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You know all too well how tension headaches or migraines can affect your life. The intense pain can feel unbearable. Although medication can offer some temporary relief, rebound headaches are often severe. Once your headache starts, you feel powerless to stop it.

Imagine if you were able to get to the root of what was causing your headaches. What if you could get control of the pain? What if you could make unique changes in your life that would reduce your risk factors? What if you could lessen the frequency and severity of your headaches naturally without medication? You don’t have to imagine any more. With pt Health’s Headache Treatment Plan, YOU CAN!

The pt Health Headache Treatment Plan:

  • Addresses the full range of common headache causes such as:
    • Stress
    • Potential joint dysfunction
    • Muscle strain
    • The cumulative effects of tension.
  • Is covered by most extended health plans.
  • Starts quickly with next day appointment availability.

Tension Headache Symptoms

  • Dull ache
  • Sensation of a tight band or vice around your head
  • Nausea and vomiting tend only to occur with migraines, and not with tension headaches

Tension Headache Rehab

  • Provides an effective therapeutic approach designed to relieve pain
  • Prescribes appropriate stretches and movements that patients can do at home to relieve headaches on their own
  • Provides preventative strategies to deal with lifestyle, work, and other risk factors

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Treatment Plan


A Comprehensive Approach to Headache Care

pt Health’s Headache Treatment Plan focuses on an approach that takes all lifestyle, work, medical, and personal factors into account. Our program is geared to manage factors that might be causing or affecting the severity and frequency of tension headaches or migraines.

Thorough Assessment

During your assessment, your pt Health physiotherapist will ask you a series of questions about your medical history, daily activities, work, and current state of health. The first priority is always to manage and treat pain. Your physiotherapist may use acupuncture to relieve pain. Using heat and cold might be another alternative.

Your physiotherapist will check to see if there is a level of muscular involvement triggering your headaches. They will check your posture and suggest a series of stretches designed to increase blood flow and relieve muscular tension that might be pinching your nerves. Manual therapy can also be used to reduce any stress built up in joints in your jaw and upper neck, for example.

Lifestyle Evaluation

Investigation into your daily habits and work life will also inform your course of treatment. Is your job high stress? Do you have to maintain and hold a certain position frequently at work? Do you chew a lot of gum during the day or chew tough foods? Do you eat regularly and get enough sleep? Do you think you might need your eyes checked? If your answers reveal that you grind your teeth, for example, your physiotherapist might recommend that you see your dentist to be fitted for a mouth guard as part of your treatment.

Personalized Recommendations

Your physio might also suggest – if you are a stomach sleeper – to try lying on your side or your back at night. A cervical pillow might be another option that will help to support your neck during sleep and reduce any tension that builds up overnight.

Your physiotherapist could tell you that seeing a massage therapist to keep your muscles supple and unlock the cumulative effects of tension would be helpful. A naturopath could also find natural and alternative therapies to help you manage your stress, tension, and pain.

Each patient is unique, even if they all suffer from tension headaches or migraines. Our Headache Treatment Plan helps us to act like detectives. We diagnose what exact combination of factors is contributing to your headaches and focus on the most effective approach for your unique needs.

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Emmett's StoryEmmett’s story

Emmett is a 42-year-old investment banker. He is very successful at what he does and recently got a promotion to vice president of his firm. He is happy about the promotion and enjoying the lifestyle benefits that come with his higher salary. Unfortunately, the time he has spent at work over the years have taken its toll. He recently separated from his wife and is now sharing custody of his two children. Things are difficult in his personal life and stressful at work.

Emmett’s Headache Problem

Over the last 6 months, Emmett has been experiencing headaches on a very regular basis. At the end of his workday, he feels like his head is in vice. He is aware that he’s taking too many painkillers – his stomach is starting to feel really irritated and he’s worried about developing an ulcer. He feels fatigued and unable to concentrate frequently. His assistant has noticed and told him that he should consider going to see a physiotherapist to see if that would help his headaches. She has a friend who is the receptionist at a ptHealth clinic near Emmett’s house, and she sets up a time for him to have an assessment.

Emmett’s First Day of Treatment

When Emmett goes to the clinic a week later, he’s impressed by how thorough his pt Health physiotherapist is with her intake process. She asks him all about his medical history, work, lifestyle, and mental state. When Emmett says he spends a lot of time at his desk looking over facts and figures, she asks about the position of his desk, the light in his office, and whether or not he has had his eyes checked recently. She makes note that his job is very high stress and that his personal life is going through a difficult transition.

During his physical examination, the physio notes that Emmett’s shoulders and neck are incredibly tense. She immediately uses moist heat to help relax the muscles and tells him that she will use acupuncture in this session to help relieve pain. She shows Emmett some stretches that she can do at home to help unlock his tense muscles, and tells him to get up at least once an hour and walk around his office to keep him from holding the same position for too long.

Emmett’s Ongoing Treatment

In the following sessions, Emmett’s physio asks if he grinds his teeth or clenches his jaw. Emmett admits that he does. She says that his jaw clicks, indicating that he might have TMJ. She does some manual therapy around the joints and suggests that he come in to see the massage therapist at the clinic as well to have more in depth focus paid to the muscles of his jaw, neck, and shoulders. She tells him to stop chewing gum and to make an appointment with his dentist to get a mouth guard made. She also suggests that he try to stop sleeping on his stomach and change to sleeping on his back or side if possible. She gives Emmett a cervical pillow to use at night to help support his neck and relieve his neck muscles.

Update to Emmett’s Condition

After a couple of months, Emmett is feeling a lot better. He has taken all of his physio’s recommendations to heart and diligently practices his stretches. He sees the pt Health massage therapist once a week. He has stopped chewing gum and has invested in a mouth guard, both of which have significantly reduced his TMJ symptoms. Overall, Emmett is more mindful of how his muscles become rigid during times of stress – he tries to release tension and correct his posture whenever he can. His headaches are far less frequent and severe and he finds that his concentration has increased and he feels more positive in general. Although he knows his life will continue to be challenging, he now feels he has the knowledge and the ability to prevent and control his tension headaches.

Tension vs Migraine


What is a tension headache?

A tension headache is the most common form of headache. Typically adults and adolescents get tension headaches – they are less common in children. Tension headaches happen when neck and scalp muscles become tense or contract.

What is a migraine?

After tension headaches, a migraine is the second most common kind of headache. Migraine headaches are classified as neurovascular headaches. Although the science is not completely clear, doctors believe that migraines are caused by an interaction between blood vessels and nerve abnormalities.

What is the difference between the two?

Tension headaches are primarily caused by tension and migraines are neurovascular. Tension headaches tend to make your head ache all over, typically with a dull pressure. You might have the sensation of a tight band or vise around your head.

Migraines more typically involve throbbing or disabling pain on one side of your head that can sometimes spread to the entire head. Nausea and vomiting tend only to occur with migraines, and not with tension headaches.

What can trigger tension headaches and migraines?

Overall, migraines and tension headaches have the same triggers. In fact, for some unlucky people, you can have both a migraine and a tension headache at the same time! Triggers for both can include:

  • Emotional stress
  • Fatigue
  • Alcohol
  • Caffeine
  • Eye strain
  • Joint dysfunction (like TMJ)
  • Teeth grinding
  • Skipping meals
  • Abrupt weather changes
  • Physical exertion
  • Travel motion
  • Bright or flickering lights
  • Odours
  • Travel motion

Since there is a genetic component involved, you can be pre-disposed to developing migraines if members of your family have suffered from them. Fluctuations in female hormones can also trigger migraines.

Migraine Facts

Migraines are different from tension headaches in that they have a neurovascular component. Although doctors aren’t totally certain, they believe that there might be an underlying central nervous system disorder. They also appear to be genetic.

75% of migraine sufferers are women between the ages of 25 and 40. During childhood, girls and boys are equally affected.

Migraines may have up to four symptom phases. These phases vary depending on the person and, often, on the headache. They are:

1. Prodrome phase: A group of vague symptoms that occur before the headache (even a couple of days before). Symptoms include:

  • Sensitivity to light or sound.
  • Change in appetite, thirst.
  • Mood changes.
  • Fatigue and drowsiness.

2. Aura phase: Sensory disturbances that occur before a migraine in one out of five patients.

  • Positive auras – bright or shimmering light or shapes at the end of the field of vision. They can get bigger and fill the field of vision.
  • Negative auras – dark holes, blind spots, or tunnel vision.
  • Patients may also experience speech disturbances, confusion, tingling, numbness, or weakness in arm or leg.

3. Attack phase: The acute phase of the migraine.

  • Throbbing pain on one side of the head (can sometimes spread to affect the whole head)
  • Nausea and/or vomiting.
  • Sensitivity to light or noise.
  • Physical activity makes the pain worse.
  • Look pale, feel cold, facial tingling or numbness.
  • Postdrome – Often after the attack phase, patients can feel exhausted and mentally foggy.


pt Health clinicians believe that you deserve the best treatment available to deal with tension headaches and migraines. We know that headache pain can change your life and your ability to participate in everyday activities. We know you want relief! That is why the pt Health clinical team has developed our Headache Treatment Plan. Our clinical approach involves a comprehensive individual analysis that takes your risk factors, lifestyle, and work function into account so that you can get well and stay well – now!

Coverage Options

At pt Health, we know that sorting out insurance paperwork can be time-consuming and confusing. We want your focus to be on getting well and staying well. With that in mind, we do our best to help you navigate through the necessary forms. We speak with your insurance providers and we’ll answer any questions you may have about your coverage.

pt Health services are covered by most health care insurance plans.  In most cases, if you are using your extended health care carrier or work plan, we do not require you to pay for your therapy sessions up front.* Instead, we bill your insurance company on your behalf.
If you have extended health care benefits that cover therapy, most auto insurance companies require that your claim be placed through your extended health plan first. Any remaining balances for services are then covered by your auto insurance plan. On your first visit, you may be asked to provide information about your extended health plan. If you do not have extended health care benefits that cover therapy, your treatments may be billed directly through your auto insurance company. For residents of British Columbia, ICBC covers a partial amount of treatment visits. Patients will be asked to co-pay the difference at each visit. If a patient has extended health care benefits, it is possible to claim the difference back.
Although each clinic’s approach to intake, assessment and therapy do vary, generally speaking your physiotherapist will ask a series of questions that will help better describe all of your symptoms in detail. Your physiotherapist can then carry out your assessment. The physiotherapist will examine you physically and discuss the findings, the cause of the problem, and suggest a solution that can effectively treat your health problem.
OHIP covered physiotherapy services must be provided by a designated OHIP physiotherapy clinic. OHIP covers physiotherapy treatments, but does not cover the cost of an initial assessment. To qualify for OHIP coverage, you must have a medial doctor’s referral, be 19 years or younger, be 65 years or older, or be receiving benefits under the Ontario Disability Support Program or Family Works. If you have been admitted overnight in hospital for a condition that now requires physiotherapy, you are also eligible.
Some pt Health clinics will be able to bill Blue Cross direction for physiotherapy and massage therapy treatments if you are a member of:

  • RCMP
  • DND
  • Canadian Forces
  • Veterans Affairs

For any treatments that are only partially covered, you may be asked to co-pay the difference at each visit.

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