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Summit Medical Group of Oak Ridge

Tension-Type Headaches vs Cervicogenic Headaches

According to research, approximately 47% of the population suffer from headaches. It is not uncommon for these headaches to be severe or frequent enough to affect the quality of one’s activities of daily living. Depending on the source or origin, Physical Therapy can often significantly reduce or abolish the pain produced from these headaches.


Two common types of headaches we’re discussing today are “tension” and “cervicogenic.” Tension-Type headaches (TTH) are usually related to the groups of muscles located in the back of the upper shoulders, neck, and head that attach near and around the base of the skull. Typical causes of TTH are anxiety, emotional stress, poor posture and lack of sleep. It’s actually common to have more than one of these causes occurring at the same time. These postural muscles can become overworked or stressed, causing an increase in tightness, and begin to generate pain or headaches due to the increased strain applied to the head.

Cervicogenic headaches originate from dysfunction of tissues in the head or neck, such as vertebral joints, discs, and nerves. These dysfunctions may lead to poor mobility that can lead to added stress to the head and neck, and result in headaches. Poor or undesired postures of the head, neck, and shoulders can also contribute to the production of pain such as sleeping in an awkward position. A sudden, unexpected movement may also cause stress to the cervical tissue and result in a cervicogenic headache.


TTH typically present mild-to-moderate pain on both sides of the head with symptoms lasting anywhere from 30 minutes to up to a week and are often described as a constant pressing/pressure pain or dull ache. Cervicogenic headaches typically presents unilaterally, or on one side of the head and can spread towards the front of the head and side of head. These symptoms can begin as intermittent and progress to constant pain and may include: a stiff neck, steady, non-throbbing pain, and pain when you sneeze, cough or take a deep breath.

Home Treatment:

As stress and posture can play a big part in both types of headaches it’s important to be able to self-analyze your activities throughout the day. What activities do you perform for long periods of time? What position or movements are your head and neck doing during these activities? Can you make adjustments to reduce the stresses on your head and neck? For instance, sleeping. I get asked all the time about pillow types. What I’ve come to realize is it’s not so much about the pillow type but maintaining your head position. Whether you’re a side sleeper or back sleeper, find a pillow that keeps your head held in a neutral position (not pressed forward, not cranked back, not pressed towards one side or the other).

Stop holding tension in your shoulders. My wife used to constantly complain about headaches and tension/pain in her shoulders. A while back while we were on a jog together I noticed that she was hunching her shoulders up as she ran, with her hands clinched tightly into fists and held around chest height. I advised her to relax, or drop, her shoulders, loosen her grip and swing her arms near her hips vs chest. She stated that she didn’t even realize she was doing that. That next day she came home from work and said, “I notice that when I get in a hurry walking at work or when I’m typing at my computer that I’m shrugging my shoulders up like you pointed out.” After finding these activities and bad “posture” habit she began consciously reminding herself to “drop her shoulders.” Mastering this one concept had a significant impact on reducing her headaches and tension in the shoulders.

Perform a towel snag to relieve a headache. Place a towel at the base of your skull where the head meets the neck as pictured. Gently pull the towel in a slightly upward direction and hold this for anywhere between 15-60 seconds, depending upon your tolerance. Repeat 3-5 times. Perform as needed to reduce your headache.

Physical Therapy:

A Physical Therapist will be able to perform a physical exam to determine the origin of your headaches and if physical therapy is a good course of treatment to help or resolve your symptoms. After the exam is performed, your physical therapist will construct a detailed plan for treatment that will likely consist of various manual therapies, therapeutic exercises, and patient education that are tailored to your individual needs.

Manual therapies may consist of hands on techniques that facilitate decreased pain and tension, improving range of motion, and correcting joint motions or alignments. Therapeutic exercises may include activities to address postural deficits or muscle weakness through the use of stretches or resistance activities. Part of the treatment plan will also consist of a home exercise program and patient education so that you have a good understanding of the various factors affecting your condition, expectations, and goals.

Chronic or frequent headaches should not be something that you must accept or tolerate as part of your life. If you are experiencing headaches that affect the quality of your life, talk to your doctor or physical therapist about PT as an option to address your symptoms. If your headaches are appropriate to address with physical therapy, it is very possible to see results within the first few visits. Don’t let headaches keep you from experiencing your best life!
If you, or someone you know is struggling with headaches please call us at (865) 483-4172 to schedule an appointment to see a provider or physical therapy.

Pictured from left to right: MaKenzie Jennings, PT Tech; David Coleman, PT; Crystal Boshears, PTA