Cervicogenic headaches are headaches that originate from the cervical spine (neck). Patients with this condition usually experience a gradual onset of head and neck pain associated with a sustained posture or causative movement. Pain is typically experienced on one side of the head, usually at the back of the head, but it may radiate over the temple or behind the eye and spread to both sides of the head.
Most patients will experience tenderness upon palpation of their upper neck joints and tenderness through the surrounding muscles.
Cervicogenic headaches are often accompanied by stiffness and pain in their neck, particularly in the upper three vertebrae. Some patients may also experience associated pain, pins and needles or numbness radiating into their upper back, shoulders or arms.
There are many factors that may cause patients to experience cervicogenic headaches. Your physiotherapist will thoroughly assess and help you to address these factors. Such factors may include:
• Poor sitting posture, excess slouching and rounded shoulders.
• Inappropriate desk set up
• Poor lifting technique or poor workplace ergonomics
• Previous history of whiplash injury
• Poor sleeping posture or inappropriate mattress/pillow
• Muscle imbalances
• Muscle weakness
• Muscle tightness
• Neck and upper back stiffness
• Increase in stress
In most cases a thorough clinical history and physical examination by your physiotherapist will be sufficient to diagnose cervicogenic headaches. In some cases your physiotherapist or GP may request an MRI, X-Ray or CT scan to confirm the diagnosis. Specialists and surgeons may also request a diagnostic nerve or joint block in some cases, where pain is chronic and does not respond to conservative.
Treatment for cervicogenic headache is multi-faceted and will depend on each individual’s contributing factors. Treatments often will include:
• Postural re-education including exercises, taping and/or bracing
• Clinical pilates
• Exercises to strengthen postural muscles, improve flexibility and strengthen the deep cervical neck flexors
• Soft tissue work and trigger point therapy
• Joint mobilisation or manipulation
• Dry needling
• Ergonomic advice
• Recommendation of appropriate pillow and sleeping posture
• Advice regarding analgesia and referral to pharmacist or GP where appropriate
Most patients who experience cervicogenic headache will make a full recovery with appropriate physiotherapy intervention. Rate of recovery may vary depending on severity of pain, how long it has been happening, and compliance to treatment. In the case of acute cervicogenic headache you should experience relief in symptoms within a few days, although pain may take several weeks to resolve completely. More chronic pain will generally take longer to resolve and may take weeks to months.
In the event that despite appropriate physiotherapy management symptoms remain persistent, your physiotherapist may suggest referral to a specialist who can offer other treatments including injections and in some cases, surgery.
Feel free to contact our clinics to help relieve some of your neck pain.
Blog by Claire De Vos.