Working as a physiotherapist within a headache clinic

By: Anne-Marie Logan, Consultant Physiotherapist in Headache, St George’s University Hospitals NHS Foundation Trust, and NIHR Pre-Doctoral Academic Fellow

7th April 2021

“What’s a physio doing in a headache clinic?”

That’s a good question and one that causes some confusion. People tend to think that I offer treatment for neck pain or run Pilates classes, and although many physios do that, my role is a little different.

I started in the Headache Service at St George’s University Hospitals NHS Foundation Trust in 2010.  I became interested in headache conditions having worked with patients with spinal pain for many years. I could see how incredibly disabling headaches were and what an important area this was to work in.

The skills you develop as a physio are really suited to the management of headache conditions. A physiotherapist’s work is based on core principles of helping patients to live healthier lives, through engaging with their medical, emotional and physical health. In each area of physiotherapy the types of treatment a physiotherapist might use will be different but the principles are still the same.

Working with migraine and headache disorder patients

I use those same principles in my work with people with headache. The types of treatments I use now are a little different; prescribing medicines and using injections, advising on exercise and encouraging people to seek treatment for mental health problems when needed. These are the same ones that my clinical nurse specialist and medical colleagues in headache clinics use.

Living with headache means that you are constantly juggling. Your medicines, how much you do every day, your emotions, if you can do your job that day, play with your children, do some exercise. This list feels endless sometimes. Much of my role as a physiotherapist, like all my clinical nurse specialist colleagues, is to help with that juggling. That juggling is self-management and this is an important area that physiotherapists have helped patients with for years.

Self-management of migraine and headache disorders

Self-management is important in headache, whether you have occasional headaches or daily headaches. As a physiotherapist in a headache clinic, one aspect of my role is to help people who live with headaches gain the best self-management skills.

These might be how to pace their activities, to set a goal to improve one aspect of their headache health or use a headache diary to monitor a particular medicine. These are all important skills in managing any health condition well.

More physiotherapists helping headache patients

Looking forwards to the future, I would like to see more physiotherapists alongside our nursing colleagues in headache clinics around the UK. There are few physiotherapists working in NHS headache clinics and bringing them into headache teams adds to what we can offer our patients.

As roles diversify within the NHS, we will be joined by more physician associates and pharmacists, each profession adding their skills, giving people living with headache the support they so desperately need.