Have you ever described your headache as a real “pain in the neck?” This phrase may contain more truth than you realize.
Headaches can be caused by a number of external factors including stress, illness, injury or poor posture. What all headaches have in common is that the pain experienced is caused by nociceptors (pain receptors) in the body. The brain itself does not have nociceptors. Thus, it’s not the brain, but everything around it, that creates the sensation of pain that we recognize as a headache.
Cervicogenic headaches
Headaches that stem from the neck muscles and spine are termed “cervicogenic.” Studies indicate that these headaches make up approximately 20 percent of all headache disorders. Common causes of cervicogenic headaches are weakness in the muscles in the front of your neck, and overuse of muscles in the back of your neck. Combine a desk job with seated activities and, over time, this strength imbalance can lead to chronically poor postural adaptations and, eventually, lead to pain. Cervicogenic headaches may also be spinal as a result of a neck injury such as a car accident, athletic injury, or fall. In these instances, along with your headache, the joints of the neck can feel stiff, sore, or inflamed. You may, however, only feel a headache and not notice any neck pain despite the affected joints. Such instances are termed “pain referral” where the problem starts in one place in the body but manifests in another.
Seek treatment
A PRO physical therapist can help you determine if a headache is cervicogenic or if it is non-musculoskeletal in nature. If muscle tension or joint irritation in your neck is the cause, physical therapy can be helpful to include in your treatment plan. On your first visit, your therapist will complete a comprehensive evaluation including a thorough subjective history, muscle palpation, joint mobility and range of motion, strength testing, and postural analysis. Your therapist will also consider your life stressors, work ergonomics, and recreational activities that may be contributing factors. Finally, you and your therapist will work together to create goals for your treatment, monitoring progress with research-based assessment criteria until your headaches and their root cause are eliminated. Early sessions will often begin with postural endurance training and modalities to relieve pain. A home exercise program will also be established early in your treatment and progressed appropriately.
By Ken Jones, Physical Therapist
