30 Nov 2017

Is it true that my headache could be coming from my neck?

As Physio’s we often have patients complaining of neck issues such as stiffness or pain which they believe is accompanied by some sort of ache or tension around their head or face…. So is it true that some types of headaches are actually caused by some dysfunction in the neck?
It seems to be more common knowledge now that yes your neck can be the source of your headache, so in this blog we’ll explore neck related headaches and how likely it is that your headache is one of these!
We’ll also give you some tips for treatment and some things you can try at home to help ease your pain!
Remember if you’re concerned about your pain or have experienced your pain for a few consecutive days make sure you consult your Physio or GP!
 
 
 
 
What is it?
Cervicogenic headache is a syndrome characterised by pain around the head or face that is referred from a source in the neck. Often this pain is referred from the soft tissue or bony structures.
The prevalence of this type of headache in the general population is only around 2-4%. They are most common around the age of 40 and are 4 times more likely in females than males. They can also affect quality of life to the same extent as migraines! The most common factors related to these headaches are mental stress and poor neck position (posture, weak or tight muscles).
 
The mechanism of this pain is thought to arise from a crossover of information from the nerves supplying the neck and those that supply the head and face. This occurs with a convergence between the sensory fibres from the upper cervical nerve roots and trigeminal nerve fibres.  This basically means that although the source of pain is a joint, muscle or ligament in the neck, your body is PERCEIVING the pain in the head or face!

 
How do I know if my headache is coming from an issue in my neck?

The features of cervicogenic headaches can be similar to that of other headache disorders such as tension type or migraine. So how do we determine if the source of pain is from the neck?
The following criteria are more likely associated with cervicogenic type headaches but it is important to remember that you may be suffering from more than one type of headache at any given time.
 
 
Cervicogenic headache signs/symptoms:

  • Head pain is aggravated by neck movement or poor neck postures
  • Head pain is exacerbated by external pressure over the upper cervical/occipital region
  • Reduced neck movement
  • Neck/shoulder/arm pain on the same side as the headache
  • One sided head or face pain without change of sides
  • Intermittent attacks of pain lasting hours to days
  • Moderate to severe pain intensity that is non-throbbing

 
 
 
 
Treatment
To successfully treat cervicogenic headaches your physiotherapist will perform a complete assessment to determine the source of the pain and whether there may be a secondary source.  It is relatively common to suffer these headaches along with other non-specific neck pain as well as other headache types.
Successful treatment often involves the combination of pharmacologic and physical/manual therapy. Studies support the use of therapeutic exercise along with soft tissue therapy in the short term treatment of this condition as well as good results in the long term prevention and control of headaches.
 
How can a physiotherapist help with my headaches??

  • Mobilisation and manipulation aimed at restoring the range of motion in cervical spine joints particularly in the upper joints
  • Soft tissue techniques to alleviate tight musculature or release responsive muscles
  • Dry needling
  • Targeted exercise program aimed at restoring range of motion, stretching tight musculature, improving strength
  • Pilates
  • Posture correction
  • Ergonomic assessment

 
What can I do myself to help decrease my pain?

  • Avoid prolonged positions eg sitting at work
  • Maintain good posture in standing and sitting
  • Maintain adequate strength and flexibility in the shoulder and neck region
  • Self-release upper back/neck muscles
  • Try to manage mental stress   

 
So where to from here? Do your symptoms appear similar to what we’ve talked about in this blog? Maybe your headaches are actually coming from a neck issue instead of just a chronic headache which seems to keep coming back. Instead of reaching for the pain killer next time, try Physio!

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