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Cervicogenic headache is a term to indicate that the primary contributing structural source of the headache is the cervical spine (neck). It can be from chronic tension, acute whiplash injury, intervertebral disc (the cartilage between vertebrae) disease, progressive joint arthritis in the spine (mainly upper three levels of cervical spine), front and back neck muscles, upper shoulder muscles ( upper trapezius) or upper three cervical nerves. The neck can be a severely debilitating source of headaches. Cervicogenic headache is the most common persistent symptom following head trauma.
Cervicogenic headache can present in the forehead or behind, in and around the eyes. It tends to be precipitated by neck movement, sustained head postures or external pressure over the upper neck region on the symptomatic side. People with cervicogenic headache are likely to have restriction in range of motion in the neck and neck, shoulder or arm pain at the same side of the headache. If headache is on one side, it would stay at the same side. Other possible characteristics are nausea, dizziness, difficulties swallowing, moderate ? severe pain usually starting in neck, blurred vision on the symptomatic side, photophobia (avoidance of light), phonophobia (fear of voice or sound).
The joints connecting the top three levels of the cervical spine to the base of the skull handle almost 50% of the total movement of the entire neck and head region. Therefore, these joints absorb repetitive stress and strain, in addition to the weight bearing of the head. Fatigue, poor posture, injuries, disc problems, joint degeneration, muscular stress and even previous neck surgeries all can compound the wear and tear on this critical region of the spine. Development of narrowing of the spinal canal (a condition termed spinal stenosis) can also be a possible source of headaches among other symptoms.
The management of cervicogenic headache is starting by a thorough assessment to identify the underlying causes. Your physiotherapist is one of the best professionals to see and to receive treatment, not just for symptoms relief, but also for long term prevention and management. They will assist you in managing chronic pain problems or acute flare-ups of headache pain initiating from the neck area. Chiropractor and acupuncture are also excellent therapeutic options to assist in symptom management. Everyone has to remember that symptom relief is only a short term benefit. Active commitment to the management regime is critical for the long term benefit.
Common physiotherapy treatment methods for cervicogenic headache are mobilization or manipulation of upper three cervical joints, mobilizations of neural tissue, treatment of tight muscles (for example by massage), postural correction, training of deep neck muscle and shoulder muscle stabilization, traction, Physiotherapy in Brisbane, Physiotherapist in Brisbane, Physiotherapists in Brisbane, Massage in Brisbane, Back pain, Physiotherapy in Brisbane, electrotherapy (such as TENS machine and interferential current), and ergonomic education (such as work environment). With electrotherapy, they may be used in an effort to reduce pain. However, they are not directed at the primary cause and therefore the relief is only temporary.
In summary, in order to have control over cervicogenic headache, triggering activities need to be recognized. Early pain-building warning signs must be learned and counter-acted. Posture and exercise need to be attended to, while stress must be diffused out of the body. Medications are very effective for cervicogenic headaches, to the degree that they can be tolerated while you go on living a functional life. Certainly in severe pain crises, the goal is to maximally relieve pain as quickly as possible. The balance is to work toward minimizing the number of crises you have to experience, whether through corrective treatment or proactive effective management.
Terry Kung
Spring Hill Physiotherapy