Cervicogenic Headaches - Headaches arising from the neck

Headaches can be really debilitating and limit your every day activities. There are many different causes of headaches, so Osteopaths are trained to assess and diagnose what type of headache it is. In some cases, investigations via the GP are required, so we recognise that and refer on when necessary. The most common type of headache I see in clinic are due to neck problems, these are called cervicogenic headaches and are successfully treated with Osteopathy.

The symptoms of a cervicogenic headache can include:

• Pain in the neck.
• Pain travelling up into the head and sometimes over the eye.
• Neck stiffness/reduced movement in the neck.
• The pain can be aggravated by neck movements, coughing or sneezing.

Diagnosis.

I usually diagnose cervicogenic headaches based on your medical history, the symptoms you describe and a physical examination. I always consider other possible causes of the headaches and use my questions and examination to rule those out.

Sometimes a scan is required to rule out a serious cause of cervicogenic headaches, such as neck fracture or tumour, but these are very rare and often accompanied by other symptoms or there is evidence in the case history pointing to this. My patients wellbeing is my utmost concern, which is why I ask a lot of questions before examining you.

Treatment.

It’s important you treat the neck problem in order to relieve the headache and Osteopathic treatment is a gentle and safe way to do so. Treatment usually involves soft tissue massage, gentle stretches, gentle joint movements (mobilisations) and manipulations.

Manipulations of the neck do carry a very small risk of cardiovascular event, so I personally choose not to perform upper neck manipulations in my practice and instead use the more gentle mobilisation techniques. I find this just as effective and usually patients are more relaxed and comfortable with that approach.

Management.

It’s very important to get to the bottom of why your neck problem developed in order to prevent the problem (and the headaches) from reoccurring.

Take a look at possible factors such as:

• Sleeping position and pillow height. It’s best to sleep on your side and your pillow should allow your neck to be in a neutral position (too low and your head drops down, too high and your head is lifted up, causing a curve in your neck).
• Car seat and steering wheel position.
• Desk posture (take a look at my previous blog post on this).

Once the problem is being addressed, it may be necessary to carry out activities to prevent the problem reoccurring. This could include neck stretches, strengthening exercises, relaxation techniques, hot/cold therapy, yoga, swimming, postural changes and ergonomic changes.

Generally once the physical problem has been treated and you've addressed any lifestyle factors that may have caused or contributed to the problem, it should fully resolve.

For more information about cervicogenic headaches, please don’t hesitate to get in contact.

Zoë Clark is a registered osteopath trained at the British College of Osteopathic Medicine in London. Practicing in Howe near Norwich (01508 558373) and Burston, near Diss (07543 557746), Norfolk.

Twitter @ZoeClarkOsteo

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www.zoeclarkosteopathy.co.uk

Sources:

https://americanmigrainefoundation.org/understanding-migraine/cervicogenic-headache/

Manual examination in the diagnosis of cervicogenic headache: a systematic literature review. Howard PD, et al.
Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. Racicki S, et al.

NICE Clinical Knowledge Summary: Headache- Assessment.

International Headache Society- International Classification of Headache Disorders (3rd Edition- Beta Version)