Tag Archives: neck pain

Headaches and TMJ Pain: Elite PT Newsletter Sept. 2018

This month I want to talk a bit about treating chronic headaches and temporomandibular joint pain (TMJ – aka the jaw).

But first I want to use this opportunity to remind you that we do free screenings for high school athletes with nagging injuries.  Sprains and strains as well as aches/pains that just don’t get better or go away with time are a perfect example of the kinds of injuries that we could help with.

If you’re son or daughter has a more severe injury then you should consult with your physician first.

I’m available most Tuesday afternoons after 1pm.  Appointments typically run about 30 minute – within that time I can give you a diagnosis and get your athlete started on the path to recovery.  Other days and times may be an option, it just depends on our availability.  Just call us at 231 421-5805 if you have questions or to schedule a free screening.


In other news….

Anniversaries this month:

Allie Hoyt PT/Athletic Trainer -1 year

Allie Hoyt DPT, ATC







Jesie Bott ATC/Massage Therapist- 5 years

Jesie Bott ATC, LMT







Jesie and Allie have been wonderful employees and we’re blessed to have them practicing at Elite Physical Therapy.

They are also a big part of the reason why we have just passed our 7th year in business.  I’m convinced we’ve done so well over the years because of our employees and their love for our patients and desire to help them achieve their recovery goals.

Headaches and TMJ Pain

These may not be the first things that pop into your head when you think of what a physical therapist would treat but we do see folks with both of these conditions.

Headaches and migraines can sometimes be the result of pain being referred from muscles in the neck up into the head.  It’s way more common than you might think.  The pictures below show the common referral patterns from our neck muscles.

Upper Trapezius

Upper Trap Trigger Points - headaches








Suboccipital Trigger Points - headaches







Sternocleidomastoid Trigger Points - headaches




Long hours staring at a computer screen or hunched over a desk can strain these muscles causing pain.  Often times the muscle itself just feels tight but it projects the pain elsewhere – in this case into your head and/or face.

Luckily its pretty easy for us to determine if this is the cause of your neck pain or headaches. And if that’s the case these muscles can be treated with a number of manual techniques such as Trigger Point Dry Needling and Graston Technique.

  •  click on Dry Needling or Graston Technique above to see video demonstrations

Many people can also have symptoms in the their jaw, or temporomandibular joint (TMJ), which are common with everyday activities like chewing and talking.  The pain can be local to the joint itself and/or the muscles around the joint can refer pain into the head or face.  Check out the pictures below:

Temporalis Muscle

Temporalis Trigger Points - Headaches









Masseter Muscle

Masseter trigger points - headaches









TMJ symptoms can also be treated with physical therapy techniques including the manual therapy techniques I mentioned above.  It might sound crazy using needles to treat these muscles but over the past month we’ve had 2 clients that achieved complete pain relief with 1-2 treatment sessions.

There is still a bit of work to do in regards to improving the function of the jaw and neck to be sure the symptoms don’t come back but treating the muscles can be a very beneficial strategy.

If you suffer from chronic headaches or TMJ symptoms give us a call and we can discuss if physical therapy would be appropriate (231 421-5805).

That’s it for this month.  Talk to you again in October!

Joe Heiler PT
231 421-5805

Elite PT March 2018 Newsletter – Curing Headaches and Migraines

Hi Everyone

Hope you’re surviving the prolonged winter.  Luckily spring is right around the corner – I hope!

Kristy and I recently drove out to Appleton, Wisconsin to take an advanced Functional Dry Needling course with Edo Zylstra from Kinetacore.  Edo is one of the top dry needling educators in the United States – THE best in my opinion plus he’s from Michigan so that has to count for something.

Anyway, we learned how to dry needle some of the more difficult to reach muscles plus how to treat more challenging conditions including headaches and migraines.  We’ve been treating headaches and migraines all along but we’ve definitely picked up some new techniques that will only help with more tougher cases.

Unfortunately I didn’t get any cool pictures this time as Kristy and I were too busy sticking needles in one another 10 hours per day.


Here are some scary stats:

In the U.S., more than 37 million people suffer from migraines. Some migraine studies estimate that 13 percent of adults in the U.S. population have migraines, and 2-3 million migraine suffers are chronic.

Almost 5 million in the U.S. experience at least one migraine attack per month, while more than 11 million people blame migraines for causing moderate to severe disability.

Migraines and headaches can have multiple causes, some of which are not well understood, but one of the most common causes is referred pain from muscles that have attachments to the head and neck.  I personally think this is very often overlooked by medical professionals as its usually easier to just prescribe drugs to cover up the pain.

Check out the pictures below showing some of the main culprits (muscles) and their referral patterns:

Upper Trapezius 
Upper Trapezius Headaches


Suboccipital Headaches

Sternocleidomastoid (SCM)
Sternocleidomastoid Headaches

These are all fairly superficial muscles that are easily treated with a number of manual therapy techniques although I do find dry needling works the quickest and the results are longer lasting.  There have been plenty of cases where a client walked in the door with a headache and left without one.

Case 1
This patient was rear ended 3 years ago resulting in severe headaches (9 out of 10 on the pain scale) 2-3x per week.  Chiropractic and physical therapy in the past gave him short term relief of his neck and back pain but didn’t help his headaches.

At the first visit we dry needled the upper trapezius muscles on both sides and over the course of the next week the intensity of his headaches decreased from a 9/10 to 2/10.

Visits 2-4 included the same treatment to the upper traps plus we hit a few of the upper back muscles (not shown above).  The patient reported no headaches at all after the 4th treatment as well as no longer having neck or upper back pain.

Follow up via phone 2 months after the last visit the patient indicated he was still pain free and had no further headaches.

Case 2

This patient had headaches so painful and frequent that she had to have an MRI/CT scan of her head to rule out serious pathology.  Luckily they didn’t find anything but we did find active trigger points in her upper trapezius and suboccipital muscles that referred pain directly into her head (basically the same patterns as you saw in the pictures earlier).

We dry needled her upper trap and suboccipital muscles 3x over a 2 week period.  Over the course of the following two weeks she had one headache that lasted 5 minutes.

Dry needling was performed only once more and following up three weeks later she had remained symptom free.


These are just two cases recently with very successful outcomes, especially considering the chronic nature of each plus all the other treatments they had been through.

I can’t guarantee that every headache or migraine has a ‘muscular’ cause, but it’s not really that hard to tell during a physical therapy evaluation if that is indeed the case.  We can apply pressure, or just squeeze the muscle, and it will often refer straight to the head.  If that’s the case then that muscle is implicated and needs to be treated.

As you can see in both cases above the results were almost immediate.  One nice thing about dry needling is that is doesn’t take more than a couple sessions to see results.  We can often get good outcomes with other manual techniques as well but in my opinion dry needling usually works the fastest and is longer lasting.

If you’d like to see a quick demo on dry needling, check out the video on our homepage here:  http://www.elitepttc.com/  The subject in the video is actually my dad.  He had intense ‘ram’s horn headaches’ that wrapped around the side of his head – which is typical of the upper trapezius trigger points.

Hope that was some helpful information.  If you suffer from chronic headaches or migraines please contact us with any questions (231 421-5805).

Have a great finish to March!

Joe Heiler PT

Video Introduction to Functional Dry Needling

Functional Dry Needling can be used to target and treat trigger points in almost any muscle of the body.  The benefits are a decrease in pain, improved tissue extensibility (flexibility), and improved function (i.e. getting you back to doing what you want to do most).

Check out the video for a brief explanation of Functional Dry Needling plus see how I would use it to treat the upper trapezius muscle.  This muscle can be a contributor to neck and shoulder pain as well as headaches, but responds very well to the technique.

Questions?  joe@elitepttc.com