Physical therapy in the treatment of chronic headache

Careful evaluation of the chronic headache patient can reveal the presence or absence of musculoskeletal factors to be causative or contributory to the headache condition. This article presents a review of the literature surrounding physical findings in patients with cervicogenic and musculoskeletal sources of pain and specific treatment with physical therapy. Included in the discussion is the identification of muscular and joint involvement in a given headache, the relevance of postural, range of motion, and strength deficits, and appropriate individualized treatment strategies with a review of relevant outcome studies. Possible mechanisms for treatment effects also are considered.