If you suffer from recurrent headaches that persist for weeks, months, or even years, it may be a Cervicogenic Headache. There are three common types of headaches:
- Tension
- Migraine, and;
- Cervicogenic headaches (CGH)
Cerviogenic headaches arise from irritation of the upper cervical (neck) joints.
CGH's typically start as neck pain and spread as a mild-moderate headache, usually on one side of the head or face, and may refer into, or around the eye on the same side. These headaches are typically accompanied by stiff and restricted neck movements, and sometimes diffuse shoulder and arm pain on the same side. About one-third of people with CGH's report some light-headedness, unsteadiness, and/or visual disturbances.
The time for CGH's to resolve varies from person to person but typically you will have relief within 2-6 weeks from beginning your physiotherapy treatment. Some people take longer to recover, and this will depend on the nature and severity of your neck disorder.
Essential Anatomy
To better understand CGH's, it is essential to understand some basic human anatomy. We have seven vertebrae in our cervical spine, each with a vital role to play. However, the top three vertebrae are where we get most of our neck movement. If there is irritation to the facet joints (sides of vertebrae) or nerves in the top three vertebrae, they can refer pain to one side of the head and into the eye.
We also have many muscles that support our upper back, neck, and shoulders. The primary postural muscles of the neck are the Deep Neck Flexors; these muscles are often weak in those with CGH's. Our larger muscle groups that help assist with our neck and chest movements are our “prime movers”. These are the Trapezius (upper fibres) and Levator Scapula in the neck, and the Trapezius (middle and lower fibres) in the upper back. In CGH's, we often see over-activation and increased tightness of these larger muscle groups.
What causes Cervicogenic Headaches?
The leading cause of CGH's is excessive strain caused by poor working postures, such as prolonged sitting and desk work. This is particularly so if the postures or activity is one-sided. These postures can irritate the upper joints of the neck, causing stiffness and uneven loading, which ca cause a headache. These joints can also be injured by trauma, such as a sporting or recreation injury or motor vehicle accident. In our late middle-aged to older-aged groups, osteoarthritis is likely to present in the upper cervical joints, and this is another common cause of Cervicogenic Headaches.
Physiotherapy Treatment
In all cases of CGH's, causative factors need to be identified and addressed. These include:
- Environmental factors (e.g. Poor desk set-up)
- Behavioural factors (e.g. Sitting all day at work without breaks, stress)
- Lack of general exercise and movement
To address these issues, have your desk set up correctly (we can come and do this for you), get up and regularly move throughout the day, try to sleep a full 7-8 hours each night, and most importantly, exercise! This will help relieve stress and reset your body.
In addition, problems with flexibility, control, and strength of the neck and shoulders are significant causes of CGH's.
Mobility:
Common flexibility issues include:
- A forward head posture (eg. Poking chin forward)
- Stiff and rounded thoracic spine
- Stiff and restricted cervical movement
- Tight upper trapezius and suboccipital muscles of the neck and shoulders
- Tight sternocleidomastoid muscles that pull on the front of the neck
- Stiff neck joints on the side of the headache. This can sometimes cause the second vertebrae to sit twisted.
To address these, we use manual therapy and soft tissue massage, as well as teaching our clients to stretch and perform self-treatment with tools, such as Bakballs.
Control:
Control refers to the ability of an individual to monitor and adjust their body position and posture through a variety of different settings. When it comes to CGH's, control of the cervical and thoracic spines is very important. Your physiotherapist will assess your control and posture to determine if this a contributing factor to the problem.
In many cases, control and postural exercises have a beneficial therapeutic effect as they introduce the body to a safe and pain-free range of motion that the person may not have been aware of.
Strength:
Strength is very important when it comes to the rehabilitation of the neck and treating CGH's. Strong and resilient tissues promote optimal function and are less likely to become tight or weak. Therefore, it less likely these structures will send the brain pain signals when under pressure from poor postures or stress-related tension.
Summary
In summary, if you are suffering from Cervicogenic Headaches remember:
- CGH's are common and easy to fix with physiotherapy treatment
- Changes to your work stations and sitting behaviours are very effective at reducing headaches and neck pain
- Flexibility, control, and strength deficits need to be identified and addressed
- General exercise is an easy way to treat and prevent CGH's!
If you are experiencing recurrent headaches, book in with your physiotherapist for a thorough assessment using this link – BOOK YOUR FREE INITIAL ASSESSMENT. Once the cause has been identified the road to recovery can begin.
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