Physical Therapy Tips to Ease Headaches

Headaches can bring a busy day to a grinding halt, making even the most simple task feel overwhelming. While there are many types of headaches, tension and neck-related headaches (aka cervicogenic headaches) are especially common — and often linked to muscle tightness, poor posture, or stress. Physical therapy offers a hands-on, drug-free approach to managing these headaches by addressing their root causes.

From targeted exercises to manual therapy and posture correction, physical therapy can help reduce headache frequency and intensity, so you can get back to feeling your best.

The two types of headaches

Headaches can be generally classified into these two main categories:

I. Primary headaches

These are headaches that occur on their own (not because of another illness) and include the following:

• Tension headaches: These are the most common type and feel like a gentle to moderate squeeze around your head. These are the most common type, and are usually characterized by a mild to moderate band-like pressure around your head. They can be triggered by things like stress, poor posture, or muscle tension.
• Migraines: These feel like severe, throbbing pain, often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraines can be debilitating and may include an aura phase before your headache begins.
• Cluster headaches: These are extremely painful headaches that happen in clusters or cycles, often around one eye. They’re less common but can be very severe.
• Trigeminal autonomic cephalalgias (TACs): This group of headaches includes cluster headaches and other conditions like paroxysmal hemicrania and SUNCT (Short-lasting, Unilateral, Neuralgiform headache attacks with Conjunctival injection and Tearing). With TACs you’ll usually have severe pain on one side of your head and autonomic symptoms like nasal congestion and eyelid swelling.

II. Secondary headaches

Secondary headaches are symptoms of another medical condition, such as sinus infections, high blood pressure, or temporomandibular joint dysfunction (TMJ).

The benefits of physical therapy for headaches

Physical therapy focuses on addressing the underlying causes of headaches, such as muscle tension, central nervous system changes, poor posture, and neck pain. 

Physical therapy offers several benefits for headache management — especially for tension and cervicogenic headaches:

• Reduction in intensity and frequency: Studies have shown that physical therapy treatments like manual therapy, exercises, and postural correction can reduce the intensity and frequency of chronic migraines.
• Improved quality of life: By reducing headache severity, physical therapy can enhance overall quality of life. It helps patients manage pain more effectively and resume daily activities without significant discomfort.
• Non-invasive approach: Physical therapy is a non-invasive treatment option, which is a good option if you’re wanting to avoid medications or surgery.

Physical therapy exercises for headache

The following are some common exercises that may be helpful for headache relief. As you do these exercises, focus on slow, deep breaths to reduce stress and tension.

I. Neck stretches

Upper Trap Release with Ball:

• Stand with your back to the wall and place a tennis or lacrosse ball on your upper trapezius.
• Lean into the ball, holding for a few breaths or moving slightly to target tender points.
• Continue for about 90 seconds, then switch sides.

Ear to Shoulder Stretch: 

• Lean your ear towards your shoulder.
• Rotate your chin down to the same shoulder.
• Gently pull your head towards your shoulder for a deeper stretch.
• Holding for 30 seconds. Repeat on both sides.

II. Posture correction exercises

Chin Tucks: 

• Sit tall with your shoulders stacked over your hips and feet flat on the floor. 
• Slowly pull your chin back towards your spine (like you’re making a double chin), keeping your head level. 
• Hold for a few seconds and repeat 10 times.

Bilateral shoulder external rotation with band:

• Stand with your feet hip-width apart, shoulders stacked above hips
• Hold a resistance band with both hands in a "thumbs up" position. 
• Bend your elbows to about a 90-degree angle and keep them close to your sides.
• Rotate both shoulders out by pulling the band apart — pinch your shoulder blades together as you move.
• Slowly return to the starting position, controlling the band's movement to avoid snapping back.
• Repeat 10-15 times.

Physical therapy treatments for headaches

The best physical therapy treatments for headaches can be different from person to person and depend on the underlying cause of your headache.

Treatments for tension headaches

Tension headaches are often related to stress and muscle tension. Physical therapy can help by:

• Recommending certain exercises for your neck and shoulder muscles to reduce tension and improve posture.
• Using techniques like soft tissue mobilization, myofascial release, and dry needling to help relax tight muscles and trigger points, improve blood flow, and encourage healing.
• Providing thorough education on things like pain science, the cause of your symptoms, and stress management (like breathing exercises and mindfulness).

Treatments cervicogenic headache

Cervicogenic headaches originate from the neck. Physical therapy for these headaches may focus on these evidence-based treatments:

• Strength and flexibility exercises
• Dry needling
• Manual therapies including spinal joint mobilizations, soft tissue mobilizations, muscle energy techniques, and Mulligan manual therapy (MMT)
• Postural correction

Treatments for migraine headache

Migraines, especially chronic migraines, can benefit from physical therapy in addition to medicine-based treatment. Research shows that medication alongside the following treatments may be helpful for migraine symptoms:

• Cardio-based exercises
• Manual therapies like instrument-assisted soft tissue mobilization (IASTM), facial proprioceptive neuromuscular facilitation, and connective tissue massage
• Hydrotherapy
• Occipital transcutaneous electrical stimulation (OTES)

Overall, physical therapy offers a range of effective interventions for managing different types of headaches, often focusing on improving musculoskeletal function and reducing stress and tension.

Get headache relief with personalized physical therapy

Headaches from tension and neck pain can be disruptive, but you don’t have to manage them alone. A physical therapist can help address the root causes with targeted exercises, manual therapy, and posture correction—reducing intensity and frequency so you can feel better and live more comfortably. 

Reach out to one of the physical therapists at Origin Physical Therapy. They can evaluate you to better understand your symptoms, and help you to get control of your headache pain.