Headache? Take Two and Call Me in the Morning

Headaches are common in adults of all ages. Most of us recognize the age-old "tension headache." These headaches are caused by face, scalp, and neck muscles contracting for long periods of time. Tension headaches may come and go, but they don't usually last weeks or months at a time. Other headaches are caused by muscle or joint problems in the neck. These are called cervicogenic headaches.

Physical therapists (PTs) often see patients with headaches. There is some question whether physical therapy is helpful for headaches. There is very little research to shed light on the subject. Therapists in Southern Australia offer some new information on the PT treatment of headaches.

Two hundred patients with cervicogenic headaches were divided into four groups. These groups were based on the kind of treatment given. The control group received no PT treatment. A second group was given an exercise program. A third group received manual therapy, a form of joint motion that includes neck manipulation. The fourth group received both manual therapy and exercise in the same treatment session.

The three groups given some form of manual therapy or exercise had better results than the control group. Neck pain and headache were less intense and less frequent with manual therapy, exercise, or both combined. The effects of treatment continued for up to 12 months. There was no change in posture with any of the treatment options. Manual therapy alone didn't change muscle function, but the prescribed exercises did.

A large study of adults from Southern Australia agrees with the use of both manual therapy and exercise for cervicogenic headaches. These treatments are given by a PT for six weeks. Almost three-fourths of the patients in the active treatment groups had fewer, less intense headaches.



References: Gwendolen Jull, PT, PhD, et al. A Randomized Controlled Trial of Exercise and Manipulative Therapy for Cervicogenic Headache. In Spine. September 1, 2002. Vol. 27. No. 17. Pp. 1835-1843.