Neck Headache

Neck Headache

Article by J. Miller, S.Armfield

Neck Headache

(Cervicogenic Headache)

What Does A Neck Headache Mean?

Neck Headache, or known medically – a Cervicogenic Headache, is a secondary headache disorder. In other words, a neck joint problem causes your headache.

Can A Neck Problem Cause Headaches?

Yes. Most head pains felt at the base of your skull, or upper neck is a neck headache. The good news is that fixing your neck problem alleviates your neck headache.

Are Cervicogenic Headaches Common?

Researchers feel that a neck headache accounts for between 4% and 22% of all clinically seen headaches. (Racicki et al. 2013; Watson 2014)

neck headache

What Are The Symptoms Of Neck Headache?

Neck headaches (cervicogenic headaches) can often be misdiagnosed or confused with other sources of a problem, including a migraine, since the head pain may refer to a similar area as a migraine. It is your headache physiotherapist’s interpretation of the whole combination of your symptoms and your physical examination findings that will confirm a neck headache diagnosis.

Commonly, neck headache sufferers will usually notice:

  • Upper neck tenderness. Or the base of your skull.
  • Neck stiffness or a mild loss of movement, although this is not mandatory. Joint movement loss can be pretty subtle and needs confirmation during your physiotherapist’s physical examination.

One of the main differences between a neck headache and migraine is that your neck’s physiotherapy treatment can immediately alter or relieve your headache pain.

What Does A Cervicogenic Headache Feel Like?

The following symptoms are characteristics of a cervicogenic headache. You may experience any one or several of these symptoms:

  • Your headache may seem to radiate from the back to the front of your head.
  • Your headache is provoked or eased by a neck movement, a sustained posture, stomach sleeping or with your head turned to one side.
  • Your headache frequently appears to be worse on one side of your head. The headache side usually is constant and does not swap sides.
  • Your headache appears to ease up when you apply pressure temporarily or massage your neck or the base of your skull.

If you experience any of the above symptoms, you are more likely than not to be suffering a neck headache. Please inform your physiotherapist, and they will assist you.

How Is A Neck Headache Diagnosed?

Accurate diagnosis is essential to guide the correct treatment and management of your neck headache. A headache and head pain can have many causes, not just neck headaches or migraines. Correctly identifying the cause will lead to better treatment. A headache physiotherapist who has a particular interest in neck headaches is the best professional to diagnose and treat your neck headache.

How Long Do Neck Headaches Last?

Even if your neck isn’t sore or painful, you can still experience neck headaches. It is important to remember that your neck joints may NOT be sore at REST, but they may be tender to touch or painful on movement. Neck joints that are sore at rest will typically be very tender to touch and painful at the extreme movement. This scenario is a more severe neck headache.

If your headache or migraine is longstanding and you haven’t examined your neck joints, we recommend a thorough neck assessment. Your physiotherapist will be able to confirm and treat your neck headache or exclude a neck disorder as the cause of your trouble.

What About X-rays, CT scans & MRI?

Unfortunately, X-rays, CT scans and MRI’s are not diagnostic of a neck headache. You can suffer a neck headache with or without some abnormal findings on X-rays or scans. Likewise, scan abnormalities do not guarantee that you will experience a neck headache. However, X-rays and scans may identify structures that could potentially be causing your neck pain or a neck headache. We recommend that you have at least cervical spine X-rays if you suffer headaches or head pain for an extended period.

For more specific advice, please consult your neck headache physiotherapist.

What if Neck Physiotherapy Doesn’t Help Your Headache?

Since there are over 300 sources of a headache, and neck headache is responsible for about 20% of headaches, your trouble may stem from a problem that neck headache treatment cannot help relieve.

You may also be suffering from a mixed or multi-source headache. In these instances, your neck headache may resolve, but another source of your head pain could linger.

Your physiotherapist will advise you if you have symptoms that could indicate a different cause for your headache. In these instances, they will also direct you towards further investigations or tests that may assist your diagnosis and subsequent treatment.

More Info

What Causes Cervicogenic Headache?

How Do You Get Rid Of A Neck Headache?

When Should You Be Concerned About A Headache?

Article by John Miller

What's Causes Cervicogenic Headache?

Your neck headache originates from a variety of musculoskeletal and neurovascular structures. These structures include the upper three neck joints, C2/3 disc, spinal cord coverings, and neck muscles. Dysfunction in these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003).

Upper Neck Joints

cervicogenic headache

The most likely source of your neck headache is a dysfunction of your upper neck joints. Your neck muscles or nerves become involved from pain signals that travel to your trigeminal nucleus in your brainstem, where you interpret the pain signals as a neck headache.

The most common cause of a neck headache is the dysfunction of your upper three neck joints. The most common neck joints involved are your:

  • atlantooccipital joint (O-C1),
  • Atlanto-axial joint (C1/2), and
  • C2/3 cervical spine joints.

In simple terms, your neck joints can cause a neck headache or pain if they are either too stiff or move too much (e.g. wobbly and unsupported by weak muscles) or locked in an abnormal joint position, e.g. a locked facet joint or poor neck posture. Once your neck joint becomes stressed and painful, the pain signals refer to the trigeminocervical nucleus in your brainstem. You start to feel a neck headache or, in some cases, face pain!

Your neck and headache physiotherapist can assess and correct neck joint dysfunctions that result in a neck headache. Their professional diagnosis and treatment are essential for neck headache sufferers.

Neck Muscles

Your neck and shoulder blade muscles that originate from your neck will cause pain if they are overworking, knotted or in spasm. Some of your neck muscles overwork when protecting injured neck joints. Other neck muscles become weak with disuse—this further demands your overworking muscles resulting in muscle fatigue-related symptoms. Your deep neck flexors are frequently weak or lack endurance. Your neck muscles work best when they have healthy resting tension, length, strength, power and endurance.

Your skilled physiotherapist assesses and helps you correct any muscle imbalances that result in a neck headache.

Cervical and Occipital Nerves

Nerves in your upper neck may become pinched by extra bony growths, e.g. arthritis, disc bulges or swelling. The results can result in nerve irritation or a reduction in the neural motion known as neuromechanosensitivity or abnormal neurodynamics. Irritation of your upper neck structures refer to pain messages along the nerves and cause your headache. In simple terms, your neck is the "switch", nerves are the "power cords", and your headache is where the "light" comes on.

Your headache physiotherapist can assess your neuromechanosensitivity.

More info:

Headache & Migraine

Neck Headache

Jaw Headache

Article by John Miller

How Do You Get Rid Of A Neck Headache?

Quality neck physiotherapy can have a speedy and effective result for relieving your neck headache—the key to better treatment response in confirming your diagnosis. After your assessment, your physiotherapist will start you with treatment techniques that address your problems.

Your neck headache treatment may include all or some of the following techniques:

Who Treats Cervicogenic Headaches?

In addition to relieving your neck headaches, your physiotherapist aims to address why you are experiencing neck headaches. After all, helping you to avoid future neck headaches is a crucial component of your rehabilitation. Chronic headache sufferers typically resolve their neck headaches within days or weeks.

Relief of your neck headache is quite often immediate! If a neck headache solely causes your trouble, it is common to experience instant relief as you walk out of the clinic.

Depending on the severity and the specific underlying causes of your neck headaches, most sufferers will experience a reduced headache after your initial consultation.

For more information, please consult your neck headache physiotherapist.

More info:

Headache & Migraine

Neck Headache

Jaw Headache

Article by John Miller

When Should You Be Concerned About A Headache?

Unfortunately, in a small percentage of patients, there is a sinister cause of your head pain, which require investigation. We call these Red Flags because they can be vital signs of more sinister underlying conditions such as brain tumours, aneurysm, stroke, meningitis and other systemic illnesses. If you experience any of the following symptoms, please seek the urgent advice of your healthcare professional.

You MUST thoroughly investigate any Red Flags!

headache red flags

Please check with your doctor to investigate further if your headaches have any of the following characteristics. Your headache is:

  • History your worst ever headache or a different headache to your usual.
  • Exertion triggers your headache (e.g. exercise, cough, sneeze or sex).
  • Age is higher than 50 years.
  • Despite treatment, your headache persists.
  • Acute onset.
  • Central nervous system findings. e.g. motor weakness, memory loss, slurred speech.
  • HIV or another immune system compromise
  • fEver or other systemic symptoms, e.g. weight loss, rash.

If you have any of the above HEADACHE Red Flags symptoms, we strongly recommend that you consult your doctor immediately.

Less Urgent & Severe Headache Types

Fortunately, most headaches do not require urgent medical investigation and should respond positively to treatment depending upon an accurate diagnosis.

For specific advice, please consult your doctor or headache physiotherapist.

More info:

Headache & Migraine

Neck Headache

Jaw Headache

Article by John Miller

What is a Primary and Secondary Headache?

The International Headache Society classifies headaches as Primary or Secondary.

Primary headaches are not related to any other problem and include migraines, tension-type headaches and cluster headaches.

Secondary headaches. Caused by an underlying problem and can include a post-whiplash headache, neck headache, jaw headache and drug withdrawal headache. “Ice cream headache” is a secondary headache caused by extreme cold within your mouth. In other words, a secondary headache is a symptom of something else being wrong rather than the cause itself. Treatment for a secondary headache involves treating the source, e.g. loosen some stiff upper neck joints or stop eating ice cream!

Mixed Headache-Migraine Types

You can simultaneously suffer one, two or more types of headache or migraine.

One type may cause another or overlap with another. For example, a painful neck can cause increased muscular tension, which will increase your blood pressure. In this scenario, you would be suffering a neck headache + a tension headache, + a migraine!

Migraine

In our experience, finding the primary source of your headache or a migraine is the key to successful management.

What Else Could Be Causing Your Headaches or a Migraine?

Your physiotherapist and doctor will be able to assist with your diagnosis and headache source. Sometimes specific tests can confirm your diagnosis. On other occasions, it can be by process of elimination.

Unfortunately, there is a sinister cause of your head pain in a small percentage of patients, which requires investigation. These can include brain tumours, aneurysms, meningitis and other systemic illnesses.

Your physiotherapist or doctor may recommend that you complete a headache or migraine questionnaire that will assist in your headache classification, diagnosis and treatment. Once you complete these questionnaires, please present your physiotherapist or doctor's results to help with your diagnosis and treatment.

At PhysioWorks, we are interested in assessing, diagnosing, and treating neck, stress, and jaw headaches.

Please consult with your healthcare practitioner for an accurate diagnosis and treatment pathway.

More info: Headaches & Migraines

Article by John Miller

Suffering a Headache or Migraine?

If you are suffering from a headache or migraine, it is appropriate that your first step is to consult your doctor. Your doctor will examine you and determine if a neurological opinion is required and whether a CT or MRI scan of your head is necessary. In the vast majority of cases, your scans will be reasonable. Occasionally, scans can identify significant but luckily uncommon headache sources such as an aneurysm or tumour.

If Your Scan is Normal?

Firstly, you should feel relieved. Scans will rule out the more sinister causes of headaches or migraines.

Discovering Your Headache Source?

headache treatmednt

We recommend that you should then commence a process of elimination, starting with the most commonly diagnosed and easily fixed sources.

Two familiar sources of headache that can undertake an assessment and elimination are neck headache and jaw headache.

Researchers believe that at least one in four headaches are neck origin. A thorough examination of your neck by a skilled headache physiotherapist is your next port of call. You'll have over a 25% chance that your physiotherapist will confirm and then relieve your headache at your first consultation.

More info:

Headache & Migraine

Neck Headache

Jaw Headache