Gentle physiotherapy treatment around the head

Headache Treatment in Cologne Worringen

Professional physiotherapy for tension headaches and migraines at Hackhauser Weg 61

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Migraine is more than a severe headache. It is a neurological condition that comes in attacks and is treated by a doctor. Physiotherapy cannot eliminate it, but it can accompany it: at the neck, with relaxation and with guided endurance training. Here you can read what that means at Praxis Pirnay in Cologne-Worringen and how you can track down your own triggers.

Complementary treatment for migraine in Cologne-Worringen

Migraine is based on altered processing of stimuli in the brain; the predisposition often runs in the family. During an attack, pain fibers in the membranes around the brain (meninges) become active. The head throbs, often on one side, and physical activity makes it worse. Nausea and sensitivity to light and noise are added. Untreated, an attack lasts several hours up to three days.

Treatment is in the hands of doctors: medication for the attack and, if attacks come often, preventive treatment. Medical guidelines also name building blocks that do not require a pill – regular endurance exercise, relaxation techniques, a steady daily routine. This is where physiotherapy comes in. It does not change the cause of migraine. But it can ease neck complaints and guide you in exercise and relaxation.

Triggers are not causes. Lack of sleep or stress do not create migraine, but where a predisposition exists, they can set off an attack. Some things are also deceptive: a craving for sweets is often already an early warning sign and not the reason. Which triggers matter for you only becomes clear through observation over a longer time.

Typical triggers of a migraine attack

Irregular sleep

Nights that are too short, but also sleeping in at the weekend, shift the usual rhythm. Some people react to this with an attack.

Stress – and the letdown afterwards

Attacks often come not in the middle of the greatest pressure, but when the tension drops, for example on the first day off.

Long gaps between meals, too little to drink

Skipped meals and too little fluid are among the commonly named triggers. Alcohol, too, can set off an attack.

Hormonal fluctuations

In some women, attacks cluster around menstruation. That is a matter for a consultation with a gynecologist or neurologist.

Tense neck

A tight neck is less often the trigger than an early sign of an attack beginning. Lasting tension can, however, put additional strain on how you feel.

Signs of migraine

Warning signs and aura

• Yawning, tiredness, irritability the day before
• Cravings or lack of appetite
• Flickering or zigzag lines in the visual field
• Tingling that travels from the hand to the face
• Aura builds up over minutes and passes within an hour

The attack

• Throbbing, pulsating pain, moderate to severe
• Often on one side, and the side can change
• Nausea, sometimes vomiting
• Light, noise and smells are bothersome
• Withdrawing into the dark and quiet

For comparison: tension-type headache

• Dull pressure on both sides of the head
• No vomiting, hardly any sensitivity to light
• A walk tends to do you good

When you must not wait

Even if you have known your migraine for a long time, you should take unfamiliar headaches seriously. Some signs are an emergency; the others belong in a doctor’s office without long hesitation. Physiotherapy only begins once they have been clarified by a doctor.

Headache that reaches its full force within seconds (thunderclap headache): call the emergency number 112.
Sudden paralysis, speech disturbance, loss of vision, double vision or confusion – even if you know an aura but this one runs differently: call the emergency number 112.
Fever, a stiff neck and a severe feeling of illness together with headache, as well as a first seizure: call the emergency number 112.
An aura that occurs for the first time or lasts longer than an hour: see a doctor the same day.
New or changed headache after a head injury, in pregnancy and the postpartum period, with cancer, weakened immune defenses or blood-thinning medication.
Headache that begins for the first time after the age of 50, steadily increases, is triggered by coughing or exertion, or comes with visual disturbances and pain when chewing.

What physiotherapy can contribute for migraine

Treatment takes place between attacks, as a complement to medical therapy and according to what is on your prescription from your doctor (Heilmittelverordnung). That attacks become less frequent as a result cannot be promised. But many people find it helps to have something in their own hands.

Physiotherapy exercises (Krankengymnastik)

We guide you through an endurance program that you increase slowly, and we show you breathing and relaxation exercises. Exercises for the neck and shoulder girdle are added. Regular, moderate exertion is among the recommended measures for preventing migraine.

Manual therapy

If joints of the cervical spine are restricted or painful, we treat them with gentle mobilizations. This targets the neck pain that accompanies the migraine – not the migraine itself.

Classical massage

Massage of the neck and shoulders can lower muscle tension and is usually well tolerated in attack-free phases. Tell us if firm pressure or scents are unpleasant, and we will change that.

Heat and cold

With tight muscles, heat on the neck and shoulders prepares the treatment. Around an attack, however, many people find coolness on the forehead or temples more pleasant. We go by what does you good.

From the prescription to the final session

1
First conversation with your headache history
We ask about frequency, course, triggers and previous medical treatment. Then we examine the neck, shoulders and posture. That is why the first appointment is scheduled for longer.
2
Agreeing on priorities
We discuss what will be worked on: neck complaints, relaxation, endurance. On days with an attack, treatment rarely makes sense; rest and your medication then take priority.
3
Treatment and guidance
The appointments combine treatment of the neck with exercises to continue on your own. The endurance program deliberately starts low, because unaccustomedly hard exertion can itself set off an attack.
4
Review together
At the end of the series, we look at the headache diary with you. What has changed in the neck, on attack days or in medication needs is also useful information for your doctor’s office.

Recognizing triggers, finding a rhythm

With migraine, regularity counts. The following steps do not replace medication; they form the foundation on which any prevention builds.

Keep a headache diary

Enter every headache day: intensity, duration, accompanying signs, medication taken, possible triggers. Only when a connection shows up several times is a change worthwhile. Strictly avoiding many things is rarely necessary.

Keep sleep and meals in rhythm

Go to bed at similar times and do not get up much later than usual on weekends. Eat regularly and spread your drinking over the day.

Make relaxation a habit

Methods such as progressive muscle relaxation only take effect once you practice regularly. Set a fixed time of day for it, especially on good days too.

When the attack is here

A quiet, darkened room and coolness on the forehead do many people good. Take medication according to your doctor’s plan. If you need it on many days a month, bring it up: frequent use can itself sustain headache.

Directions and first appointment in Cologne-Worringen

You will find us at Hackhauser Weg 61 in Cologne-Worringen, the northernmost district of Cologne, close to the Rhine. From the bus stop “Worringen Hackhauser Weg” it is a few minutes on foot. If you come by car, take the A57 to the exit Köln-Worringen and park directly in front of the practice.

Bring your prescription and your insurance card to the first appointment. Also helpful are your headache diary, a list of your medications and findings from the neurology practice. Wear comfortable clothing in which the neck and shoulders can be examined easily.

You can get an appointment by phone or via the form on this website. We hold the conversation in German, English or Spanish. Depending on the prescribed therapy, an appointment is usually scheduled for 20 to 60 minutes.

Opening hours: Mon–Tue 7:00–18:00, Wed 7:00–18:20, Thu 8:00–19:30, Fri 8:00–14:00

Frequently asked questions about migraine and physiotherapy

Can physiotherapy cure migraine?

No. Migraine is a neurological condition with a hereditary predisposition and cannot be treated away. Physiotherapy accompanies: it eases neck complaints, teaches relaxation and supports endurance training. Whether attacks become less frequent or milder as a result differs from person to person. Drug treatment remains in the hands of doctors.

Should I come for treatment during a migraine attack?

Usually that does not make sense. During an attack, most people tolerate neither touch nor light nor movement; then rest and the medication recommended by your doctor come first. Treatment takes place in the phases in between.

Does my migraine come from the neck?

As a rule, no. Neck pain is common in migraine, but is mostly regarded as part of the attack or a warning sign of it. Even so, treatment of a permanently tense neck is often experienced as relieving. Headache that actually originates in the cervical spine is a separate form with a different picture.

May I exercise with migraine?

Yes, outside of attacks regular, moderate endurance exercise is expressly recommended. Very intense or unaccustomed exertion can trigger an attack in some people. So increase slowly, warm up, and eat and drink enough beforehand. During an attack, rest is the better choice.

Does health insurance cover physiotherapy for migraine?

If physiotherapy has been prescribed by a doctor, yes: the practice bills statutory and private insurers alike. If you have statutory health insurance, you bear the usual statutory co-payment unless you are exempt. With private health insurance, it is worth asking before treatment begins which services are reimbursed.

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0221 - 782571