Migraine and chronic headache, both of which result in a high impact on the sufferers' daily lives, are experienced by approximately 12% and 4% of the general population respectively. (DoH 2004)
Worldwide, according to the World Health Organisation (WHO), migraine alone is 19th among all causes of years lived with disability (YLD's). For example, social activity and work capacity are reduced in almost all migraine sufferers and in 60% of Tension Type Headache (TTH) sufferers. (WHO 2008)
It has been calculated that in the US, 300,000 people stay in bed each day due to headaches. (ESC 2006)
Migraine and Headaches account for £4.5m NHS consultations per annum. (IMS 2008)
10 – 20% of adolescents have headaches. (NHS 2008)
Research has taken place into the effects of a range of physical therapy interventions for headache and migraine.
Physical therapy in its widest context can include:
Physical Therapy does not replace medication but offers another option to those who may not be able to take medication, to those who have not responded or by working in conjunction with medication. Physical therapy is accepted as an integral part of any headache management programme. The majority of guidelines from across the world, including those in the UK NHS, validate a multidisciplinary team approach.
Chiropractors provide assessment and physical treatment as they are trained in physical manipulation, mobilisation, soft tissue work and rehabilitation for spinal related conditions. In addition their 6 year training includes neurological assessment and neuroscience. Apart from Osteopaths, in the UK Chiropractors are the only healthcare practitioners for which manipulation and mobilisation skills are developed throughout the whole of their training. Marie has undertaken further training in headache management in order to keep abreast of changes to headache treatment regimes.
For those experiencing infrequent migraine with known triggers the benefits of physical therapy are uncertain. However, it has been found to help with underlying factors that may initiate or prolong the migraine.
For other types of headache, particularly cervicogenic and tension type headaches it can be key to their resolution. The aim of physical therapy is to help reduce headache intensity, frequency, and/or duration of the attacks. Many theories exist on the way physical therapy works for both migraines and headaches with spinal manipulation consistently shown to have positive effects. The source of the headaches is thought to be in the joints of the neck (facet joints).
Muscles have also been shown to be a source of headaches with pain referral patterns coming from large and small muscles of the neck and jaw. For example, the trapezius muscle is often found to be overused in headache patients particularly during activities such as computer work, causing muscle fibre contractures that, in the case of the trapezius can refer pain up the neck and into the temple.