Episode Summary
Discover when headaches may respond to manual therapy and exercise, and how to distinguish migraine, tension-type, and cervicogenic patterns with greater confidence. You’ll also learn why neck pain, medication overuse, and careful assessment can shape safer, more effective treatment decisions.
Physical treatment of headache is presented through a clinical reasoning approach that helps distinguish when manual therapy and exercise are likely to help. The explanation begins with how common and disabling headaches are, then outlines major headache categories: primary headaches such as migraine and tension-type headache, secondary headaches such as cervicogenic and temporomandibular-related headache, and cranial neuropathies. Strong emphasis is placed on identifying red flags, medication overuse, psychological factors, and comorbidities before considering physiotherapy.
A central concept is the link between the upper cervical spine and headache through the trigeminocervical nucleus, which helps explain referred pain between the neck and head. Learners can expect a detailed review of why neck pain is common in migraine, why not all headache patients benefit from physical treatment, and how musculoskeletal impairments guide treatment selection.
The teaching also covers assessment methods for cervicogenic headache, including movement testing, palpation, flexion-rotation testing, and motor control findings. Evidence for treatment is compared across tension-type headache, cervicogenic headache, and migraine, showing stronger support for manual therapy and exercise in the first two groups and more selective use in migraine.
