Headaches
Imagine sitting at your computer or desk to begin the day. Work is going well, but things begin to pile up and you begin to feel more and more stressed as the morning progresses. By lunchtime, you begin to get a dull ache in your neck and shoulders. As the day continues, the dull ache has intensified and a headache has emerged.
If this sounds familiar, you or someone you know may be suffering from cervicogenic headaches. In fact, it has been estimated that 1 in every 6 Americans experience frequent headaches. What you may not know is there are many different types and causes of headaches. Therefore, it is important to identify the cause of them so that the correct treatment can be implemented.
These types of headaches may begin as a small neck ache and can take as long as a few hours for serious pain to be felt. Common places for pain are the back of the head, the sides of the head, and the forehead. Factors that can lead to these types of headaches may be stress, poor posture, muscular imbalances, or a decrease in spinal joint mobility. If stress seems to be the main trigger of symptoms, then stress may be amplifying an underlying dysfunction that leads to a headache coming on.
Headaches may also be associated with an injury or trauma, such as a motor vehicle accident or fall. If serious issues are ruled out and pain persists, Physical Therapy may be a good treatment option. Physical Therapy treatment begins with a thorough examination of posture, neck and shoulder strength and range of motion, soft tissue extensibility, spinal joint mobility, and other possible contributing factors. Treatment focuses on improving the underlying cause of cervicogenic headaches.
Associated Primary Anatomy
Associated Secondary Anatomy
How Physical Therapy Can Help
There are numerous types of headaches. Some of these include tension headaches, migraines, sinus headaches, and cervicogenic headaches. Cervicogenic headache is the type primarily treated within orthopedic Physical Therapy. Your physical therapist will first perform an assessment of posture, cervical and thoracic range of motion, soft tissue flexibility, and strength. They will determine if your headache type is appropriate to be treated by physical therapy. They will then help by facilitating a personalized treatment plan to treat the deficits found during their examination. Interventions within this treatment plan may include:
If this sounds familiar, you or someone you know may be suffering from cervicogenic headaches. In fact, it has been estimated that 1 in every 6 Americans experience frequent headaches. What you may not know is there are many different types and causes of headaches. Therefore, it is important to identify the cause of them so that the correct treatment can be implemented.
These types of headaches may begin as a small neck ache and can take as long as a few hours for serious pain to be felt. Common places for pain are the back of the head, the sides of the head, and the forehead. Factors that can lead to these types of headaches may be stress, poor posture, muscular imbalances, or a decrease in spinal joint mobility. If stress seems to be the main trigger of symptoms, then stress may be amplifying an underlying dysfunction that leads to a headache coming on.
Headaches may also be associated with an injury or trauma, such as a motor vehicle accident or fall. If serious issues are ruled out and pain persists, Physical Therapy may be a good treatment option. Physical Therapy treatment begins with a thorough examination of posture, neck and shoulder strength and range of motion, soft tissue extensibility, spinal joint mobility, and other possible contributing factors. Treatment focuses on improving the underlying cause of cervicogenic headaches.
Associated Primary Anatomy
- Upper Trapezius Muscle - This is a portion of your trapezius muscle that runs along your neck and upper shoulder. It is responsible for scapular elevation and shrugging. This muscle tends to be overactive leading to a muscular imbalance which can cause trigger points and can contribute to cervicogenic headache and neck pain.
- Suboccipital Muscles - A group of muscles (rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, and obliquus capitis inferior) that run from your occiput (the back of the head) to your cervical vertebrae. These muscles support the head and also help to extend and rotate the neck.
- Levator Scapulae - This muscle helps to flex and side bend the neck. It runs from C1-C4 vertebrae to the shoulder blade.
- Cervical vertebrae - You have 7 cervical vertebrae. Vertebrae 3-7 are shaped similarly to each other and are referred to in terms of lower cervical mobility. Vertebrae C1 (atlas) and C2 (axis) are different and are referred to as the atlantoaxial joint. C1 supports the head and C2 allows for head rotation and upper cervical mobility.
Associated Secondary Anatomy
- Middle Trapezius and Lower Trapezius Muscles - The middle and lower fibers of the trapezius muscle. Middle traps help with retraction of the scapular, lower trap helps with scapular depression. They both play a big role in stabilization and if not as strong as their counterpart, the upper trapezius, can contribute to neck pain and headache among other things.
- Rhomboids - Run from the shoulder blade to the vertebrae of the thoracic spine. Help with postural stability as well as scapular retraction, elevation, and internal rotation.
- Deep Neck Flexor Muscles - A group of muscles in the front of the neck (longus colli, longus capitis, rectus capitis, and longus cervicus) which help to maintain good posture of the neck and if imbalanced from their counterparts, the suboccipital muscles, can contribute to cervicogenic headache and neck pain.
How Physical Therapy Can Help
There are numerous types of headaches. Some of these include tension headaches, migraines, sinus headaches, and cervicogenic headaches. Cervicogenic headache is the type primarily treated within orthopedic Physical Therapy. Your physical therapist will first perform an assessment of posture, cervical and thoracic range of motion, soft tissue flexibility, and strength. They will determine if your headache type is appropriate to be treated by physical therapy. They will then help by facilitating a personalized treatment plan to treat the deficits found during their examination. Interventions within this treatment plan may include:
- Manual interventions or stretches to reduce the tightness in overactive muscles and address trigger points
- Manual interventions or exercises to improve cervical mobility and reduce stiffness
- Head and neck proprioception training to improve your body’s awareness of where the head and neck are in space and to help retrain muscle activation
- Exercises and an education/training program for posture motor control to reduce the imbalances and allow for improved ability to maintain positions in sitting and standing
- Postural strengthening to allow for full return to daily activities without headache recurrence