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Cervicogenic Headache

Cervicogenic Headache

A cervicogenic headache is a chronic type headache that arises from the atlanto-occipital and upper cervical (neck) joints. It is a rare form of chronic headache that has a prevalence of between 1-4% that typically affects peoples between the ages of 30-44 years old. Symptoms usually are complex and presents similarly to primary type headaches and in that case are often mis-diagnosed. Unlike other headaches, the International Headache Society classifies a cervicogenic headaches as a secondary type headache which originates from irritation caused in and around the upper neck area (around C1-C3)
Symptoms

A thorough examination is essential to rule out a primary type headache, however those with cervicogenic headache normally report:
• Pain / headache typically on one side that radiates from over the back of the head and then over the top, sometimes into the eye socket.
• Exacerbated by neck movement or posture
• Tenderness of the upper 3 cervical spine joints
• Association with neck pain or dysfunction
• Increased tightness and trigger points in upper trapezius, levator scapulae, scalenes and suboccipital extensors
• Weakness in the deep neck flexors[
• Increased activity in the superficial flexors

Diagnosis

Possible signs and symptoms of a cervicogenical headaches, as highlighted by the International Headache Soceity (HIS) are:

• Pain localised to neck and occiput which can spread to other areas such as forehead, ears, temples or orbital regions
• Pain aggravated by specific neck movements / postures
• Resistance or limitation of passive neck movements +/- changes in neck muscle contour or tone or abnormal tenderness of neck musculature
• (If warranted) Radiological findings such as movement abnormalities or abnormal postures
• Positive flexion / rotation test may be present.

How can Physiotherapy help?

Physiotherapy is considered the first line of treatment for this particular cnondition, and treatment may involve:

• Neck manipulations and mobilisations
• Strengthening exercises including deep neck flexors
• Thoracic spine monilisation and exercise
• SNAG type exercises to help with neck range of movements.
• Soft tissue massage
• Acupuncture.

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