Cervicogenic headaches: What are they and how can physiotherapy help?

What is a cervicogenic headache?

Headaches come in all different shapes and sizes and can be from a variety of different causes. They are typically classified into two categories; primary and secondary headaches. Primary headaches are ones that don’t come from another issue, the headache is the primary problem. These include tension type headaches and migraines. Secondary headaches are those which are caused from another structure or condition. Cervicogenic headaches are considered secondary headaches as they are a result of referred pain from the neck.

Cervicogenic headaches are often chronic and recurrent/intermittent headaches that typically present following the onset of neck pain. They are characterised by pain and symptoms on the same side of the head as the neck pain. They are thought to occur because the sensory nerves that innervate the upper cervical region converge with the nerves that supply information to the head and face, meaning pain from the neck can be referred into regions of the head.

How is it different from other types of headaches?

Cervicogenic headaches are always unilateral (one sided) and are provoked by neck movement. Migraines are also often unilateral, however are also typically associated with aura (visual disturbance) and light or sound sensitivity. Tension type headaches are often described as a tight band around the head, with a more diffuse area of pain or pressure. Cervicogenic headaches are often a result of injury to the neck, such as trauma, whiplash related injuries, muscle strain, spasm or overuse.

Differentiating the different types of headaches can be tricky as they often have similar presentations. Therefore it is important to have an assessment with a physiotherapist to determine whether the cause of the headache is associated with your neck pain. A physiotherapist will go through a thorough subjective history before then assessing the movement and posture of the head and neck, and palpating structures that may be referring pain into the head.

Treatment & Management Options:

1. Manual therapy: Massage, joint mobilisation and manipulation can offer short term relief of symptoms associated with neck pain and headaches.

2. Exercise: At PROmotion, a physiotherapist will guide you through specific exercises to improve the range of motion, strength, proprioception and postural control through the head and neck. These are vital for long term management of neck pain and headaches.

3. Lifestyle Modifications: Reducing risk factors for chronic headaches such as obesity, caffeine, medication and sleep disturbances can be effective in reducing the burden of headaches and neck pain. A physiotherapist can guide you through how these specific lifestyle factors may be affecting your experience of pain.

4. Medical Management: If symptoms do not resolve with physiotherapy management, your physiotherapist will refer you back to your GP or sports physician for further medical involvement.

Josie is a qualified physiotherapist who has experience treating headaches and neck pain. Having experienced cervicogenic headaches herself, she understands how much they can affect your ability to concentrate and participate in day to day activities. If you are experiencing headaches or neck pain, contact the team at PROmotion to book in your initial assessment.