WHAT IS A CERVOCOGENIC HEADACHE
There are many causes of headaches – from migraine to tension headaches to those which are caused by irritation of the upper neck. Just as nerves in the lower back radiate into the legs and the nerves of the lower neck radiate into the arms, nerves in the upper neck, radiate into the head and brain stem referring pain in a similar fashion leading to headaches.
It is this component of headaches that is best managed by Physiotherapy with a specialised assessment and focused treatment.
Cervicogenic headaches are typically caused by sustained postures, like sitting at computer or driving for long periods, holding your head in extremes of rotation or repeated heavy lifting. These headaches usually start as neck stiffness or pain and then progress to headaches. They can also be linked to previous injury, such as a motor vehicle accident, heavy or sustained lifting, sustained reaching overhead or in front such as operating machines or from degenerative changes that occur with age and result in stiffness of the joints of your upper cervical spine.
KEY SIGNS & SYMPTOMS
There are some key features of cervicogenic headaches which help us determine a link to the movement in the neck:
• The headache is generally located in the occiput, parietal, temporal or retro orbital areas (the back, sides, front and/or behind the eyes) and typically effect one side but this depends on the activity that brings the headache on and can vary between sides and can also be on both sides with activity which is symmetrical.
•Headaches often worsen through the day with persistent loading but can be present on waking if related to sleeping position.
•The presence of neck pain – headaches are most commonly preceded by neck pain or stiffness.
•Reduced movement of your neck- stiffness in the lower neck with normal overall movement can mean the top of the neck is doing more than its fair share of the movement and can indicate an instability in the upper neck leading to headaches.
•Exacerbation of headache by movements or postures of the neck •Reproduction of headache by pressure to muscles or joints of the cervical spine.
This is not an exhaustive list but if you can identify any or all these features it is likely that you are experiencing a cervicogenic headache and you should seek the professional guidance of a physiotherapist if you would like it fixed.
While neck pain and stiffness is the most common cause of headaches, unfortunately there are other possible causes and your physiotherapist will be able to determine the presence of cervicogenic headache or will refer you to the appropriate professional for further investigation as necessary
PHYSIOTHERAPY TREATMENT FOR CERVICOGENIC HEADACHE
To effectively treat your headache or neck pain the most important thing to do is a thorough assessment. This is how your physiotherapist will find which joints are stiff, which muscles are tight, how this effects your movement and pain, how sensitive everything is and the best way to get you comfortable, fast.
Often painful things like headaches can be sensitive or irritable. How sensitive your condition is and how it responds to treatment needs to be determined in the first session. Generally, getting pain under control is the major goal with lighter techniques having a lower risk of irritating the condition. After dealing with the painful aspects of the condition the focus then moves to clearing the underlying issues of mobility and strength where we can get joints moving and load them up with a much lower risk of flare ups and improved tolerance of activity.
We have many treatment techniques at our disposal to manage cervical headaches including:
• Trigger point release
• Massage
• Joint mobilisation
• Muscle energy techniques
• Advice and education regarding posture e.g. workplace set up or head rest position when driving
• Exercises for neck stabilisers to improve the postural control of the neck
• Progressive strengthening exercises to address underlying muscle weakness contributing to your condition and the development of strength to tolerate any activity.
What we don’t advocate is the use of cervical manipulation. These are high velocity techniques that crack the joints. This increases the risk of injury, particularly to the vertebral artery that forms part of the supply to the brain. Damage to this artery can lead to stroke and death, unnecessarily when other techniques will achieve the same result without the risk.
If you are suffering with headaches or neck pain, speak to one of our Physiotherapists now and see how our treatment plans can help you to be pain free! [Book Now]
