Alleviating Tension Headaches with Physical Therapy

April 16, 2020 0

Tension Headache Treatment using Physical Therapy

Surprising benefits of physical therapy to relieve reoccurring tension headaches.

At Minnesota Head and Neck Pain Clinic (MHNPC), physical therapy treatment for headaches helps to heal many people’s headache, neck and jaw pain. Individuals suffering with similar headache aliments may be spared years of misery by gaining knowledge of our conservative methods of treatment used for alleviating tension headaches.

Are Tension Headaches Classified as a Disease?

Yes. “Tension-type headache (TTH) is a disease with a great incidence on quality of life and with a significant socioeconomic impact”, according to the National Institute of Health in its Effectiveness of Physical Therapy in Patients with Tension-type Headache article. This applies when a person’s headaches are so severe that they may indicate a serious medical condition. While a tension headache is rarely debilitating, there is no need to suffer ongoing. The MHNPC helps people suffering from tension headache disease by providing effective physical therapy pain relief and the use of manual therapy (MT) for the relief of TTH.

In most cases, if you come into our clinic with a headache, you will leave the appointment with at least half of the headache gone. You will achieve a sense of control over your headaches you may have never had before.

What Causes Tension Headaches?

Tension headaches are caused when neck and shoulder muscles tighten up and create a gripping neck pain as well as on both sides of your head. They may afflict you for any time duration between 30 minutes to seven days. Women are at least three times more likely than men to suffer from a tension headache. The more common tension headache that comes and goes lasts about 15 days a year affects a third of the population. However, you may be in the 2-3% of the population that is inflicted with a tension headache more than 15 days a month.

How are Tension Headaches Diagnosed?

Tension headaches are chiefly diagnosed by a pain specialist who recognizes the symptoms you report. A thorough medical exam, other tests or procedures may be used. Your MHNPC physical therapist looks for headache-producing trigger points. These trigger points are felt in tight bands located within the muscles of your head, neck and upper shoulders. Researchers have found that the trigger points in the neck, head and shoulder send, or refer, pain to the head. These trigger points are typically very tender to touch. They usually improve with sustained pressure. When your physical therapist applies the correct pressure, the muscle may soften within a minute. The muscle should then be stretched to prevent the trigger point from becoming tender again.

One client who achieved rapid headache relief stated:

I did not know that my headaches had muscles!

The good news is that physical therapy may offer fast relief from tension headaches pain. How fast? In our clinic, we show you techniques that generally relieve your headaches within 15 minutes.

What are People’s Main Tension Headache Muscles?

Some of the main culprit muscles are the upper trapezius, the sternocleidomastoid, the suboccipitals, the temporalis, the splenius capitis and cervicis, and the levator scapulae. The physical therapists at Minnesota Head and Neck Clinic can help you learn how to treat these muscles at home. You can rely on yourself and not need to depend on pain pills or healthcare practitioners.

What Causes Tension Headache Muscle Contractions?

Constant stress is a main cause of tension headaches. Physical stress to the muscles occurs when you sit with poor posture for hours a day in front of a computer screen, or lift objects in a way that puts a lot of torque on the neck and upper shoulders, Physical therapy can show you how to improve your daily living habits to remove the physical stress off of your neck and shoulders. You will also learn how to strengthen two key muscles that have been shown to relieve the intensity and duration of headaches. These muscles are called the longus colli and capitis. These muscles are in the front of the neck, and no postural correction program is complete if you cannot control these muscles.

You may also suffer from mental stress that causes the muscle tension to slowly build up. Check every so often to make sure your shoulders are not hunched up. If so, let them sink back down into a normal resting position. Now, check yourself in another 10 minutes. Are your shoulders hunched up again? You may be stressed out and need relaxation exercises.

Physical therapists can show you how to do a program of deep breathing exercises, biofeedback or frequent reminding to relieve the muscle tension in your shoulders. In our clinic, we also offer you treatment with a health psychologist who can help you uncover underlying sources that may be leading to your current stress. Cognitive Behavioral Therapy may also be beneficial to you. As well, we will assess whether or not you are suffering from cluster headaches.

Are Tension Headaches Different from Migraine Headaches and Cervicogenic Headaches?

Tension-Type Headache (TTH): TTH is the most common and primary headache disorder.

Tension headaches share features with both migraine headaches and cervicogenic headaches (headaches that start in the neck). Migraines afflict 12% of the population. Women suffer migraines far more frequently than men. Cervicogenic headaches occur much less frequently. All these headaches may have the same tight muscles that the tension headaches do. Stress also is a major contributor to migraine headaches, but not cervicogenic headaches. If you have two types of headaches co-existing at the same time, you have a “mixed headache.”

Symptoms of Mixed Headaches:

  • Migraine triggers: Migraines can be triggered by light, noise, odors, food sensitivities, dehydration, mental upset, lack of sleep and a host of other factors. Physical therapy can help you uncover the specific factors that lead to the onset of your migraine headache. Neck pain can be a trigger for 40% of those with a migraine. Many people we find can short-circuit the migraine reaction if they can quickly shut down the neck pain.
  • Nausea and vomiting: You may have nausea and vomiting associated with your headaches, which occur with migraine headaches, but not tension headaches. Many people with migraines have nausea and vomiting preceding the outbreak of the migraine headache. The clients at our clinic often find acupressure points helpful to shut down nausea before it triggers a full-blown headache. Pressure to a point in the lower forearm called “Pericardium 6” can help decrease your nausea in 60 seconds. Of course, if your nausea is from the flu or systemic disease, the point won’t work.
  • Acupressure points: Specific acupressure points can have a significant effect on headaches. When a pressure point in the head is pressed for 15-30 seconds an immediate decrease in the headache pressure can be felt. Arm or leg pressure points also have a profound effect on headaches. Clients are frequently amazed as they feel their headache pressure melt even though the treated acupressure point is distant from the head.
  • Jaw pain: Many people struggle with a condition known as temporomandibular joint dysfunction. This jaw joint allows people to open their mouth and close it while chewing. This jaw joint needs to work properly or eating and even talking can become difficult. A poorly functioning jaw joint even sends pain to the head. If you can get your jaw pain to subside, your headaches frequently will subside with it. The jaw pain itself is a trigger for headaches. In general, our treatment philosophy is, use a splint by night, physical therapy exercise by day. You would need to see one of our specialized dentists to provide you a custom-made splint to fit your specific shape of your jaw.

5 Common Physical Therapy Treatments for Tension-Type Headaches

1. Relax your muscles that are involved with clenching.

How do you get the stubborn jaw muscles to relax? One strategy begins by putting your tongue into an “N” position onto the roof of your mouth, making sure you are not touching the teeth. Now, open your mouth as your fingers move down the side of the face, elongating the jaw muscles as you go. Your mouth should start to open wider with repetitive downward massages of these clenching jaw muscles.

2. Trigger point massage that relieves tension headaches.

Culprit jaw muscles often benefit from a specific massage which can only be done on the inside of the mouth. Our pain specialist will demonstrate how to do this mouth massage at home. Our pain patients usually find this quite relieving, even if it seems awkward at first.

3. Massage therapy for your temporalis muscle and chewing muscles.

Strengthening your chewing muscles is also important. People’s temporalis muscle is the one that hurts during a tension headache. Our human body has additional chewing muscles; such as the medial pterygoid, masseter, and supra hyoid muscles. Each one of them is capable of producing inflammation producing headache pain and problems with sleeping well. Once you get your jaw open, everyone needs the ability to bite down to eat. Jaw muscles can be strengthened just as any other muscle, with gentle resistive exercises with a specific finger placement on the chin.

4. Use of Upper cervical spine joint manipulation.

Joint mobilization to push the jaw downwards. You may need that little extra gentle boost from the therapist to get the jaw unstuck.

5. Identifying overall health habits that trigger chronic headaches.

Finally, you need to think about what got your jaw into trouble in the first place. Do you clench and grind your jaw, especially at night? Do you lean with your hand on your chin? Do you tend to protrude your jaw forward with poor posture? Do you get a solid night’s sleep or sleep on your stomach, with your jaw stretched in an unnatural position? Do you chew gum?

The above tension headache treatment suggestions are a few options for jaw treatment offered at our Minnesota Head and Neck Pain Center. Treatments generally respond very well in just a matter of several weeks. Once your source of headache pain is diagnosed and treated, people often find their headache problem resolved with little additional effort.


Our motivation at the Minnesota Head and Neck Clinic is straightforward. We can help you improve your quality of life by preventing and treating chronic pain. This may include your relationships, work environment, get better sleep, and general daily activities that are currently impeded by your miserable headaches. We see people who have been afflicted with headache pain for years and then leave our clinic after the first visit with immediately reduced headache pain.

Call 763-577-2484 or request a telemedicine visit today online by clicking here: Schedule A Clinic Visit

About the Author

Craig Sather DPT, received a Bachelor of Science degree in Physical Therapy from the University of Wisconsin. He received his Doctorate in Physical Therapy from Arcadia University in Pennsylvania. He is a physical therapy clinician at the MHNPC. Currently, you can see Dr. Leslie Hovda or one of our other providers for your tension headache needs.

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Our mission is to provide high-quality, effective patient care for head and neck disorders through a multispecialty, interdisciplinary approach designed to reduce pain and improve function for all our patients.

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