Headaches are a very common complaint seen in our society. Unfortunately, not all headaches are alike. In fact, there are literally dozens of different types of headaches found in the available literature. One type of headache which physiotherapists commonly treat is the cervicogenic headache. A cervicogenic headache is a specific type of headache caused by a neck injury or disorder, such as whiplash, a concussion or simply poor posture.
There are 2 types of structures in the neck which can produce this headache.
1. Muscular Structures
Your head is connected to your neck and upper back by many muscles. Large muscles such as the splenius and the trapezius attach to the base of the skull. Beneath the splenius and trapezius are smaller muscles, called the rectus capitis posterior and scalenes that also help support and move the head. When the head is in a more forward position, it pulls on the muscles in the neck and creates unnatural tension. With a cervicogenic headache, pain is felt in the head from a source in the neck. Continuous tension in the neck muscles can lead to pain commonly associated with a cervicogenic headache.
2. Articular Structures
The cervical spine is made up of 7 vertebrae, stacked upon each other. C1-7. Each vertebrae articulate with each other via the facet joints in the rear and the intervertebral disc in the front. It is well documented that the upper 3 cervical vertebrae and with their associated facet joints can be the source of headache. It is thought that poor postures and trauma can produce irritation and stiffness in the facet joints, resulting in referred pain to various parts of the head. Cervicogenic headache is an example of referred pain, which is pain felt in a part of the body other than its true source. Cervicogenic headaches often occur on one side of the head, and typically cause pain around the eyes, the forehead, and the temples.
A physiotherapist can help ease headaches by alleviating any excessive muscle tension, educating you on healthy posture, advice on work modification, restoring mobility to stiff cervical facet joints, re-strengthening the supporting muscles of your neck and providing you with a tailored neck flexibility program of stretches. Some of the treatments may include massage, cervical joint mobilisation, dry needling, traction and exercise using biofeedback.
By Oscar Yildirim – Physiotherapist