I have a headache?
Can my headache be from my neck?
Headaches are one of the most prevalent pain disorders; with 47% of the adult population experiencing symptoms within the last year. 15-20% of those headaches are cervicogenic in origin and commonly caused by dysfunction of the upper neck joints. It is thought the connection of the nerves from these joints to the upper part of the spinal cord to the brain result in referred head pain.
Other causes are compression of the nerves that supply the top of the head as they pass through the muscles of the top of the neck.
The official term for these headaches are “cervicogenic headaches” but we will term them neck related headaches in this article.
Females seem more predisposed to neck related headaches affecting 4 times as many women as men, it is also common in weight lifting athletes and has been linked with certain occupations (e.g. truck driver, hair dresser and carpentry).
At our clinic, the common group of clients we see are office workers who suffer from this condition.
Clients report their symptoms are typically described as a steady dull ache that is only affecting one side of the neck and head. The headache can be consistent or intermittent depending on what is causing the pain.
The symptoms usually are located at the back of the head or radiating over the top of the head to the face or the back of the eye.
Clients also report symptoms like a pulling or gripping feeling or as a tight band around the head.
Classically, neck related headaches are aggravated by neck movement or neck postures.
The diagnosis is often a clinical diagnosis as imaging often cannot identify the source of pain.
The important clinical signs of a neck related headache are;
Signs of neck involvement with aggravating positions due to sustained or awkward head positioning.
Unilateral headache, neck pain or arm pain that doesn’t change sides
Restricted neck range of movement
Poor posture is often associated with a neck related headache.
The stereotypical posture is rounded shoulders, forward head, chin poked with extension through the upper neck joints. This results in shortening and increased tone through the upper neck extensor or deep neck extensors (back of head) muscles and weakness of deep neck flexor (bend head forward) muscles. These muscles are highly important as they maintain segmental control of the neck joints.
It is essential to address and teach postural awareness. Reinforcing good posture (as shown in the picture) through regular cuing can help reinforce the stretching and strengthening exercises to restore muscle balance.
How can All Care help?
Your All Care physio can address the main problems leading to neck related headaches.
Treatement typically includes
- Postural correction
- Hands on treatment to mobilise tight stiff neck joints
- Exercise therapy to strengthen the deep muscles at the front and back of the head
- Address any poor ergonomics in the client’s desk set up at work
- Dry needling of any tight muscles
- Home programme of muscle and joint stretches
- Advice regarding any other factors that may influence neck tension like stress related tension
- Good exercises for neck related headache
Deep neck flexor retraining
Retraining of the deep neck flexors is a vital step in reducing the incidence of neck related headaches. This can be achieved by lying on your back with a rolled up towel under your neck. Place your hand on the front of the neck to monitor the bigger neck muscles (we don’t want these working). Then gently tuck your chin (only a small movement) and let the back of your head slide up on the towel, there shouldn’t be any lifting of the head. Hold this for 5 seconds and repeat 10 times. This exercise can also be done in standing against a wall while you’re work.
The easiest way to think about good posture is to think about growing tall through the top of your head, tuck your chin in gently and bring your shoulder blades back gently.
Sit up tall and gently retract your chin back in a line level with the ground and hold 6 sec. Do 6 repeats.