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How can Physiotherapists Help Headaches?

Updated: Sep 3, 2019

Headaches are one of the most common aches some endure regularly and can be disruptive to everyday life. Cervical headaches - headaches caused by neck dysfunction - are especially under diagnosed, and incorrect diagnoses and treatments may further damage the nerves and muscles involved. Understandably, symptoms of a cervical headache are quite similar to a range of other headaches including tension headaches, migraines, hormonal headaches and cluster headaches, making them quite difficult to diagnose.

Cervical headaches can result from several factors. These triggers may range from hormonal and/or dietary imbalances to environmental stressors. Although a cervical headache onset can occur at any time, these triggers are further exacerbated during times of increased sensitivity in the structures of the upper cervical spine. Therefore it is essential that the upper cervical spine is assessed as a potential source of subsequent pain.



Symptoms:

There are several indicators of a headache relaying back to pathology of the neck:

● Dizziness and lightheadedness

● Worsening of the pain with either neck movement or sustained positions

● A crucial distinction from other headaches in cervical headaches

● Pain radiating from the back to the front of the head

● Pain being eased through application of pressure to the base of the skull.


Dysfunction in the upper neck consequently causes these symptoms by sending signals to the trigeminocervical nucleus in the brainstem, then to the brain, which the brain then interprets as a headache. It is thus critical to consult a physiotherapist who can thoroughly assess your neck and headaches. Physios will not only ask several specific questions to determine if there is another cause of the headaches, but will also feel the structures of the neck in order to help identify if they are the source of the headaches.



Treatment:

There are a range of treatment options for patients suffering from cervical headaches.


These include the following:

Postural Assessment and Advice: Education on correct trunk posture and postural retraining is essential to shorten the duration of cervical headaches.

Mobilisation: Stiff joints in the neck should be mobilised in order to restore movement and prevent stiffness when stationary for elongated period of time.

Stretching: Shoulder and neck stretches help to alleviate headaches.

● Strengthening: A physiotherapist can show a patient how to retrain deep neck muscles in order to restore normal muscle balance.

Stress and Tension Management: Stress and tension commonly results in tightness to the upper back and neck muscles. Identification and reduction of sources of stress is critical.

Soft Tissue Work and Massage: Physiotherapists can use different massage and soft tissue techniques to aid muscles in the neck and upper back.

Neural Stretching: Abnormal tension on your nerves can contribute to cervical headaches. A physiotherapist will assess this and demonstrate appropriate stretches.

Workplace and Ergonomic Assessment: Office and workplace set-up can have consequences on posture, and thus headaches. A poorly positioned chair or computer, or a desk at the wrong height can which contributes physiotherapist can advise on workplace set-up.



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