Could Physical Therapy Help Your Headaches or Migraines?

A Self-Assessment Using the Questions Our Physical Therapists Ask

If you live with frequent headaches or migraines, you’ve probably spent a lot of time trying to figure out what causes them.

Maybe you’ve noticed they appear after a long day at work. Maybe stress seems to make them worse. Or perhaps they show up without warning, leaving you wondering what triggered them in the first place.

At The Therapy Network, one of the first things we do during a headache or migraine evaluation is look for patterns. Physical therapy may help identify factors such as muscle tension, posture, movement restrictions, and breathing mechanics that could be contributing to symptoms.

To help you better understand your own symptoms, we’ve put together a self-assessment using some of the same questions our physical therapists may ask during an evaluation.

Grab a notebook, open the notes app on your phone, or simply reflect on the questions below.

Question 1: When Do Your Headaches or Migraines Usually Occur?

Think about the timing of your symptoms.

• Do they start first thing in the morning?
• Do they develop as the day goes on?
• Do they appear after working at a computer?
• Are they worse after long periods of sitting?
• Do they seem to occur during particularly stressful times?

PT Insight

The timing of symptoms can reveal patterns related to posture, stress, work habits, and muscle fatigue. For example, headaches that worsen throughout the day may point toward accumulated tension or prolonged positioning.

Question 2: What Seems to Trigger Your Symptoms?

Sometimes the activities surrounding a headache can be just as important as the headache itself.

Consider whether your symptoms are commonly associated with:

• Computer work
• Looking down at your phone
• Driving
• Poor sleep
• Stressful situations
• Certain physical activities
• Long periods of sitting

PT Insight

Physical therapists look for activities or positions that consistently increase symptoms. Triggers can provide clues about posture, movement patterns, or muscle tension that may be contributing to discomfort.

Question 3: Where Do You Feel the Pain?

Try to be as specific as possible.

• Behind your eyes?
• Across your forehead?
• At your temples?
• At the base of your skull?
• On one side of your head?
• On both sides?

PT Insight

Here’s something that surprises many patients: the location of your headache doesn’t always tell us where the problem starts.

Certain muscles in the neck have common referral patterns and can create symptoms in other areas of the head. For example, muscles in the front and side of the neck may refer discomfort across the forehead, behind the eyes, or into the temples.

Question 4: Do You Notice Tension in Your Neck, Jaw, or Shoulders?

Headaches and migraines don’t always occur in isolation.

Ask yourself:

• Does your neck feel stiff or tight?
• Do your shoulders carry a lot of tension?
• Do you clench your jaw during the day?
• Do you wake up feeling tight or sore?

PT Insight

The neck, shoulders, jaw, and upper back work together. Tension in one area can influence the others and contribute to ongoing discomfort. That’s why physical therapists often assess movement patterns beyond the neck.

Question 5: How Do You Breathe?

This question surprises many patients because they don’t expect breathing to come up during a headache evaluation.

Take a moment and notice your breathing without trying to change it.

• Does your chest rise significantly when you inhale?
• Do your shoulders lift?
• Do the muscles in your neck visibly tighten when taking a deep breath?
• Does your breathing feel shallow or restricted?

PT Insight

Some people unknowingly rely on their neck muscles to help them breathe, especially during stress or prolonged desk work. Over time, those muscles can become overworked and tense, which is why physical therapists often assess breathing mechanics and rib cage movement.

Question 6: How Much Stress Are You Carrying?

This isn’t about suggesting headaches are “all in your head.”

Migraines and headaches are complex, real conditions that deserve proper evaluation and care.

However, stress can influence how the body responds to pain and tension.

Consider:

• Have your symptoms increased during particularly stressful periods?
• Do you feel like you’re constantly carrying tension?
• Do headaches appear after demanding days at work or home?

PT Insight

Stress, sleep, muscle tension, and physical symptoms are often connected. Physical therapists may incorporate strategies to reduce tension, improve breathing patterns, and promote relaxation.

 What Physical Therapists Are Really Looking For

By now, you may have noticed that none of these questions focused solely on your head.

That’s because physical therapists aren’t just looking at where the pain occurs, we’re looking for patterns.

For example:

• Headaches that worsen throughout the day may suggest muscular fatigue or prolonged positioning.
• Symptoms that increase during computer work may indicate postural or movement-related stress.
• Pain behind the eyes, across the forehead, or into the temples may be associated with common muscle referral patterns.
• Frequent neck tension may indicate the cervical spine is contributing to symptoms.
• Shallow breathing or excessive neck muscle activity during breathing may suggest additional tension throughout the upper body.

At The Therapy Network, we don’t just evaluate the neck. Your physical therapist may assess posture, movement patterns, rib cage mobility, breathing mechanics, muscle tension, and how the body functions from head to toe.

Because the body works as a connected system. When one area isn’t functioning well, another may compensate. Understanding those compensation patterns can provide valuable insight into recurring headaches and migraines, especially for patients who have tried other treatments without finding lasting relief.

 What Might Treatment Look Like?

Once a physical therapist identifies potential contributing factors, treatment focuses on addressing those findings.

Depending on the individual, treatment may include:

• Manual therapy
• Trigger point release
• Dry needling
• Cupping
• Improving rib cage mobility and breathing mechanics
• Postural and movement education
• Stretching and strengthening exercises
• Strategies to reduce excessive muscle tension
• Relaxation and nervous system regulation techniques

Every treatment plan is individualized because every patient’s symptoms, triggers, and goals are different.

Bring Your Notes to Your First Physical Therapy Appointment

If you took the time to work through these questions, you’ve already completed an important first step.

Bring your observations with you to your evaluation.

Information about your symptoms, triggers, tension patterns, and daily habits can help your physical therapist better understand your experience and develop a treatment plan tailored to your needs.

You don’t need to have all the answers before your first appointment. Paying attention to these patterns can help your therapist understand the full picture.

If headaches or migraines are affecting your daily life, physical therapy may be worth exploring as part of your care team.

Sometimes the first step toward relief starts with asking the right questions.