Headache Clinic

 

Headaches, Migraines and pain in the neck?

 

 

 

Headaches and migraines can be extremely disruptive to everyday life, as any headache sufferer or their colleagues and family members will tell you.

Types of headaches and referred pain

 

Many headache sufferers see their GP or neurologist and have numerous medical investigations that detect no abnormalities.

 

This can be both relieving and frustrating. They often then rely heavily on medications, which only mask the headache symptoms instead of solving them. There are over 300 types of headaches classified by the International Headache Society. Many of these headaches (including migraines, cluster headaches, tension headaches, cervicogenic headaches etc) have very similar symptoms.

 

 

Cervicogenic headaches and referred pain

 

Pain that is felt in the head or face that is referred from structures in the neck is called a Cervicogenic headache. The nerves from joints and soft tissues of the neck link directly with the part of the brain associated with headaches.

 

This means that you may perceive the pain to be coming from your head, but in actual fact it is coming from your neck. This is similar to lumbar or lower back pain that refers down a leg (sciatica).

 

Cervicogenic headaches are very easy to treat with quick and effective results, but unfortunately many GPs and the general public do not realise how effective physiotherapy can be in alleviating headaches and migraines.

 

 

Symptoms cervicogenic headaches can include

 

• Dull ache which can be constant
• Sharp stabbing pain
• Pain radiating to the temples, eyes or eyebrows
• Pain/tenderness to the base of the head
• Pain that worsens throughout the day or with neck movement
• Nausea and sensitivity to light
• Pain co-inciding with the menstrual cycle in females
• Pain that persists after your doctor has checked for other causes

 

Causes of cervicogenic headaches fall into two main categories:

Traumatic

 

• Whiplash/ motor vehicle accident
• Falls onto the neck or shoulder
• Direct compression or blow onto the top of the head

 

Atraumatic

 

• Poor posture (e.g. sleeping position or inappropriate pillows, working position or poor ergonomic set up of a workstation)
• Repetitive or sustained activities resulting in unbalanced tight muscles (e.g. cycling, shooting, holding your phone to your ear with your shoulder, carrying heavy bags on one shoulder)
• Stress (resulting in increased muscle tension through the neck, shoulders and upper back)
• Age and degenerative conditions (e.g. Osteoarthritis, disc degeneration)

Treatment

 

What to expect with physiotherapy

 

The aims of physiotherapy are to identify the source of the pain and treat it so that we can alleviate your pain/symptoms.

We also want to identify any underlying causes or influencing factors so that we can stop the pain from coming back

 

Physiotherapy assessment would involve

 

• Taking a detailed history, analysis of your posture and vertebral alignment, and a thorough physical examination of your neck to determine if any structures in your neck may be a source of your pain.
• Temporary reproduction AND lessening of your pain/headache would confirm that structures in your neck are a source of the pain that is referring into your head
• If no relevant disorders in your neck or upper back can be found then physiotherapy treatment would not be appropriate for you, and you would be referred back to your GP or neurologist

 

Physiotherapy treatment would potentially involve

 

• Direct treatment to the structures in your neck that have been identified as being sources of your referred pain (passive mobilisation to the vertebrae or joints, loosening of any tight muscles, and possibly acupuncture. It would NOT involve “cracking“ or manipulation of the neck)

 

• Identifying and addressing any influencing factors to stop the problem re-occurring (posture correction or re-alignment, ergonomic assessment and advice, specific strengthening or stretching exercises to improve muscle balance and control)

 

Physiotherapy treatment for cervicogenic headaches and migraines is available with Julie Gear at the City clinic.

 

 

Julie has had specific training in the treatment of headaches and migraines.

See these websites for more information:

 

 

www.yourheadachesolutions.co.uk

www.headachesandmigraine.com