Headaches

What is a headache?

Headache is considered to be pain in the head which can extend from the base of the skull into the side, front or top of the head. 15-20% of all chronic and recurrent headaches are attributed to problems in the upper three joints in the neck and are known as cervicogenic headaches. Other common headache types include migraine and tension-type headaches.
Research has shown physiotherapy consisting of manual therapy and exercise to be an effective treatment of cervicogenic headaches. Our aim is to establish what type of headache you have and then implement a plan to resolve the headache and avoid a re-occurrence.

What Causes Headaches ?
Neck Joints
Neck pain is a common symptom associated with headache and is reported in 70% of all headache cases. The upper three joints in the neck can refer pain into the head and are often the cause of cervicogenic headaches.

Poor Posture
Slouched spinal postures and forward head postures are related to neck pain and headaches. This results in overstraining of the muscles and joints in the neck and hence headaches.

Weak Muscles
Deep muscles in the front of the neck have been shown to be dysfunctional in headache pain patients and neck pain patients. This can result in muscle imbalances and result in overloading of the upper neck joints.

Trauma
Neck trauma is commonly the precipitating factor in patients with cervicogenic headache. Motor vehicle accidents are the most common reported trauma and are associated with a higher risk of headaches.

Serious Pathology
Headaches can be caused by serious pathology such as brain tumours, infection and aneurysms. Our physiotherapists are well trained in recognising these patients.

How does Physiotherapy help?
Manual therapy
Research has shown that manual therapy (mobilisation and manipulation) of the upper joints in the neck to be an effective form of treatment. This restores normal movement in the joints and allows the neck to move freely.

Exercise Therapy
Re-training the deep muscles in the front of the neck and the muscles around the shoulder blade is an effective form of treatment in headache pain patients. Your physio will assess these muscles and determine if re-training is required.

Postural Advice
Correct sitting posture is essential in managing headaches, your physio will assess your posture and give advice on the correct spinal alignment.

Several of our practitioners have post graduate qualifications in Musculoskeletal Physiotherapy and have a special interest in head and neck related pain. More recently several clinicians have undertaken further postgraduate training in the assessment, treatment and management of the role of high cervical spine segmental dysfunction in benign recurring headaches.

Headache may occur from a variety of reasons that cause nociceptive cervicogenic input into the trigemino-cervical nucleus. Manual therapy has been shown to assist in the confirmation or otherwise of the cervical spine as a source of, or contributing factor to, benign recurring headaches.

Clinically we see the multi factorial nature of headache (biochemical, trigeminal, cervicogenic) and can assist in the treatment and management of many patients. The assessment techniques allow us to differentiate those patients who are suitable for treatment and those who are unsuitable via manual assessment.
The management and treatment of patients with headaches is generally more complex than other musculoskeletal conditions

What can I expect?
Our training and experience helps us to recognize the potential of cervical spine dysfunction to contribute to a wide range of headache. We are in a position to identify spinal dysfunction and believe it is vitally important to work closely with concurrent medical management. During your examination you will also be asked about your symptoms, history and the behaviour of your headaches (often more than one). Sometimes a headache diary can be useful to both the clinician and yourself in better understanding and managing your symptoms.