With over 200 types of headaches and migraines now classified, research has shown that different headache and migraine conditions may share a common disorder. So, if we can effectively learn to treat headaches by influencing that common disorder, then we may be able to have an effect across the entire range of headaches that exist. Neck pain is one disorder that is common across a number of different types of headaches and migraines.
Headaches coming from the neck have now been termed as “cervicogenic”. A study conducted by Watson and Drummond (2012) found that examining joint mobility in the upper neck reproduced headaches all patients presenting with ‘tension headache’ and in almost all (94%) of those diagnosed with migraines. Knowing this opens the possibility that in treating these common symptoms we may be able to effectively treat most, if not all, headaches that are truly cervicogenic.
Signs and Symptoms
Key features of cervicogenic headaches include:
- Experience of head or neck trauma
- History of a “trigger”, e.g., sustained neck postures, stress, poor sleeping positions
- Gradual increase in headache frequency and intensity over time
- Neck stiffness, discomfort, and pain
- Symptoms can be one sided or switch sides
- Headache is reproduced via manual techniques (e.g., joint mobilisation) and the symptoms resolve or improve if the technique is maintained
Treatment
Through pressure on deep tissue, utilising techniques such as manual therapy (“trigger point release” and joint mobilisation) and/or needling, we aim to reproduce the headache during treatment. As the technique is sustained, the sensitivity of the headache symptoms should begin to ease.
We believe this occurs through several mechanisms, such as inhibition of neurological input, biomechanical remodelling, and, perhaps, through the restoration of joint mobility.
Ideally, this is followed up by addressing the cause of your headache; if postural, managing those loads with education and advice and/or giving an appropriate home program to shift those loads, correction of sleeping postures and prescription of appropriate pillows, correction of workplace set up and so forth. Our aim is to treat the symptoms, but also to identify and correct the cause.
References
- Watson DH, Drummond PD. Head pain referral during examination of the neck in migraine and tension-type headache. Headache 2012;52:1226-1235