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  • Dr. Ryan Albert

Getting Help with Headaches: First Steps



Let’s start by addressing the obvious: Headaches suck!! If you can relate, you’re in the right place. If you can’t, then consider yourself lucky. 


Headaches are a common experience and can really put a pause on your daily life activities and responsibilities. They are the 3rd most common condition I see in clinic and can respond very well to the right approach. If you're asking yourself, would this be me? Then, the most important first step is categorizing your headache. This will help us figure out what approach is appropriate. Let’s go through some of the usual suspects (Note: There are numerous headache disorders and you may not fit into one of these classifications).


Migraine Headaches: 


Probably the most commonly self-diagnosed classification but true migraines should fulfill these criteria: 


-They are recurrent (have happened at least five times)

-They last 4-72 hours

-They occur on one side of your head (under 18 years, they can sometimes affect both sides)

-They are pulsating

-You experience one of: nausea, vomitting, sensitivity to light/or sound

-They typically interfere with your ability to function normally 


**Migraines can also occur with a phenomenon called aura, which usually consists of (but not limited to) visual disturbances like lights or halos, and can occur before a migraine headache occurs.


If this sounds like your headaches, there is definitely a place for you here. Migraines can be successfully co-managed by physios and chiros alongside your medical professional. Trials of care may result in decreasing frequency and severity of migraine headache attacks. #winning


Tension-type Headaches:


The classic type of headache, sometimes referred to as a stress headache or an ordinary headache. It was past believed to be caused mainly by emotional and mental stressors but we are now uncovering possible neurobiological mechanisms (science stuff…). Here are some of the diagnostic criteria:


- typically bilateral

- last minutes to days

- pressing or tightening (band-like) character

- mild to moderate in intensity

- not aggravated by physical activity

- NO nausea or vomiting 

- may or may not have pericranial (surrounding the skull) tenderness 


Tension-type headaches have been poorly studied by the manual therapy world. When it comes to whether or not chiro/physio can help with these, most guidelines say ‘inconclusive’, meaning they cannot support being for or against.


Like any form of health treatment, I would always urge someone to weigh the benefits and risks. Manual therapy is a very safe, non-invasive form of treatment relative to other forms of therapy prescribed for headaches. ;)



Cervicogenic Headaches:

(Preface: this is my jam) These types of headaches are referred to as secondary headaches, so unlike migraines and tension-type headaches, they are being caused something else. In this case, cervicogenic headaches are caused or referred by structures in and around the neck.


- headaches appear in association to some sort of dysfunction in the neck

- headaches can improve with resolution of issues relating to the neck

- movement of the neck or structures surrounding the neck can aggravate the headaches


Cervicogenic headaches are the MOST responsive of headache types, to chiro management. Treatment may include joint manipulation or mobilization as well as prescribed rehab exercise. I would urge anyone thinking this picture may fit them, to get assessed by a trusted, reputable practitioner. You may be surprised at how much better you could feel.


(Disclaimer: This is not unique medical advice. Always consult with a professional)

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Foundation Physiotherapy & Wellness

123 Edward Street, Suite 100

Toronto, ON

M5G 1E2

p. 416.979.3022

f. 416.979.3023

ryan@foundationphysio.com

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PHOTOGRAPHY: MISHELLE RABKIN      ©2018 BY DR. RYAN ALBERT