Cervicogenic Headaches

Headaches that originate from the neck are termed 'Cervicogenic Headaches'.  The International Headache Society accepts cervicogenic headaches as a distinct form of headache.

For the purpose of this blog they will be called them neck headaches. Neck headaches are common and affect almost half the population at one point in their lifetime. There is much overlap in the symptomatic complaints between neck, tension-type and migraine headaches. It has been reported that almost 2/3 of headache suffers have neck pain with the headache.  So, while there are some similarities in symptoms between the types of headache, assessment by a manual physiotherapist will help determine if the headaches originate from the neck.

Typical complaints of an individual with a neck headache are:

• The headache is primarily one sided or one side dominant.
• The headache will typically not shift from one side to another during the course of the headache.
• The headache can be associated with neck, shoulder or arm pain on the same side.
• The pain typically starts in the neck and spreads to the head.
• The headache is often worsened with prolonged neck postures or repetitive neck motion.
• Other symptoms that can be associated with a neck headache are nausea, visual disturbances such as blurriness and/or light sensitivity, and dizziness.

To help determine if the headache is in fact related to the neck, a manual physiotherapist will evaluate the mobility of the neck and upper back. Joint stiffness of the upper three neck joints, which is evaluated by hands-on palpation, is highly correlated with neck headaches. The neck muscles will also be evaluated for their performance and strength. These assessment findings have been found to be reliable in differentiating between the different forms of headache.

Treatment would consist of joint mobilization and/or manipulation as well as special soft tissue techniques to help restore normal mobility. Specific neck exercises to help restore normal muscle recruitment and control are taught initially. These exercises would then progress to neck strengthening. Muscle imbalances around the shoulder blades are corrected with specific stretching and strengthening exercises. Other exercises for general mobility and specific self-mobilization are taught to help patients self-manage the headache. Other more traditional physiotherapeutic modalities can also be employed to aid with decreasing the symptoms.  Education on posture and the other factors that contribute to the headache must also be addressed.

In summary, neck headaches can be effectively managed through manual physiotherapy and a home-based exercise program.