Neck is a complex structure consist of multiple Vertebrae, ligaments holding bones together and muscles to accommodate movement. Modern lifestyle is causing shoulders to slouch resulting into stiff neck, shoulders and headaches as a common problem. Longer periods of screen time e.g. phone and laptop use, can also cause a lot of strain in the neck, shoulder and surrounding muscles. There may also be other causes like whiplash, bad posture, Arthritis or simply stress causing you discomfort. However, the most common reason for headaches is associated with your neck and shoulder. Pain that starts at the base of skull and radiates to the front of the skull along with pressure behind eyes and sometimes jaw stiffness are common symptoms of cervicogenic headaches.
A cervicogenic headache is simply another name for a headache which originates from the neck. It is one of the most common types of headache and although this type of headache can occur at any age, it is most commonly seen in patients between the ages of 20 and 60. Cervicogenic headaches are often called secondary headaches because they originate from a primary underlying neck disorder, frequently with nerve irritation. The good news is that by fixing your neck problem, your headache can be alleviated. Research has shown that upwards of 22% of all headaches seen clinically are cervicogenic. The upper part of your neck consists of cervical vertebra which support the skull, and weight of your head, as well as being responsible for movements like flexing and extending your neck (looking up and down), as well as rotating your neck by looking left and right. Any dysfunction in the vertebral joints of the upper neck can limit the range of motion or fluidity of movement and result in nerve irritation. This could include the ligaments, tendons, and muscles that attach to the vertebra or even the cartilage discs between the vertebra. Commonly a history of neck injury, especially whiplash, is found in people who suffer from cervicogenic headaches; although a traumatic injury is not necessary to cause damage to the neck structures. Repetitive or sustained poor postures can over time, also ‘damage’ these structures. The pain associated with this condition is an example of referred pain. This is where pain arises from a different source, in this case the neck. This occurs because the nerves that supply the upper neck also supply the skin overlying the head, forehead, jaw line, back of the eyes and ears. As a result, pain arising from structures of the upper neck or irritation of the nerves in this region, may refer pain to any of these regions, thereby causing a cervicogenic headache. Your headache can also be referred pain from surrounding muscles of your upper neck, the front and back of your neck. These muscles commonly refer pain to the temples and side of the head. Muscle spasm, weak or overloaded muscles from sustained poor postures can result in them developing trigger points and referring pain to the head and face.
Cervicogenic headache typically occurs due to activities placing excessive stress on the upper joints of the neck. This may occur traumatically due to a specific incident (eg. whiplash or heavy lifting) or more commonly, due to repetitive or prolonged activities such as prolonged slouching, poor posture, lifting or carrying (especially in poor posture), excessive bending or twisting of the neck, working at a computer or activities using the arms in front of the body (eg. housework).
It is important to diagnose this headache correctly and differentiate it from a migraine as treatment plans are different for different headaches.
A thorough examination from an experienced physiotherapist or doctor is usually sufficient to diagnose a cervicogenic headache. Unfortunately X-rays, CT scans and MRIs are not always diagnostic of a cervicogenic headache. You can suffer a cervicogenic headache with or without abnormal findings on X-rays or scans. On examination, a physical therapist may find:
Although this type of headache may respond to medication including analgesics, anti-inflammatories, stronger opioid-based medication, even nerve blocking injections – these drugs usually treat the symptoms of the headache and not the primary underlying cause. Unless the origin of the headache ie. the upper neck dysfunction, is treated and corrected, the headache will return in time. Physiotherapist in Alton treatment will focus on the soft tissue and joint restrictions in the upper neck as well as areas like the front of the neck and upper back area. It may also involve some exercises to strengthen weak muscles and stretch tight muscles.
There are some simple steps you can take to decrease neck pain or avoid recurrence.