Diagnostics and Physiotherapeutic Treatment of Tension-type Headache

Diagnosis and Physiotherapeutic Treatment of Tension-Type Headache

In this workshop, Dr. Rene Castien will briefly discuss the International Classification of Headache Disorders (ICHD III) and the neurophysiological background of the most common type of headache: tension-type headache. Using a case study, the strategies a physiotherapist can use in the examination and treatment of a patient with tension-type headache will be explored. Based on recent evidence, we will discuss which cervical dysfunctions can be assessed and which diagnostic tools can be used to investigate the underlying pain mechanisms (referred pain, central sensitization).

The physiotherapeutic treatment will cover the evidence supporting various physiotherapeutic interventions for tension-type headache eg manual therapy.

The challenge for the physiotherapist is to use this knowledge to determine which treatment—such as manual therapy—may be appropriate for a patient with tension-type headache. This will take into account the neurophysiological explanatory mechanisms of tension-type headache as well as specific (individual) patient characteristics.

Various treatment techniques will be demonstrated and practiced, including strength training, manual therapy/mobilizations, and manual pressure techniques.

As in the webinars Diagnosis of Headache: Is Physical Examination Useful? and Effectiveness and Mechanism of Action of Physiotherapeutic Treatment for Headache, no ready-made answers will be provided. Instead, participants will be encouraged to apply clinical reasoning to develop their own treatment strategies.

Learning Goals

By the end of this workshop, the participant will be able to:

Analyse pathophysiological mechanisms

• Critically analyse and integrate peripheral and central sensitization mechanisms underlying tension-type headache into clinical reasoning and physiotherapeutic assessment.

Differentiate critically within diagnostic reasoning

• Apply evidence-based differential diagnosis between TTH, migraine and cervicogenic headache using ICHD-III and NHG guidelines, while recognizing red-flag symptoms.

Design and substantiate an advanced treatment strategy

• Develop a substantiated multimodal treatment plan incorporating manual therapy, muscle training, posture correction, pain education and self-management strategies based on current evidence.

Apply and evaluate advanced manual interventions

• Safely and effectively apply manual and myogenic pressure techniques, cervicothoracic mobilisations and pain-modulating interventions, and evaluate their clinical outcomes.

Translate scientific evidence into clinical decision-making

• Integrate current research on the trigemino-cervical complex and related neurophysiological mechanisms into evidence-based clinical decisions and therapeutic strategies.

Accreditation

The course is accredited by the Kwaliteitshuis Fysiotherapie (KNGF and Keurmerk) for the registers General Physiotherapy, Manual Therapy, and Psychosomatic Physiotherapy.

Instructor Dr. René Castien

Dr. René Castien is the owner of the Paramedical Treatment Center for Headache in Hoofddorp and has extensive experience treating musculoskeletal complaints in primary care, with a specialization in the cervical spine, headaches, and dizziness. Dr. Castien is a researcher at Vrije Universiteit Amsterdam and a lecturer in manual therapy at SOMT University of Physiotherapy. In 2013, he obtained his PhD from the Faculty of Medicine at Vrije Universiteit Amsterdam.