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Headaches – Neck Related

Headaches – Neck Related

Headaches are a common complaint. There are various causes of headaches and practitioners need to be aware of these.

The most common causes are:
– Headaches associated with viral illness, such as the ‘flu’, common cold and sinusitis.
– Vascular headaches also know as migraines.
– Cervical headaches (headaches arising from the neck).

Sometimes headaches show features of more than one cause that is overlapping. This is important as the outcome will depend on an accurate diagnosis. This article will focus on cervical headaches or neck-related headaches. These headaches may or may not be associated with neck pain. They can be felt at the back of the head, in the temporal region or even behind the eye. They tend to be on one side of the head and if there is neck pain on the same side. Less frequently headaches occur on both sides. These headaches tend to be dull, be constantly present during the day and may last days.  Sometimes these headaches may also be associated with dizziness or light headedness. If you have these symptoms and your GP has checked for other causes, physiotherapy for your cervical headaches will help sort your problem out.

Cervical joints, muscles and nerves can causes these headaches. If the joints are the cause it is usually high up in the neck (C1/C2/C3) or low down (C6/C7). These joints are usually stiff and tender to move (palpation).Sometimes knots in the muscles can generate headaches. Trapezius, Levator Scapulae and Sternocleidomastoid muscles are often the source of these trigger points. Neural tension or tightness of cervical spinal nerves can also be the source of headaches.

Once the source of the headaches is identified (it can be a combination of these) treatment to relieve stiffness of the cervical facet joints, reduce muscles tension (trigger points) and stretching cervical nerves is given .Applying ultrasound to the neck prior is effective in improving the success and extent of stretching the above structures. Home exercises are given to continue the stretching process. But what caused these structures to become tight and cause headaches?

Sometimes anxiety and stress is the cause. Some people carry stress in the muscles of their neck and shoulders, so stressful times seem to trigger headaches.  For these people ways to combat stress, heat and muscles stretches are very important. Sometimes it may be due to poor sitting posture at work or home and sitting too long. It is important to point out correct posture and demonstrate this to the patient. It is also important to remind the patient to get up frequently during the day as we are not designed for long periods of sitting. Too much sitting, particularly with poor posture means that cervical joints, nerves and muscles are put under stress and can be injured and then stiffen/tighten up.

Finally, injuries to the neck such as motor vehicle accidents can cause headaches. Cervical joints, muscles and nerves may be injured and then tighten up. Neck pain is commonly associated with headaches if this is the case.

How do we prevent headaches? Here is come useful advice.

  • Keep good posture – think tall, shoulders relaxed, chin tucked in.
  • Sleeping – a soft down pillow is usually best, the height of which depends on how you sleep.
  • Relaxation – be aware when you are tense- you may be clenching your teeth and hunching your shoulder.
  • Exercise – keep the muscles and joints in your neck strong and flexible. A physiotherapist can show you how.
  • Work – keep good posture at work when sitting. Make sure the computer is at eye level and your arms are supported on your desk. Remember we are not designed for prolonged sitting so try to get up every 30-40 minutes.

So if you have a headache and you think it is coming from your neck, see your physiotherapist!

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