Physiotherapy and headaches- cervicogenic headaches

Are your Headaches Coming from your Neck?

Most people have at least had an occasional headache and many people suffer from various types of headaches. According to the Canadian Headache Society, nearly half of adults have headaches and it is one of the most common reasons patients seek help from family physician
If you are suffering from migraines, tension type headaches, cluster headaches or any other severe or worsening headache it is first best to see your family doctor (if you haven’t already done so) who can assess you and provide you the appropriate referrals, medications and rule out serious pathology.
Once common source of headaches that is often overlooked is dysfunction in the muscles in your neck!  This type of headache is called a cervicogenic headache. Of all chronic headaches, the incidence of cervicogenic headache has been estimated to be 14-18%. This occurs when the muscles in your neck are tight and have painful trigger points (or muscles knots) that can refer pain to your head and cause headaches. Common symptoms include one sided-headaches, exacerbated by neck movement or neck postures, associated with neck pain, and the headaches are often located in the forehead, temple, around the eyes or top of head. Often, medication does not reduce the symptoms of cervicogenic headaches.
Cervicogenic headaches result from structural problems in the neck and are often due to problems with vertebrae at the top of the spine, called the cervical vertebrae, and specifically the C2-3 vertebra. These are the vertebra right under your skull.
Some people develop cervicogenic headaches because they work in jobs that involve them straining their necks, sit in poor positions for long periods of time, or strengthen muscles that lead to poor head and neck alignment. People can also develop cervicogenic headaches after an injury to the neck, such as whiplash.
Below are common muscles in the neck, their trigger points (the black X) and where the pain is typically referral to (the red dots). Dysfunction in these muscles (strain etc.) can refer pain into the head, mimicking the symptoms of a headache.

Image source – http://www.kulpphysicaltherapy.com/headache.html

Symptoms of Cervicogenic Headaches:

 Typically, people who have cervicogenic headaches experience a headache accompanied by neck pain and stiffness. Certain neck movements, positions, or sitting postures can provoke cervicogenic headaches.
In most cases, cervicogenic headaches develop on one side of the head, starting from the back of the head and neck and radiating toward the front. Other symptoms of cervicogenic headache can be:

  • a reduced range of motion in the neck
  • pain on one side of the face or head
  • pain and stiffness of the neck
  • pain around the eyes
  • pain in the neck, shoulder, or arm on one side
  • sensitivity to light and noise
  • nausea
  • blurred vision

If you think that your headaches make be coming from your neck, after speaking to your doctor, consider finding a physiotherapist who can assess and treat your neck. Physiotherapy can address muscle dysfunctions, and correct muscle patterning, which will result in a decrease in headache symptoms.
By Jennifer Harvey, Physiotherapist

References:
https://www.physio-pedia.com/Cervicogenic_Headache
http://www.kulpphysicaltherapy.com/headache.html (Image source
 

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