Physical Therapy for Headaches and Migraines

Headaches are one of the most common medical complaints.  Recent data suggests the prevalence of this condition is rising.  Most people experience headaches at some point in their life regardless of age, race or gender.  

There are a multitude of different types and classifications of headaches. It is important that your type of headache is accurately diagnosed as many people suffer from a combination of different types; this will determine the specific treatment approach.

Headaches can be debilitating; affect your ability to work or study and can have a profound effect on the quality of your life.

Here are examples of more common types of headaches as noted by the International Headache Society:

Tension type headaches: (myofascially driven)

  • Lasts 30 min to 7 days
  • Typically bilateral (both sides)
  • Pressing/tightening quality
  • Mild to moderate intensity
  • Does not worsen with physical activity

Migraine headaches: (Neurovascular disorder)

  • Attacks lasting 4-72 hours
  • Usually unilateral (one sided)
  • Pulsating quality
  • Moderate to severe pain
  • Aggravated with routine physical activity
  • During the headache experiencing at least one of following:
    • Nausea or vomiting
    • Light or sound sensitivity and/or disturbances

Cervicogenic headaches: (neck related)

  • Clinical evidence of a disorder of the cervical spine (neck)
  • Headache has developed in relation to the onset of a cervical issue
  • Headache improves with resolution or improvement of cervical condition
  • Headache triggered by head/neck movements or postures

Physical Therapy for Headaches

Physical Therapists at One on One Physical Therapy specialize in the treatment of headaches and migraines, and when necessary, work closely with your physician to obtain optimal pain relief.  The musculoskeletal factors that contribute to headaches can be treated effectively by physical therapy, along with patient education and behavioral modification. We cannot cure migraine headaches, which typically require medications, but studies show that physical therapy can reduce the intensity and frequency of migraine attacks. Determining and addressing trigger lifestyle factors  such as alcohol, foods, menstruation, poor posture, stress, lack of sleep, can also be helpful in management.

We will evaluate to determine what type(s) of headache you may suffer from. If you have been diagnosed with true migraine headaches we ask that you bring your emergency headache medications with you (one study of migraines showed that 30% of subjects had provocation of their migraine attack during the examination). There are many soft tissues (including trigger points) that refer directly to the head/face as well as nerve and joint issues that also produce headache pain.  These are treatable with specific manual therapy techniques. We examine for specific motion restrictions, tissue tension, tenderness and postural faults while carefully trying to reproduce your symptoms to determine cause. In addition, you will be provided with specific exercises to improve cervical mobility, reduce muscle tissue tension, and improve posture/body mechanics.

With treatment, education and self-awareness…you can learn to control this condition rather than it controlling you!


Savas Koutsantonis PT, DPT, CMTPT, brings over 30 years of physical therapy experience to One on One, and holds a Doctorate of Physical Therapy Degree from A.T. Still University of Health Sciences, Arizona School of Health Sciences. Savas can be reached at