Headaches are one of the most common complaint affecting approximately 2/3 of the population and something almost every adult has experience at some point in time. Headaches can be caused by a number of things.
Types of headache:
1) Associated with viral illness (eg respiratory infections, sinusitis or influenza)
2) Vascular headaches (eg migraine, cluster headache)
3) Cervical headache (eg referred from joints, mucles and fascia of cervical region)
4) Tension headache or muscle contraction headache
5) Intracranial causes (eg tumor, hemorrhage, subdural hematoma- note a previous head trauma even if relatively mild should be noted as symptoms can come on some time after, meningitis)
6) Exercise-related headache (benign exertional headache, “footballer’s migraine)
7) Other causes (drugs, psychogenic, post-spinal procedure, post traumatic).
As Physiotherapists we are trained at identifying the cause of your headache. If we deem it to be a cervicogenic headache there are a number of things we can do to help relieve your symptoms. Cervicogenic headaches that are caused by abnormalities of the joints, muscle, connective tissue and nerve structures around the head and neck region.
– Most common cause referred pain caused by irritation of the upper cervical (neck) nerve roots.
– Commonly pain can referred to the head from active trigger points in sub occipital, upper trapezius, splenius capitus and cervicus and sternocleidomastoid muscles (the muscles around the base of your scull and sides of your neck).
– Steady dull ache with a gradual onset and may be present for days, weeks or even months.
– Often only affects one side of your head
– Can be Intermittent or constant, depends on mechanical factors as well how long your have had the condition
– Usually wake up with a headache that improves over the day but can also be brought as a result of occupational factors such as repetitive movements or sustained postures.
– Aggravated by neck or head movements such as repetitive jolting when traveling in car or bus
– Often associated with light headedness, dizziness and tinnitus (ringing in your ears)
– Nausea may be present but vomiting is rare
– Can complain of impaired concentration or feelings of low mood/depression
Physical Exam Findings:
– Associated neck pain or stiffness found in joints
– Poor posture ; often forward head posture with extension of the upper cervical spine and protruded chin.
– Results in shortening and increased tone through upper cervical extensors and weakness of deep flexor muscles.
What Can Physiotherapy Do to help your Headache:
– Correction of abnormalities in the joints, muscles and neural structures found on examination
– Provide advice education and exercises to correct postural issues
– Assessment of how the muscles around the neck are working and correcting non optimal strategies
– Release of tight muscles and fascia (commonly cervical extensors)
– Dry needling
– Manual therapy to improve joint movement
– Home exercise programs and postural retraining
What Should You Do If You Think You have a Cervicogenic Headache?
It is important to have the source of your headache diagnoses by a qualified General Practitioner or Physiotherapist who will be able to guide your treatment in the right direction.