Physical Treatment of Headaches

Neck pain commonly accompanies migraine and tension-type headache, but the literature is divided on whether this neck pain is a headache symptom or is associated with cervical musculoskeletal dysfunction.  Clarification is essential for hypotheses on the pathogenesis of these headaches and their variants and for decisions on suitability of local neck treatments, both from research and clinical practice perspectives.

Testimonial:

"Very informative and relevant."  Alpheus Mogale, Physiotherapist

BACKGROUND:  Pain-associated psychological distress adversely influences outcomes for patients with musculoskeletal pain. However, assessment of pain-associated psychological distress (ie, yellow flags) is not routinely performed in orthopaedic physical therapy practice. A standardized yellow flag assessment tool will better inform treatment decision making related to psychologically informed practice.

OBJECTIVES:  To describe the development of a concise, multidimensional yellow flag assessment tool for application in orthopaedic physical therapy clinical practice.  J Orthop Sports Phys Ther 2016;46(5):327-345. 

The objective of this online course is to estimate and contrast the occurrence of ictal and interictal cutaneous allodynia (CA) in individuals with migraine with and without temporomandibular disorders (TMD). Both TMD and CA are common in migraine and may be associated with migraine transformation from episodic into a chronic form. 

Testimonial: 

"Better understanding of the different types of headaches and their aetiology."  Alpheus Mogale, Physiotherapist, North West

The results of most recent epidemiological studies are consistent to show an inverse association between physical exercise and migraine, but it is quite challenging to establish whether physical inactivity may be the cause or the consequence of migraine, since migraine is a well-establish disabling condition that may actually limit social and physical capabilities. 

Background:  Current theories associated with the cause of tension type headache are mostly focused on muscle tissues. No study has investigated the presence of role of nerve tissues in this population.  

Objective:  Our aim was to examine the responses to different mechanical provocation tests of the nerve tissues in women with tension type headache when compared to healthy women.

Objectives:  People who suffer from headache frequently present with multiple headache forms and the precise diagnosis of the dominant headache form can be challenging. This case report describes a headache symptom modification approach in the diagnosis and management of a patient presenting with combined features of chronic migraine and cervicogenic headache (CGH).

Discussion:  This case report illustrates the use of a manual therapy symptom modification approach in the management of headache. Improvement in headache symptoms and disability suggests that the musculoskeletal impairments and headache symptoms were more a feature of CGH rather than migraine. The mechanisms underlying these changes in symptoms and impairments are discussed.