Do you experience regular headache? Suffer from constant headaches? Our physio Tegan Skipworth discusss cervicogenic headaches and how physiotherapy can treat them.
There are many different causes and sources of headaches, it is estimated that there are actually over 200 different causes. Headaches are broken up into two distinct categories, primary and secondary headache types.
Primary headaches are not the result of an underlying medical condition, the best example of these headaches are migraine and tension type headaches. While these headaches can cause significant pain and disability, they are not life threatening and are not linked to further pathology.
A Secondary headache is the result or symptom of an underlying pathology or condition that can activate pain sensitive nerves in the head. These headaches can be harmless or they can be linked to dangerous pathology, these more harmful signs and symptoms are called ‘red flag’ symptoms.
Physiotherapy and headaches
Physiotherapy can assist in the management of a very common secondary type headache, a cervicogenic headache. This is the result of a mechanical disorder/disruption of the upper cervical spine (upper part of the neck). Any pain producing structure of the neck can be responsible for these headaches. This can include the joint, intervertebral disc, nerve root and/or soft tissue structures.
Common presentation of a cervicogenic headache
- Loss of range of motion of the neck.
- Worsening of headache with certain cervical movement and/or with direct pressure applied to certain areas of the neck.
- One-sided headache symptoms.
- Symptoms originating at the base of the skull/upper neck.
- Possible radiation of symptoms into the head above.
- Usually associated with neck pain.
Many primary type headaches will also cause pain and symptoms in the neck, this can lead to misdiagnosed headaches and poor management approaches. A cervicogenic headache must have evidence of disorder of the upper cervical spine, not just neck related pain to be correctly diagnosed as cervicogenic.
What should I do if I think I have a cervicogenic headache?
If you are experiencing the symptoms of a cervicogenic headache, you should see a physiotherapist as soon as possible. Your physio will conduct an assessment of the head and neck to determine whether or not your headache can appropriately be managed by physiotherapy intervention.
Possible interventions could include:
- Manual therapy
- A self management plan to undertake independently
If your headache is a true cervicogenic headache, the headache symptoms will reduce as the responsible structures in your neck respond positively to treatment. Your physio may refer you back to your GP if they are not the correct person to assist in management of your symptoms.