Can Physios Help Cervicogenic Headaches?

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What is a cervicogenic headache?

Cervicogenic headaches (CGH) can often be mistaken as a migraine since they both have similar symptoms. However, the distinguishing feature of CGH which differentiates it from a migraine is that the non-throbbing ache begins at the base of the skull and increases in intensity with movements of the head or neck. Unlike migraines, CGH only occur on one side of the head with the pain being referred from the structures in the neck. Common symptoms of CGH include:

  • Pain starting at the base of the skull and radiating up the back or side of the head
  • Pain on one side of the head or face
  • Stiffness of the neck
  • Pain which increases with movements of the neck
  • Non-throbbing achy pain
  • Pain when coughing or sneezing
  • Pain around the eyes

What can a Physio do?

Because the source of the pain is in the neck and not in the head, physiotherapy can play a major role in relieving the symptoms and preventing the recurrence of CGH. Often the cause is from tight muscles, stiff joints, or an injury to the soft tissues in the neck. A physiotherapist can diagnose the cause of the CGH and treat the impairment to relieve symptoms. Below is a list of treatment modalities that a physiotherapist may use to treat a patient with CGH.

Manual Therapy

Joints in the neck can become stiff which will restrict movement. A physiotherapist may use manual therapy techniques to mobilise the joint and stretch the joint capsule to allow more fluid into the joint to lubricate the joint and get it moving more freely. Manual therapy techniques are also used to release tight muscles which can seize up from being constantly held in a shortened position.

Dry Needling

Dry needling is the application of single-use, sterile, fine filament needles into tight muscles to release myofascial trigger points (knots in muscles). Often people with CGH will typically have a forward head posture (head poking out) particularly when sitting and working in front of a computer. Sitting in with this posture for long periods of time can cause the muscles at the base of the skull to become tight. Dry needling into these tight muscles will release tension and allow the muscle to lengthen into a more optimal position for movement.

Instrument Assisted Soft Tissue Mobilization (IASTM)

Fascia is a thin casing of connective tissue that wraps around the muscles and organs in our body. Fascia can often be a contributor to chronic musculoskeletal pain which is commonly overlooked. IASTM is the application of a thin, blunt, metal instrument over the skin of the affected area to stretch and release the fascia which lies underneath the skin.

Therapeutic Exercise

One of the most common causes of CGH is poor posture and muscle imbalance. A physiotherapist can give you a tailored exercise program to help target muscles that are weak. These exercises may include stability or strengthening exercises, as well as, proprioception and motor control exercises to help improve the activation and control of your neck muscles.

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