck.

Migraine is usually a more severe condition compared to tension-type headache. Both conditions can significantly impact a person's quality of life, causing disruptions in work, social activities, and overall well-being.

While medications are commonly used to manage tension-type headaches and migraine, they often come with many side effects and may not be suitable for everyone.

This is where a physical therapist that specializes in headache disorders, like myself, plays an important role as a non-pharmacological treatment option. Physical therapy treatments can focus on addressing the underlying triggers of headache and migraine attacks through targeted exercises, manual therapy, and lifestyle interventions.

Physical therapy offers a more natural approach to pain management by considering the entire body, including mobility, strength and endurance, lifestyle factors, and activity levels.

As a physical therapist practice that specializes in headache disorders my aim is to provide long-term relief and reduce the frequency and intensity of attacks, without relying solely on medication.

By addressing the musculoskeletal impairments and promoting overall well-being, treatments can have a profound impact on the lives of individuals suffering from these debilitating conditions.

If you are seeking a non-pharmacological approach to manage your headaches or migraine attacks, Kelos Physical Therapy might just be the solution you've been searching for.

Understanding Tension-Type Headache and Migraine

Differentiating between tension-type headache and migraine

Tension-type headache and migraine are two distinct types of primary headaches, each with its own characteristics and symptoms.

Tension-type headache, as the name suggests, is primarily associated with muscle tension and stress. They typically manifest as a dull, aching pain on both sides of the head, often described as a tight band or pressure.

Generally, Tension-type headaches are mild to moderate in intensity and do not worsen with physical activity. Unlike migraine, they are not typically accompanied by nausea, vomiting, or sensitivity to light and sound.

On the other hand, migraine tends to be more intense and cause significant impairment with attacks. Migraine attacks are characterized by severe, throbbing pain, usually on one side of the head, and include neck pain.

Migraine is accompanied by other symptoms such as nausea and/or vomiting, sensitivity to light (photophobia) AND sound (phonophobia). Auras may also occur in some migraine attacks but not all.

Migraine can be disabling, leading to the need for rest and avoidance of bright lights or loud noises.

Causes and triggers of tension-type headache and migraine

The exact causes of tension-type headache and migraine disease are not fully understood. However, several factors can contribute to their development and trigger episodes / attacks.

It’s important not to confuse cause and triggers. Read more about the difference HERE!

Tension-type headaches are commonly associated with muscle tension and stress. Fatigued postural muscles, prolonged sitting or computer use, anxiety, and emotional stress are just some of the known triggers for tension-type headaches.

Other factors such as lack of sleep, jaw clenching, or grinding teeth (bruxism) can also contribute to their occurrence.

Migraine, on the other hand, has a more complex pathophysiology and is believed to involve a combination of genetic, environmental, and neurological factors. Hormonal fluctuations, sensory stimuli (bright lights, strong smells, loud noises), psychological stressors, fasting and dehydration, changes in sleep patterns, and physical exertion are common triggers for migraine.

Weather changes and caffeine consumption have also been thought to contribute migraine attacks in susceptible individuals.

Remember, that these types of triggers are unique to each individual's headache presentation!

Impact of tension-type headache and migraine on daily life

Both tension-type headaches and migraine can have a significant impact on a person's daily life and overall well-being. The pain and discomfort associated with these conditions can hinder concentration, productivity, and engagement in social activities.

Individuals experiencing tension-type headaches may find it challenging to focus on work or perform daily chores, leading to decreased performance and increased stress levels due to difficulty in meeting responsibilities, both professional and personal.

Symptoms of these headache conditions can force individuals to withdraw from their usual activities, cancel social engagements, and even require time off from work or school.

The effects of tension-type headaches and migraine extend beyond the physical pain, impacting emotional well-being and quality of life. The chronic nature of these conditions can lead to depression, anxiety, and a sense of helplessness.

Therefore, it is crucial to explore effective treatment options, such as physical therapy, to manage and minimize the impact of these headaches on daily life.

Role of Physical Therapy in Headache and Migraine Management

Physical therapy is a holistic approach to healthcare that aims to address the triggers of headache and migraine attacks, rather than just treating the symptoms. It focuses on improving mobility, muscular strength & endurance, cardiovascular function, and overall well-being through various therapeutic techniques.

By taking a comprehensive approach to treatment, physical therapy can provide long-lasting benefits by reducing headache frequency, pain intensity, and attack duration.

The overall goal is to improve the quality of life for individuals suffering from headache and migraine disorders.

Goals of physical therapy in treating headaches and migraine

The more specific goals of physical therapy in treating headaches and migraine disorders are acute and longer-term pain management, addressing musculoskeletal dysfunctions of the head, neck, and jaw, providing education on stress management and lifestyle modifications.

As a physical therapist that specializes in headache disorders I employ various techniques to reduce pain and decrease the intensity and frequency of attacks. This can be done by targeting specific areas of tension and promoting relaxation.

In an evaluation we can identify and address common musculoskeletal dysfunction that may contribute to headache and migraine disorders. This includes assessing joint mobility of the neck and jaw, muscular strength and endurance, and trigger points that may be contributing to headache symptoms.

As a specialist, I understand the impact of stress and tension on headache and migraine frequency. I can provide relaxation techniques and breathing exercises to help relax tension muscles. We can employ stress management strategies to help effectively manage stress and reduce its impact on headache.

Physical therapists’ can also provide education and guidance on lifestyle modifications that can help prevent and manage headache and migraine. This may include recommendations for ergonomic set up for work, exercise programming, and strategies for improving sleep hygiene.

Techniques used in physical therapy for headache and migraine management

In physical therapy sessions I use a variety of techniques and strategies to manage headache and migraine disorders effectively. Here are a few techniques that I commonly use.

Manual therapy includes hands-on techniques such as massage, joint mobilization, and soft tissue manipulation to relieve muscle tension, improve mobility, and reduce pain.

Exercise can be prescribed to address musculoskeletal impairments by improving mobility, stability, and muscular strength and endurance. Exercises can be both specific to the headache, face, and neck to directly target headache triggers (example program).

But can also be generalized exercise to reduce pain and improve overall health. Learn how exercise can benefit those with migraine HERE !

I can teach you relaxation techniques such as deep breathing, progressive muscle relaxation, and guided motor imagery to help patients manage stress and promote muscular relaxation resulting in decreases in pain.

There are several modalities that can be used as part of a comprehensive approach to managing headaches and migraine disorders. Modalities are therapeutic tools that can complement manual therapy and exercise interventions.

Three common modalities I use in physical therapy sessions for headache and migraine management are cold therapy (ice packs), heat therapy (hot packs), and electrical stimulation (TENS unit). The last is sometimes referred to as neuromodulation.

I often use a combination of these treatment techniques and strategies to develop a comprehensive and individualized approach to headache and migraine management.

By the end of a course of care, you should feel like you are improving in your headache condition, and that you now have the tools and knowledge on how to manage your condition without frequent treatment sessions.


As a physical therapist that focuses on headache and migraine disorders I offer a comprehensive non-pharmacological treatment option for individuals.

While medications may provide temporary relief, they often come with side effects and may not be suitable for everyone.

Physical therapy, on the other hand, provides a non-pharmacological approach that addresses the underlying triggers of headaches and migraines.

By using a combination of targeted exercise, manual therapy techniques, and lifestyle interventions, as a physical therapist specializing in headache disorders I can help you reduce the frequency and intensity of your headache attacks.

Kelos Physical Therapy, specializing in headache and migraine disorders, can provide the tools, techniques, and knowledge to help you effectively manage your condition, have fewer headache days, and improve your quality of life.

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