Head & Neck

Migraine Headaches

A migraine headache is a form of vascular headache. Migraine headache is caused by vasodilatation (enlargement of blood vessels) that causes the release of chemicals from nerve fibres that coil around the large arteries of the brain. Enlargement of these blood vessels stretches the nerves that coil around them and causes the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.

Migraine attacks commonly activate the sympathetic nervous system in the body. This activation causes many of the symptoms associated with migraine attacks such as nausea, vomiting, and diarrhoea. Sympathetic activity also delays emptying of the stomach into the small intestine and thereby prevents oral medications from entering the intestine and being absorbed hence why they tend not to help with migraine type headaches.


  • Intense throbbing or pounding pain often felt in the head, forehead or back of the eye
  • Pain is one sided however in a third of cases and be bilateral
  • Nausea, vomiting and diarrhoea
  • Light and sound sensitivity; suffers often prefer dark and quiet rooms

Article on Migraine Headaches and the likely causes.

Cervicogenic Headaches

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.

Article on Cervicogenic Headaches and the likely causes.


These come in many forms and affect people in varying ways. From mild tension type headaches to intense migraines that stop people in their tracks. Cranial osteopathy can help several types of headaches but firstly, you should visit us to make sure there are no other reasons why the headaches are presenting.


  • Vary massively!
  • Can have band-like tension over the forehead or temporal area
  • Tingling or shooting pain over the scalp
  • Ocular pain
  • Visual changes/Light sensitivity

Article from NHS Direct