Migraine headaches are often a debilitating condition for which many patients find relief to be elusive. Migraine pain typically stems from a disorder within the central nervous system (the spinal cord and brain) that involves the nerves and blood vessels, resulting in neurological symptoms. It is not uncommon for migraine sufferers to experience neck or back pain, stiffness, and tension at the onset of a headache, and research has shown that in many cases these tight, tense muscles are a cause (or trigger) rather than a symptom of migraine pain. In cases where tension and muscles spams are the onset of a migraine, specific physical therapies can be helpful in reducing the symptoms and frequency that migraines occur and in some cases may stop migraines from occurring.
Treating Headaches and Migraines

Physical therapy is often an unknown and underutilized form of treatment for headaches and migraines. Tense or tight muscles in the cervical region can develop from overuse, static posture, or other events which can result in referred pain that presents as headaches. Because neck and back pain/tension can be a cause rather than a symptom of headaches and migraines, physical therapy can be extremely effective for headaches by treating the triggers for the pain. Physical therapy for migraines can help reduce pain and restore the ability to function in daily activities. Physical therapy for headaches and migraines focuses on:
Active Treatments
- Specific postural modifications for work and daily activities
- Gentle mobilization of joints and soft tissue
- Myofascial release
- Postural strength and conditioning exercises
- Stretching and range-of-motion exercises for pain relief
- Low-impact aerobic activities
Passive Treatments
- Massage / joint mobilization
- Ice / heat therapy
- Passive stretching and cervical distraction/ traction.
- Craniosacral therapy
Once implemented in an individualized treatment plan, many physical therapy techniques can be especially effective when applied at the onset of symptoms.
Goal for physical therapy migraine treatment include:
- Decrease in medication use
- Resolve or decrease intensity, duration, and frequency of headaches
- Improve neck function, motion, and mobility
- Improve quality of life
Other Types of Headaches That Can Be Treated with Physical Therapy
Headaches/migraines associated with musculoskeletal problems of the neck and jaw can also be successfully treated with physical therapy. Problems within these muscles and joints can produce referred pain in the head. Trigger points can develop in muscles, such as the trapezius at the top of the shoulder, that refer pain up the neck to the temple.
Goals of physical therapy for headaches associated with musculoskeletal problems may include:
- Normalizing the musculoskeletal system
- Reduction of stress/tension on joints and soft tissues
- Stretching problematic muscle fibers
Other types of headaches that can be treated/alleviated with physical therapy include:
- Cervicogenic headaches: Caused by mechanical dysfunctions of the vertebrae, neck, and joints, cervicogenic headaches can often be alleviated through strengthening muscles, improving mobility, and decreasing everyday stresses on the upper/middle back, lumbar spine, and pelvis.
- Tension headaches: With many factors being possible contributors to tension headaches, the pressure and tightness associated with tension headaches can be treated through therapeutic relaxation of the muscles, alleviating stiff joints, and posture correction.
- Vestibular migraines: Vestibular migraines usually originate from a peripheral weakness in the vestibular organs of the ears or from a central cause post TBI or concussions. In these cases the vestibular mismatch causes vestibular migraines to occur and may cause symptoms of dizziness that lasts for hours at a time, nausea, light and noise sensitivity, and a sensation of over stimulation. Vestibular migraines can occur with or without head pain which is atypical for a typical migraine. This type of migraine can be improved with VRT and vestibular rehab.
Unspecified headaches can also be diagnosed and treated at Physical Therapy and Vestibular Rehabilitation FW. If you are unsure of what is causing your headaches, our skilled physical therapists can help diagnose the type of headache you are experiencing and develop a treatment plan to prevent and alleviate your symptoms.
For those experiencing unresolved migraines, please contact our office for help achieving your treatment goals through physical therapy.