Headaches

There are lots of different types of headaches, In 2014, the International Headache Society (IHS) classified some headaches, such as migraine, tension type headache, cluster headache and exertional headaches, as ‘primary headaches’. The most common types of headaches are Tension and Cervicogenic (neck) headaches.  Cervicogenic (neck related) headaches are caused by tight muscles and stiffness in the joints of the top 4 joints in the neck (cervical spine).

Symptoms of Cervicogenic (Neck) Headaches

Cervicogenic (neck related) headaches are primarily caused by tight muscles and stiffness in the joints of the top 4 joints in the neck (cervical spine).  This is often associated with tightness in the muscles around the neck.  The symptoms of Cervicogenic headaches include:

  • Cervicogenic headache is usually felt on one side of the head.

  • Unlike migraine, neck headaches do not swap sides.

  • Cervicogenic headache is of mild-to-moderate intensity and is typically accompanied by neck pain.

  • Most typically, the pain begins in the neck and then spreads to a headache.

  • About one-third of people with cervicogenic headache also report some light-headedness, unsteadiness or visual disturbance

Symptoms of Tension Headaches

 

Tension headaches can radiate from the lower back of the head, the neck, or the eyes and will often affect both sides of the head.  Our patients often describe a constant pressure, like the head is being squeesed.​  To be diagnosed with a tension headache the following criteria applies:

  1. A duration between 30-minutes and 7-days

  2. At least two of the following are true:

    • Affects both sides of the head​

    • Pressing or tightening (non-pulsating) quality

    • Mild or moderate intensity

    • Not aggravated by routine physical activity such as walking or climbing stairs

  3. Both of the following:

    • no nausea or vomiting

    • no more than one of photophobia (sensitivity to bright light) or phonophobia (sensitivity to loud sounds)

Common Causes

  • Muscle tension or tightness

  • Physical or emotional stress

  • Posture - particularly prolonged sitting or working in awkward positions

  • Whiplash Injury

  • Other neck/spinal injuries - such as sports related injuries

Treatment

There are many different ways physiotherapy can help with your headache including; soft tissue massage, joint mobilisation and manipulation, dry needling, stretching and strengthening exercises, postural advice and self-management strategies.

  • Mobilisations of the joint will help to restore normal movement of the joint of the neck and back.

  • Dry needling can help to target the tight parts of the affected muscles and to help reduce tension in the muscle and restore range of movement.

  • Stretching exercises to help improve and maintain the muscle length in your neck, back and shoulder muscles to support good movement.

  • Strengthening exercises will help to improve the strength of your deep neck muscles and upper back muscles to help keep your neck and head supported and reduce future issues.

  • Postural advice on ways you can adjust your posture and work-specific ergonomics to support you in the workplace.

  • Self-management strategies including education on how you can help reduce symptoms yourself including heat, ice, positions of ease, exercises, self-mobilisations and stretches.

 

The time for improvement varies between people, and clinical trials indicate there can be relief within 2–6 weeks of beginning management. Some people take longer and this will often depend on the nature of your neck disorder.

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