Physical Therapy and its Value for Headache Management

by: Brice Bhalla, PT, DPT

Headaches, a common occurrence for most people, can vary greatly in terms of pain type, severity, location, and frequency. While most headaches aren’t dangerous, they often cause missed days from work or school and also cause visits to healthcare providers. Over-the-counter as well as prescriptions drugs are used to resolve headache pain, but physical therapy can often be very beneficial for recurrent headache management.

Before we get into the important work that physical therapy accomplishes, here are some suggestions to resolve headaches on your own:

  1. Apply a cold pack to your forehead.
  2. Try using a heating pad if the cold pack doesn’t work.
  3. Drink a lot of water.
  4. Get some caffeine.
  5. Dim the lights and reduce noise.
  6. Close your eyes and lie down.

If none of this works, think about what type of headache you may be experiencing. A physical therapist can help with this. The following headaches are common:


The most common type of headache is a tension headache which is often described as a band of pressure around the head. They can be triggered by poor posture, muscle tension, and stress.


Migraines can last from a few days to several hours and can be debilitating. Intense throbbing pain, often accompanied by nausea, vomiting, sensitivity to light and sound, and visual disturbances, point to a migraine.

Dr. Bhalla is attending a cervical course with Dr. Joe Spagnolo from the Rehab Associates Timberlake clinic.


Cluster headaches are marked by a cyclical pattern with intense pain and sometimes with nasal congestion. The headaches go away and then return a short time later.


Originating from problems in the neck, these headaches can be felt on one side and can be exacerbated or relieved by moving the neck into different positions.


Headaches are a common symptom of temporomandibular joint (TMJ) disorders. Headaches as a result of TMJ are often similar to tension headaches and also include symptoms such as jaw pain, clicking or locking in the jaw, neck pain, facial tightness or pain, jaw tightness or pain, bite changes, and ringing in the ears.


Other types of headaches can be symptomatic of conditions such as sinus infections, high blood pressure, neck injuries, or tumors. So, it’s important to take headaches seriously and to do all you can to alleviate or successfully manage them.

At Rehab Associates, we conduct a comprehensive evaluation to identify specific factors contributing to your headaches. The evaluation includes posture analysis, range of motion tests, and manual assessment of joint mobility and soft-tissue flexibility of the cervical spine and surrounding muscles.

Once the physical therapist identifies the source of the pain and understands the type of headache, he or she develops a treatment plan that varies depending on the source of the pain. Physical therapy is very beneficial for headaches from tension and musculoskeletal issues. Some common treatment plans:

Physical therapy is an important part of headache management.

Manual Therapy

Manual therapy on the neck alleviates issues like stiffness and muscle tightness which reduces headache pain, particularly cervical headaches.


Weakness in the neck and the upper back contributes to headaches. Physical therapists can recommend targeted strengthening and stretching exercises to reduce the strain on the head and neck.

Postural Training

Our posture has significant impact on pain in our neck, back, hips, and other body parts and, yes, plays a large part in contributing to headaches. Physical therapists help patients understand what constitutes good posture and help them achieve alignment of the neck and spine. Correct posture is taught for walking, standing, sitting, and driving.

Dry needling is a tool that can be beneficial for certain headache types.

Dry Needling

Trigger point dry needling can also be beneficial to relieve headache pain. Dry needling causes the muscle to contract, then relax, to release the trigger point. The result is improved muscle flexibility and performance and decreased pain and symptoms.


Although headaches can significantly affect quality of life, physical therapy is great way to help manage and minimize the impact of headaches. By addressing the issues through manual therapy, exercise, postural training, and dry needling, physical therapists can help patients achieve long-term relief.

If you are experiencing headaches and would like relief, please give Rehab Associates a call today at 855-722-8478. With 16 locations throughout Central Virginia, Rehab Associates is a convenient choice for quality physical therapy.

For more information about dry needling and headaches, please follow this link

Dr. Brice Bhalla treats patients at our Rustburg clinic where he is site director. He enjoys general orthopedics, manual therapy, and sports rehabilitation. He is also skilled at treating TMJ. Dr. Bhalla received a bachelor’s degree and doctorate of physical therapy from the University of Lynchburg.



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