Cervicogenic headaches are ones described as hemicranial (half the head) that are triggered from a structure in the neck such as; a muscle, joint, fascia, etc.
These types of headaches are relatively rare in the general population (between 0.4 – 2.5%) however for those with chronic headaches it can be previlant in 20%.
- Altered neck posture
- Restricted neck movements
- Head pain triggered by neck movements; especially rotation and extension (tilting back)
- Trigger point pain in the neck
- Tenderness over the shoulders and neck
The symptoms in the neck and shoulders cause the neck pain due to the close proximity of the spinal nerves from the neck and the cranial nerves supplying the face. This functional convergence means that bilateral pain reference can happen, i.e. pain can be felt in the head or neck which is actually caused by the other.
Treatment for cervicogenic headaches should be multifacted i.e using lots of different methods such as simple medication such as non steroidal anti-inflammatory drugs (NSAIDs) which are found in drugs such as nurofen, but you should see your pharmacist/Dr for more advice on this.
As osteopaths we use and focus on manual and manipulative techniques to treat cervicogenic headaches. A study comparing an exercise program with manipulative therapy for cervicogenic headache reported substantial and sustained reductions of headache frequency and intensity that were similar in both treatment groups but with a showed that even better benefits could be achieved if the treatments were combined.
Another study showed that to reduce headache in the long term a well structured excercise and stretch routine helped significantly.
Osteopathic manipulative techniques such as craniosacral, strain-counter strain, and muscle energy techniques are particularly well suited for the management of cervicogenic headache. Physical treatment modalities are generally better tolerated when initiated with gentle muscle stretching and manual cervical traction. Therapy can be slowly advanced as tolerated to include strengthening and aerobic conditioning.