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)
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.
Common Causes of Headache & Migraine
Specific Migraine - Headache Types
- Neck Pain
- Bulging Disc
- Wry Neck
- Text Neck
- Pinched Nerve
- Cervical Radiculopathy
- Facet Joint Syndrome
- Neck Sprain
- What Causes Cervicogenic Headache?
- How Do You Get Rid Of A Neck Headache?
- When Should You Be Concerned About A Headache?
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
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.
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.
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:
- Stiff neck joints may need to be loosened or unlocked via joint mobilisation (gentle gliding techniques), joint traction or, in specific cases, a gentle and localised joint manipulation technique.
- Hypermobile (or dynamically unstable) joints may require specific deep neck muscle strengthening exercises to stabilise, control and limit the joint movement available.
- Tight or overactive muscles may require muscle stretching, neck massage, acupuncture, dry needling, trigger point release or other relaxation techniques.
- Weak muscles may require specific strengthening exercises. This weakness may include your postural shoulder blade and neck muscles.
- Nerve dysfunction identified by your physiotherapist will depend upon your specific examination findings. Neurosensitivity is a common finding that needs addressing with attentive, professional care.
- Posture correction via specific posture exercises, posture awareness techniques, posture taping, or a brace.
- Provide helpful advice on preventing neck dysfunction in the future, e.g. workstation setup, ergonomics, awkward neck positions and postures to avoid.
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.