Headaches are very prevalent and marred with a complicated hierarchy of classification. Current best-evidence classifies headaches as cervicogenic, tension-type or migraine, with various sub-classifications. Unbeknownst to many, physical therapists are ideally suited to treat a large proportion of patients struggling with headaches with conservative, non-pharmacological treatments. To develop an updated working knowledge of headaches, clinicians need an update in pain science. Various neurophysiological processes underlie the development, maintenance and treatment of headaches, including the relay function of the trigeminal cervical nucleus, development of hyperalgesia and allodynia, photo and phono phobia, referred pain, etc. The examination portion of the lecture will discuss headache classifications, identifying subjective clusters to classify headaches and using this information to develop a comprehensive physical examination. Tests and treatments discussed include pain neuroscience education, graded motor imagery, sensory discrimination, neurodynamics, manual therapy, soft tissue treatment, trigger point therapy, sensorimotor retraining, lifestyle changes and more. Headaches affect nearly one in five people in the world and most are treated with medication, with limited success. This lecture will show how safer, effective nonpharmacological treatments can help patients suffering from various types of headaches.
