Almost all of us will experience a headache in our lifetime, and for many of us they're vastly more frequent.
What many people don't know is that headaches can have many different causes, and up to a quarter may be due to musculoskeletal problems in the neck (what are known as a cervicogenic headache, or neck headache).
The good news is this type of headache can often be helped with physiotherapy, reducing the duration, frequency and intensity of your pain.
How do necks cause headache?
Problems in your neck may be causing your headaches even if your neck isn't sore.
This is because when joints and muscles in the upper neck are damaged or stressed, they trigger pain signals that your brain then interprets as a headache.
Problems can be caused by an injury or something more long-term, including:
- Poor posture
Our physios are experienced in assessing the function of your upper neck joints to determine if this is the cause of your headaches.
How can physiotherapy help?
If your headache is caused solely by upper neck joint dysfunction, pain relief from physio can be almost immediate.
Treatment will always begin with a thorough assessment of joint and muscle function, plus assessment of accompanying syndromes (such as dizziness or pins and needles) if needed.
Treatment of headache will usually involve:
- Manipulative therapy (including joint mobilisation and massage)
- Exercises to promote deep cervical neck strengthening
This combination is the most effective treatment for cervicogenic headache, according to an Australia-wide trial in which we took part.
Causes of neck pain
There are several reasons your neck may be a problem that needs a little help.
Neck pain can be a one-off problem such as due to a poor sleeping position from which you wake with an acute locked neck, or it can be a more debilitating, chronic tension which drives you mad when you’re trying to get some work done at the computer, read in bed or simply watch TV.
In the first instance, it's due to a joint derangement. This means there has been a specific stress from a prolonged position or stretch, causing an acute local reaction (swelling, irritation and muscle spasm).
In the second instance, it may be more related to habitual postures, chronic stresses and learned muscle dysfunctions. Chronic neck tension often comes hand-in-hand with upper back tension and stiffness, which benefits from manual therapies and other modalities, but responds best to exercise prescriptions for long-term benefit.
How physiotherapy can help
Treatment for acute locked neck involves muscle and joint management to reduce the spasm, with techniques including:
- soft joint mobilisation
- muscle energy techniques
- dry needling
This is typically followed by education and advice to prevent recurrence, postural support to off-load the joint and exercises to restore and maintain mobility.
For chronic neck pain there needs to be a thorough assessment. This involves asking a full history to understand the contributing factors and rule out any medical causes, and looking at your postures of concern (sitting/standing), your movement patterns (sport-specific like golf swing or surfing), your joint mobility and limb flexibility, and your muscle strength, control and endurance. We will ask what approach you are looking for, discuss its suitability for your condition and work with you to find the best combination of hands-on therapy and exercise prescription.