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Migraine is a neurological condition marked by intense, often debilitating headaches. It can also be accompanied by symptoms like nausea, sensitivity to light or sound, and numbness or tingling.

There are various treatments for migraine, and physical therapy may be helpful in treating migraine for some people.

Physical therapy is not typically thought of as a treatment for migraine. This can be partly due to a lack of understanding what physical therapy can entail, as well as an overreliance on medication for pain relief.

Right now, there are not enough high-quality, randomized controlled trials of physical therapy for migraine to have it be part of standard treatment recommendations. The studies that do exist have significant limitations, or only focus on one type of migraine.

A 2020 review of studies notes there are two main approaches of physical therapy that may be beneficial for migraine relief:

  • addressing injuries to the muscles, nerves, tendons, joints, cartilage, and spinal discs
  • addressing posture and inner-ear-related balance issues

It’s important that you see a physical therapist who has experience treating headaches in order to ensure they are knowledgeable about proper techniques.

Risks of physical therapy for migraine can include worsening of symptoms. Or you may experience no change in your migraine at all.

Physical therapy techniques for migraine can vary, depending on the person and symptoms. The physical therapist will examine you to determine what is needed and how they can best help.

Stretches

Physical therapy can involve stretching and guidance on body mechanics as well as posture. This can help people position their head and neck in a better way, minimizing tension and odd positioning. In turn, the muscles are not as strained or tense, potentially helping to reduce migraine symptoms.

Read more about stretches for migraine relief.

Mobilization

Soft tissue mobilization is also a tool that physical therapists use in the treatment of migraine. This may help relax trigger points that worsen migraine headache symptoms.

Education

Education is a part of many physical therapy appointments. The physical therapist may provide guidance on how to:

  • sit properly
  • align your head and neck
  • exercise and stretch so that your muscles are more relaxed, and to increase range of motion
  • reduce muscle tension

Physical therapy can be used to treat other types of headache, such as cervicogenic headache. While migraine headaches originate in the brain (which may be why physical therapy has mixed results), cervicogenic headache stems from structures in the cervical spine.

Physical therapy is often prescribed for those with cervicogenic headache, according to the National Headache Foundation. The therapist can examine you to see which areas are contributing to symptoms, and then do manual techniques in order to relieve tension and pain, and improve head and neck range of motion. Soft tissue mobilization may be done, as well as education about posture and stretching.

A 2019 review of controlled trials found that physical therapy is more effective than placebo for tension-type headache. These headaches are caused by muscle contractions in the head and neck areas, and can be related to stress.

Physical therapy may relieve tension in the head and neck areas, help with posture and positioning, and provide education on how to move to reduce tension and consciously relax under stress.

For those who get migraine once a month or less, with known triggers and neurological symptoms like aura, physical therapy may be minimally beneficial, says the Michigan Headache & Neurological Institute. However, effectiveness is debated because of theories of where and how migraine attacks originate.

People who get headaches from cervical spine and muscle tightness may find relief in physical therapy. This is because the therapy helps to relax these muscles, releasing tension and getting rid of any referred pain that may go into the head, causing a headache.

If you’ve decided to try physical therapy for migraine, speak with a doctor first to make sure it’s safe for you. If they give the go-ahead, you should look for licensed physical therapist who has experience treating headaches.

Different physical therapy clinics may specialize in different types of care. Ask if they specialize in or have experience treating migraine headaches. Some have board certified clinical specialization in neurology. This means the physical therapist is specialized in examination, treatment, and reassessment of people with neurologic dysfunction.

Not all physical therapists take insurance, so this is also something to consider when looking for a therapist. A physical therapist with whom you feel comfortable is also important. They should welcome questions and make you feel at ease.

To find a physical therapist in your area, ask your healthcare professional if they have any recommendations. You can also search the American Physical Therapy Association database.

The most common treatments for migraine include medication (over the counter and prescription) and lifestyle changes like stress reduction. Physical therapy may help with that.

While more research is needed to include physical therapy as a first-line treatment, it may be helpful for some people as a complementary treatment. Speak with a doctor about the potential risks and benefits for your particular situation.