Tension (Cervicogenic) Headache
What are the usual complaints from people who suffer from Cervicogenic headache?
Most sufferers complain of a deep dull ache starting from the base of the skull to the top of the head, usually over just one side of the head. It may be present on both sides of the neck pain and stiffness are on both sides of the neck. Other complaints include feeling pressure at the back of the eye and discomfort in the jaw.
Another symptom that confirms the diagnosis the presence of tenderness when pressure applied over the area of the cervical spine immediately under the skull. In some cases, when pressure applied for long enough, sufferers feel some relief from the headache.
What are some of the activities that aggravate this condition?
Typically, activities that require the neck to be in a sustained strained position for a prolonged period of time will aggravate this problem. The neck posture is often faulty, the head is turned or tilted to one side or if the sufferer is adopting the “poke chin” position.
Examples of such activities including reading, using the computer especially the laptop, putting on makeup, looking up for too long or watching movies or theatre when seated on the side of the hall.
Why do these activities aggravate the Cervicogenic headache?
When we adopt the “poke chin” posture, we apply compressive stress to the upper part of the cervical spine, namely, C1 and C2 levels (C1/C2 refers to the first two cervical vertebrae in the spine). Similarly, when we turn our head to one side, we compress the C1-2 level on the same side. This happens as most of the movement of the head occurs at these 2 spinal levels. So if we sustained these postures or repetitively perform them, these 2 levels will start to degenerate and the cartilage wears out over time. This in turn results in stiffness of the upper cervical spine.
What is the relevance between the C1-2 levels and headaches?
The nerves that exit C1-2 and sometimes C3 supply sensation to the back of the skull to the top of the head and in some people, to the jaw area. The nerves that exit from the right side of the neck will supply only the right side of the head, likewise for the left.
When joints are stiff or mal-aligned, the nerves at the affected levels irritated causing pain. So when one has a right-sided upper neck pain or stiffness, the pain always referred to the right side of the head.
What can we do?
We need to improve the cervical joint alignment and mobility at the C1-2 levels and to remove the compressive forces; which is to adopt good posture. This will reduce the irritation to the nerves.
If the cervical facet joints slightly rotated due to contractile forces of tight muscles surrounding the neck, the affected joints already in some amount of compression and may not allow full functional or physiological range. In this situation, physiotherapists can apply the “MUSCLE ENERGY TECHNIQUE” to realign the joint position. This technique uses the muscles to reposition the joint.
Once the joint in a neutral position, the actual stiffness (hypomobility) can accurately assessed. Stiffness treated by various techniques; such as passive mobilization through the MAITLAND technique or with the clients’ active movement with the MULLIGAN SNAG technique.
If the joints remain stiff even after a few sessions of mobilization, MANIPULATION applied. Once the ideal mobility achieved; the client will expect to maintain it by self-mobilization with a strap.
Once the mobility improved, the headache will resolve. The client can remain pain-free for a long time provided the original cause of poor posture solved. Good ergonomics was here paramount.
First appeared at /neck-related-headaches/
Experiencing neck pain? Click here to find out more about physiotherapy for neck pain relief and how Core Concepts can help