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Headache: Causes, Treatment and Physiotherapy


Cervicogenic headaches account for 4-22% of all headaches seen clinically. They are caused by neck pathology which may include discs, nerves, joints and muscles. Pain signals travel from the source of pain to your trigeminal nucleus (in the brainstem) and are interpreted by your brain as a headache.

Cervical joints may cause headaches if they are too stiff, locked in an abnormal position, or too mobile and not adequately supported by neck muscles.

Muscles of the neck as well as those around the shoulder blade may cause pain when they are in spasm or overworking.

Nerves may be compressed by disc bulges, swelling and/or bony growths such as arthritis. This compression can also be a source of pain.

Symptoms of cervicogenic headaches

The symptoms of cervicogenic headaches may include;

  • Tenderness at the base of the skull and top of the neck

  • Neck stiffness with/without mild loss of movement

  • Temporary relief with pressure or massage

  • Consistent area of pain- cervicogenic headaches generally do not swap sides however may affect both sides of your head simultaneously

  • Radiation from the back to front of your head

  • Provocation/relief with neck movement

  • Provocation with prolonged postures

  • Occassionally cervicogenic headaches may be associated with nausea, lightheadedness, tinnitus, decreased concentration and/or a decreased ability to function normally

Factors that may make you more susceptible to cervicogenic headaches include;

  • Poor posture

  • Inappropriate pillow and/or sleeping posture

  • Inappropriate ergonomics including office set up

  • Muscular tightness

  • Muscular weakness and imbalance

  • Neck and/or upper back stiffness

  • Sedentary lifestyle

  • Supportive pillow

  • Avoiding poor posture including at your work station


Types of treatment for cervicogenic headaches

  • Physiotherapy intervention involves identifying the source of pain and treatment will be individualised to reflect this. Treatment may include; mobilization of stiff joints, strengthening of weak muscles especially deep stabilisers, dry needling, heat, postural correction, correction of office set-up, and the promotion of self-management

  • Corticosteroid injections

  • Pharmaceutical intervention