Headache is a very common complaint throughout the community. There are many causes of headaches and many different symptoms experienced in conjunction with headaches. The role of the upper cervical spine (neck) in the production particularly of more chronic, ongoing or recurring headache symptoms is becoming much more clearly recognised.
Cervical Contribution to Headache
Headache information to the brain is carried through part of the brain stem called the trigemino-cervical nucleus, which receives information from the nerves that supply the head and face as well as the top 3 levels of the neck. In the presence of an increase in information being transmitted from the top of the neck due to mechanical problem there, the pathway becomes hypersensitised. In this state what would otherwise be normal input from the neck or face becomes magnified and can be perceived in the brain as a headache. Pain can also be generated from active trigger points in the muscles of the upper cervical spine and referred into the face and head to produce headache symptoms.
Some symptoms associated with headache caused from the neck include: pain in the neck, head, face or eyes, dizziness, blurred vision and muffled or altered hearing.
Commonly these mechanical problems in the neck which lead to headache are generated as a result of poor posture, weak core or stabilising muscles of the neck and shoulder girdle, trauma or degenerative spinal changes.
Treatment of Headache Originating from the Neck
Phase 1
The first phase of treatment for headache arising from the neck involves restoring normal upper cervical mechanics. This is generally achieved through massage, stretching and joint mobilisation by your physiotherapist. Acupuncture can also be very effective in releasing tight, painful trigger points in the muscle. By restoring normal mechanics there is a decrease in stress and strain on sensitive soft tissue in the neck and a decrease in the information being sent from the neck to the trigemino-cervical muscles and a resultant decrease in the hypersensitivity of the pathway. Under these circumstances there is a normalisation of signal processing in the brain and a decrease in headache symptoms.
Phase 2
The second phase of treatment involves removing or reducing the initial cause of the problems in the upper cervical spine. This usually involves postural correction in conjunction with strength, stability and range of motion exercises for the neck to maintain normal spinal mechanics. This is done in order to prevent headache symptoms from recurring in the future and also to decrease excessive wear on the joints of the neck as a result of poor loading.
