Headaches are painful, annoying, and can feel like a constant pounding in your head, making concentrating virtually impossible. They are also an incredibly common ailment - three quarters of adults between 18-65 year olds have had a headache in the last year. But did you know that often when we experience headaches, the pain is originating from dysfunctions in the upper part of the neck?
These neck-based headaches are also known as cervicogenic (cervico= neck, genic=arising from) headaches and they’re caused by dysfunctions in the muscle joints or nerves in the upper cervical spine. The majority of cervicogenic headaches develop on one side of your head, starting from the back of the head and neck and radiating towards the front, causing a lot of pain.
The main symptoms of cervicogenic headaches include:
- Pain on one side of your head or face
- Pain in the neck, shoulder or arm on one side
- Reduced range of movement in your neck
- Headache pain which is worsened by certain neck movements and positions
- Up to 50% of patients will have temporomandibular joint (jaw) dysfunction as well
Other symptoms of neck headaches that are less common include sensitivity to light and noise, nausea and blurred vision.
What are the other main causes of headaches?
There are many different causes of headaches and sometimes they can be overlapping. It’s not always clear cut. The International Headache society Splits headaches into two distinct categories:
- Primary headaches e.g. tension headaches and migraines
- Secondary headaches caused by disease or medical conditions. E.g. inflammatory conditions or injuries to your head or neck
Cervicogenic headaches are part of the secondary type of headache but can also overlap with other primary headache conditions.
What causes Cervicogenic headaches?
The cause of cervicogenic headaches come from the upper part of your neck that then can refer pain to the head. Cervicogenic headaches are often due to problems with the vertebra at the very top of the spine specifically around the second and third cervical vertebra. These neck problems can have many different causes, but we can break these causes into traumatic, and atraumatic causes.
Traumatic causes are most often from a whiplash-type injury, (link) such as a vehicle accident or a sports injury where the vertebra experiences sharp trauma. Atraumatic causes can include diseases such as arthritis in your neck, or even just poor sitting posture which, over time, can cause dysfunctions in the upper part of your neck.
How does Physiotherapy help with Cervicogenic Headaches?
Physiotherapists are the leaders when it comes to treating cervicogenic headaches. We can deal with the pain at the source, get rid of your headaches, and work on making sure they don’t come back.
First, we’ll take a detailed subjective and physical assessment of your condition. This will involve measuring your neck range of motion, assessing your level of symptoms, and looking closely at the upper three cervical joints of your neck. Your physiotherapist will apply gentle selective pressures to the neck joints which will most likely reduce neck and headache symptoms on the spot. From here we can determine where to go next with treatment.
Treatment is in two distinct parts. The first focuses on reducing your symptoms. We’ll do this by:
- Using manual therapy techniques as described above with close monitoring of your head and neck symptoms
- Analgesic medication, (in conjunction with your G.P.)
- Neck stretches to relieve tight musculature around the neck
- Therapeutic exercises to relieve the headache
The second stage involves muscle strengthening and endurance training to relieve pressure on the upper part of the cervical spine. This will reduce the chances of recurrent neck headaches in the future. The key exercises are:
- Specific postural endurance exercises that train the deep neck flexors. The deep neck flexors are the muscles that are vital to relieve pressure on the upper part of the cervical spine helping create long lasting symptom relief.
- Global strengthening exercises for the neck, upper back, shoulder blades and arms
- Re-training your sitting posture position.
If headaches are stopping you from working or enjoying life, give us a call to chat to one of our friendly physiotherapists or book online above!