Neck-related (Cervicogenic) Headaches & Physiotherapy
Cervicogenic Headaches
Approximately 47% of the global population suffers from recurrent headaches, and 15-20% of those headaches are classified as Cervicogenic Headaches.
What Causes Cervicogenic Headaches
Cervicogenic Headaches (CGH) are headaches that arise from a dysfunction or issue within the neck joints and local muscles. The main culprits for causing these issues are muscles that attach the base of the skull to the upper neck bones (vertebrae) and all the joints between them. These joints are commonly injured with trauma (whiplash or concussion related injuries) either during a sporting or recreational event or a motor vehicle crash. In the late middle-aged to older age groups, osteoarthritis (degenerative changes) of the upper neck joints is another common cause of neck pain of these headaches.
Additionally, excessive strain caused by poor working postures (prolonged sitting, working in awkward neck postures) can irritate the upper joints of the neck and cause a headache. Essentially, muscle tightness or dysfunction of the neck can cause you to have a headache.
This headache will typically match the following criteria:
One-sided. Unless, there is an issue within the neck on both sides – then it may present on both sides, bilateral.
Neck pain and headaches are made worse by sitting (often poor posture) for long periods either at a desk working or school, or driving, and typically made worse with certain neck movements.
Often associated with neck pain
Increase in tenderness and tightness around the neck and shoulder muscles, often that will bring on your headache when squeezed or massaged.
Weakness of the deeper neck muscles
How is it diagnosed?
Diagnosing CGH’s can be tricky. Your physiotherapist can diagnose your CGH by getting a detailed history of your pain, analysing your symptoms, and eliminating other diagnoses, such as migraines, tension headaches, or very high blood pressure. We can also carry out a special test called the Flexion rotation test, which has been researched and found to be very accurate and helpful in diagnosing CGH.
How do you treat Cervicogenic Headaches?
As the most common cause of CGH is a dysfunction of the upper cervical joints and muscles, we start by finding out specifically which ones are causing your symptoms. You and your physiotherapist can work together to release the tight muscles and joints within the upper neck by manual therapy and specific exercises.Physical therapy and an ongoing exercise regimen often produce the best outcomes. Over time, our aim will be to strengthen the deep stabilizing muscles of the neck, and to improve our posture while at work or school.
References:
Page, P. (2019). CERVICOGENIC HEADACHES: AN EVIDENCE-LED APPROACH TO CLINICAL MANAGEMENT. [online] PubMed Central (PMC). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201065/
Ogince M, e. (2019). The diagnostic validity of the cervical flexion-rotation test in C1/2-related cervicogenic headache. - PubMed - NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17112768