Physical Therapy for Migraine

Medically Reviewed by Melinda Ratini, MS, DO on February 22, 2022
4 min read

Migraine disorder affects your central nervous system, which includes your brain and spinal cord. It also affects your peripheral nerves and your blood vessels. This all causes the neurological symptoms and pain common to migraine. Experts refer to conditions like this as centrally mediated pain disorders.

Migraine drugs go to your central nervous system to treat pain. But, unlike these medications, physical therapy focuses on treating the muscles and joints outside your brain and spinal cord.

Physical therapy techniques can help temporarily lessen your pain during a migraine attack. These techniques are especially helpful if you use them during the beginning of a migraine. They include:

Massage. Your physical therapist can teach your family members or other loved ones how to perform certain massages to ease your migraine symptoms.

Manual cervical traction. This non-invasive procedure can ease neck pain from your migraines. It can help separate the bones, joints, and disks in your neck. Cervical traction can help relieve tension from your nerves and stretch your neck muscles.

Self-help methods. Your physical therapist can teach you how to use ice and heat to ease your symptoms. They can also give you self-relaxation tips to lessen pain during a migraine.

Stretching. Certain stretches can help you feel better during a migraine. Your physical therapist will show you movements to help with specific pain areas in your body.

In addition, your physical therapist should give you instructions for exercises to do at home. They might give you handouts or send you video links on how to perform the movements correctly. If you’re unsure about a specific exercise, ask your physical therapist for more guidance.

Experts don’t yet have enough information to suggest that physical therapy should be a part of all migraine treatment plans. But there are some potential benefits of physical therapy that may ease your pain. Physical therapy techniques may:

  • Treat migraine-related musculoskeletal problems
  • Help ease vestibular symptoms (such as vertigo, dizziness, loss of balance, and sensitivity to motion)
  • Improve postural control impairment (issues related to your stability)

It’s always important to talk to your doctor before you start any new treatment for migraine. Your care team can help you decide if physical therapy could help your symptoms or not.

Some people with this condition have exercise-triggered migraine attacks. For this reason, physical therapy may actually make certain people’s symptoms worse.

It’s important to know if physical therapy could be a trigger rather than a treatment for your migraine pain. One study found that 38% of people with migraine had worsened symptoms from physical activity. In the same study, experts found that those with exercise-triggered migraines had neck pain as a beginning symptom during regular attacks.

Since physical therapy for migraine addresses your muscles and joints, each person’s response to the treatment may be different. Your success with physical therapy has a lot to do with how much your muscles and joints are involved in your migraine pain.

Physical therapy as a migraine treatment might not be as effective if you:

  • Rarely have migraines (they happen once a month, give or take)
  • Have classic symptoms (like neurologic signs such as aura) with clear triggers

Not all physical therapy facilities will provide the right care for your migraine symptoms. It’s important to discuss your needs with your primary doctor first. They can help point you in the right direction.

You should also do your own research on physical therapists. As you search for an expert:

  • Consider your wants and needs to ensure you find a provider that’s right for you.
  • Ask questions if you’re unsure about what they specialize in.
  • Ask about how much experience your provider has.
  • Ensure that your physical therapist is licensed.
  • Look for a location that’s suitable for you.
  • Visit the facility before and make sure you like the atmosphere.
  • If you want to use health insurance, ensure that the facility takes your insurance.

Once you find a physical therapist, it’s important that you communicate your needs to them. Remember that you and your therapist are partners in your physical care. To get the best results, it’s crucial that you speak up about what works and what doesn't.

If you don’t feel that your physical therapist meets your needs, it’s OK to have a discussion with them or switch providers. Your well-being is the most important thing when exploring options in your migraine care.