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Cervicogenic Headache (CGHA)



Headaches can be a debilitating condition, especially for those who suffer regularly, and interestingly, there are many different types of headaches.


The most common include:

  • Migraines – with or without aura

  • Tension headache

  • Cluster headache

  • Cervicogenic headache

  • Sinus headache

  • Hypertension headache

  • Hormonal headache

Approximately 47% of the global population suffer from headaches, with 15-20% said to be cervicogenic (Page, 2011). Of those who experience cervicogenic headaches, the condition affects females 4x more than males (Page, 2011).

Today, we are going to look more closely at a headache we commonly see at the clinic, the cervicogenic headache.

What is a cervicogenic headache?

A cervicogenic is a headache that occurs as a result of pain referred from the top three vertebra in your cervical spine (neck). When the nerves around these joints are irritated, they refer pain around to the front of your forehead, typically on the same side as the irritated vertebra.


Irritation to these nerves can be a result of neck trauma, whiplash, sleeping position or pillow, sitting and standing posture (especially at work), or from jaw issues.


Symptoms

The symptoms of a cervicogenic headache can include one or multiple of the following:

  • Unilateral (one sided) headache originating at the back of the neck and referring to the forehead, eye, temple, and/or ear

  • Headache exacerbated by neck movement

  • Reduced neck range of motion

  • May have same sided shoulder and arm pain


How can osteopathy help?

As mentioned previously, there are many types of headaches. Your osteopath will take a thorough case history and examination to identify the most likely cause of your headache and also eliminate any nasty red flags.


Your osteopath will carefully consider why you are experiencing cervicogenic headaches by assessing the following:


  • Assessing any restrictions in your cervicals (neck) and jaw

  • Identifying any weakness in your cervicals, shoulder or thoracic (upper back) region

  • Looking at your overall posture

  • Discussing work station or role ergonomics

  • Discussing ergonomics of hobbies

  • Discussing sleeping position and pillow

Your osteopath will then treat any restrictions with techniques such as, gentle soft tissue, articulation and/or manipulation, to increase the range of motion in your cervical and thoracic region.


Based on your assessment, your osteopath will then provide you with the appropriate advice on work ergonomics, posture, sleeping position, pillow, and a stretching and strengthening program, if necessary.

Self-management

After you and your osteopath have identified the predisposing and maintaining factors of your cervicogenic headache, you can then take a pro-active approach to manage and prevent future re-occurrences.


If you experience headaches, a few easy things you can start doing now to try and help reduce the occurrence of cervicogenic headaches, include:

  • Putting an alarm for every 30mins at work to get up and move! This promotes blood flow to your muscles, which helps relaxes the muscles, so you aren’t so stiff (also helps with productivity at work and helps de-stress - as if you needed another reason!)

  • Practicing a good posture and ergonomics at home, and at work (especially if you are a desk worker)

  • Anti-inflammatories for the early days, when the inflammation and pain is high (speak to your pharmacist or GP first)

  • Get a good sleep!

  • Heat pack on the base of your neck to help reduce the tension in the neck and shoulder muscles

  • Stretching and strengthening exercises for your back, neck and chest

See below for 2 x exercises which may help with reducing tension and preserving mobility in your neck.


Prognosis

Cervicogenic headaches may last anywhere from 3 hours, to a week, to fully resolve. The duration can depend on whether you use the appropriate management and treatment approaches.

For those who have experienced multiple cervicogenic headaches, it is important to speak with your primary healthcare practitioner* (such as your osteopath), to understand what is causing your headaches to minimise/ prevent re-occurrence in the future.

*Important*

Your osteopath is highly trained at identifying any red flags (concerning symptoms) associated with your headache, but, if you are experiencing any of the following, we recommend booking in with your GP:

  • Onset of headache after a head injury or signs of concussion

  • Headaches that are worsening over time

  • Sudden onset of a severe headache

  • A headache with accompanied fever, neck stiffness or rash

  • Vomiting, dizziness, blurred vision, weakness in arms or legs, difficulty speaking or difficulty swallowing

  • Headaches that are relieved by vomiting

Exercises

As, promised, here are two quick and easy self-management strategies, that can be done anywhere, anytime, to help reduce the tension and assist in preserving the range of motion throughout your upper cervicals (neck):


NB: If concerned, please seek professional advice prior to trying these exercises.

Self-inhibition (trigger point release)

1. Find a tight trigger point (tender point) at the back of your head, where the base of your skull and top of cervicals meet – right or left side - dealers choice

2. Using your thumb, slowly introduce pressure into the trigger point. The pressure should be a 5/10 and not cause extreme pain. Adjust pressure to suit your tolerance.

3. Hold this position for 20-30 seconds, or until you can feel a release/ reduction in tension

4. Repeat on opposite side if necessary

5. Repeat 1-2x throughout the day

Head nod

1. Find a comfortable seat that will allow you to sit up straight comfortably

2. Start by elongating your neck and with your shoulders back

3. Within pain free movement, slowly start to nod your head (chin to chest) and then slowly going the opposite direction to look towards the roof (only as far as pain allows)

4. Continue for 10 repetitions, 2-3x a day


References

Page P. (2011). Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy, 6(3), 254–266.



Retrain Health is based in the Northern Rivers, NSW. From our Byron Bay and Ballina clinics, our team provides a range of quality healthcare services and products.

Retrain Health offers osteopathy, remedial massage and strength and conditioning, and PT sessions with qualified practitioners.

If you are interested in finding out more information or would like to book an appointment, please contact the clinic by phone (02) 6680 7447, send us an email or click here to book an appointment online.

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