Neck Pain and Headaches

Have you ever wondered what triggered your headache in the first place? Headaches can sometimes be caused by a problem in the neck. These types of headaches are called cervicogenic headaches and are often misdiagnosed. Pain typically starts at the base of the neck and extends up and around the head. How does neck pain cause headaches? The roots of the three cervical nerves located at C1, C2 and C3 happen to share a pain nucleus with the trigeminal nerve. This nerve is a sensory nerve that transports messages from the face to the brain. There are shared nerve tracks.

Diagnosing Cervicogenic Headaches

Determining the cause of cervicogenic headaches can be tough. Most symptoms of headaches include pain, sensitivity to light and nausea. A person with a cervicogenic headache may have an increase in symptoms with moving the head or neck and therefore restrict their mobility. Some symptoms may increase with prolonged positions or postures, such as sitting or long periods of time working at a specific workstation. It’s a type of headache that also has tenderness at the base of the skull. A diagnosis can include:

  • Full physical exam and medical history
  • A series of x-rays of the cervical spine and views of the joints in the upper three cervical spine segments
  • A lateral skull x-ray and open mouth view of the skull
  • Diagnostic nerve block evaluation
  • CT or MRI

Causes of Cervicogenic Headaches and Treatment

Cervicogenic headaches can be caused by psychological stress, sleeping habits, carrying heavy items, using a shoulder strap for a purse, poorly designed workstations and sitting in chairs. A physical therapist will take a full history and assess biomechanical components of the cervical spine and design a specific plan to treat these headaches. They may use manual therapy techniques and mechanical cervical traction. Manual therapy techniques may include relaxation stretching, cranio-cervical exercises, cervical mobilization, postural correction or active exercises of the shoulder and neck. Patients are also given specific advice for positioning during daily activities. Physical therapy is highly effective for neck pain relief and relief from cervicogenic headaches.

Studies of Physical Therapy for Cervicogenic Headaches

Studies have been done to support the effectiveness of using physical therapy for cervicogenic headaches. In one study, participants ranged in age from 18 to 60 with symptoms lasting from one week to 10 years. Treatment groups were organized into a control group, a group that received manual therapy, and a group that received both manual therapy and therapeutic exercise. All treatment groups demonstrated a significant reduction in headache frequency and intensity after treatment. Seventy-two percent had a reduction of 50 percent or more and 42 percent experienced an 80 to 100 percent reduction in pain at the 12-month follow up.

Cervicogenic headaches are a common problem incurred by teenage and adult populations. Physical therapists strive to relieve symptoms of headaches and address underlying musculoskeletal malfunctions.

In six weeks of conservative manual therapy, researchers demonstrated positive long-term outcomes and provided patients with self-management strategies, including exercises and postural awareness to reduce the risk of headaches recurring.