Cervicogenic headache? How physio can help when your headache is a pain in the neck!

Updated: Apr 26

by Laura Oxley

There are many different types of headache, tension-type, migraine, cluster to name a few. Chronic headaches can have serious impact on both quality of life, affecting our performance at school, or at work, and our ability to continue enjoying our hobbles. Headaches can also impair the quality of our sleep, making it doubly difficult to perform to the best of our ability during the day. They can be difficult to predict and more difficult to avoid, and we resort to a handful of treatments like painkillers, rest, staying hydrated, and applying hot or cold packs when they strike to try to relieve the symptoms.

But is this all we can do? That all depends on understanding the type of headache you have.

Many people who know me know that I have a particular interest in treating headaches. In fact, my Masters thesis was about assessing headaches safely and effectively!

Can physiotherapy help treat headaches?

You may think "Physio can't help headaches!", a view held by many Doctors too. But this misconception is why many people suffering from perfectly treatable headaches end up relying on painkillers when this doesn't need to be the case.

The truth is that there is a group of headaches, called cervicogenic headaches, that physiotherapy is very effective at treating. Cervicogenic simply means "originating from the cervical spine". These headaches are caused by structures in the neck, such as the muscles, discs, joints and ligaments, referring pain to the head, where it is felt as a headache. This is because the nerves that supply these structures also supply the skin of the head. So if you have pulled a neck muscle from lifting something, or are suffering from neck tension due to stress you may find the pain is felt over the head as well as (or instead of) the neck. Prolonged poor posture causing the muscles at the base of the head and around the neck to get overworked or the joints in the neck to get compressed can do the same.

Who gets neck, or cervicogenic, headaches?

Although we are not sure exactly how many headaches are actually caused by neck problems (estimates range from 2.2 to 18%), cervicogenic headache is a common enough condition to be recognised by the International Headache Society in their headache classification. The headaches can last anywhere from an hour to weeks at a time, and tend to affect men and women broadly equally.

How can a physiotherapist tell if my headache is really a neck, or cervicogenic, headache?

Physiotherapists will ask particular screening questions to help us answer this as how the head pain behaves helps them tell these neck headaches apart from other causes of headache.

For example whether:

  • your headache affects the back and top of your head, or your is around/behind your eyes

  • your headache is preceded by or accompanied by neck pain

  • you struggle to move your neck freely

  • neck movements or sustained postures provoke your headache

  • your headache tends to affect one side only

  • your neck is painful to touch

  • the muscles of your neck feel tight?

These are all symptoms suggesting that the neck is contributing to, or causing, your headache! There are also physical tests which can be used to examine the structures of the neck to see whether they influence or bring on your headache.

How will a physiotherapist treat my headache?

To ensure that your headache really is coming from your neck, physiotherapists use some key clinical tests in cervicogenic headache assessment, for example assessing whether the upper cervical joints are stiff, the muscles sitting under the skull are tight or the postural muscles of the head and neck are weak. Whilst positive tests help to confirm the diagnosis, they also give useful information as to which specific treatments would be most beneficial to you. The aim of physiotherapy is to identify and treat the underlying cause of the pain, but if it's not clear we will recommend what to do instead, referring you to your Doctor if necessary.

Treatment may include:

  • manual therapy to settle painful joints, restore movement in the neck and address any soft tissue tightness

  • neck and upper back strengthening and stretching exercises

  • advice about posture, movement and lifestyle habits

  • acupuncture for pain relief and relaxation

How can I treat my own neck headache?

There are a few simple self-help tips that you can do to treat your headache yourself: get your neck moving with regular stretches and avoid sitting for extended periods without a break...oh, and make sure your glasses prescription is up to date so that you are not craning your neck when you read or use a computer. Keep a headache diary so you can track what your individual triggers are, and make changes to reduce their impact.

What are your next steps?

If you think that your headache might be coming from your neck, why don't you try some of the advice in this blog and read our self-help page on headaches, neck and shoulder pain, to see if you can improve things yourself? If you are suffering from a cervicogenic headache, then you should see some improvement. You can also try the exercises I demonstrate in this vlog about tension headaches that I recorded during the Corona virus lockdown.

If you are still having difficulty or would like some advice tailored to you, book an appointment at Omnia for expert assessment and treatment! Generally the quicker you seek treatment, the easier it is to resolve and the sooner you'll be back in control. Call us or book online using our online booking system.

Good luck and let me know your thoughts in the comments!



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