At some point in your life, you may have the misfortune of experiencing the enigmatic medical condition generically known as a headache. However, this broad term is often inadequate, for the head pain or discomfort associated with what we call headaches is not always caused by an issue in the head itself. Often, the source of the pain is not located in the head at all, but rather the adjacent structures of the neck. Headaches of this origin are known as cervicogenic, or originating from the cervical portion of the spine (neck), and more specifically from the muscles attaching to the base of the skull from the top of the spine. When these particular muscles become tight, it causes a pulling at the bottom of the back of the skull. This pulling uses nerves in that area to radiate the tension forward leading to similar tightness, spreading into the muscles on the top and sides of the skull just below the scalp. It is because of this, that headaches of this nature are commonly confused with tension headaches – a similar tension of the skull muscles caused by stress, but do not originate from the neck.
The nature by which this condition can develop can be diverse. They can range anywhere from traumatic injuries involving a sudden forceful movement of the skull and neck (car accident, fall, athletic collision), to more chronic—or slow developing—conditions, such as arthritis or poor posture. Regardless of how these headaches develop, they typically present themselves in a consistent manner. In the initial stages of development, they usually start occurring intermittently and then gradually become more continuous. They are usually triggered by sudden neck movements and may be accompanied by dizziness and blurred vision. A cervicogenic episode, involving increased headache symptoms, lasts anywhere from one hour to one week.
As such, it is important to distinguish cervicogenic headache from the other types, such as migraines and tension type headaches. Cervigogenics are typically one-sided, like a migraine. The side of pain is typically correlated with the side of increased muscular tightness. Therefore, unlike a migraine, those with cervicogenic headaches will almost certainly have reduced range of motion in the neck, and the precipitation of the headache coming with certain neck movements, especially turning the neck or bending it to the side. Patients may also have same-sided shoulder or arm pain associated with the headache.
Luckily, despite whether an individual’s cervicogenic headaches are the result of a chronic or traumatic condition, it is possible to decrease the frequency with which they occur, if not eliminate them altogether. This can quite often be accomplished with treatment from a skilled physical therapist. If one’s symptoms and circumstances resembled any of those previously described, they would benefit from a program consisting of a combination of hands-on therapeutic techniques, such as manual stretching of the muscles in the upper and lower neck, and prescribed exercises aimed at strengthening the postural muscles of the neck, back, and shoulders. Additionally, patients should become active in their own treatment, by adhering to a prescribed home exercise program consisting of techniques similar to those used in clinic to address these specific symptoms — self-stretches, exercises, and postural education.
Warren Rodrick DPT received his doctorate degree from The University of Hartford. A former baseball player, he has a particular interest in orthopedics and athletic injuries, along with post-surgical rehabilitation. Warren has joined the growing staff at Amity Physical Therapy now with offices in Woodbridge, Hamden and Branford. He can be reached at 203-389-4593 or visit amitypt.com.