Types of headaches — and the involvement of the neck
There are many different types of headaches, however they can be categorised into two main groups – primary and secondary (1).
- Primary headaches are caused by problems with pain-sensitive structures in the head – they are not related to underlying illnesses.
- Secondary headaches are a symptom of an underlying condition, such as infection, injury or tumour (1).
- Cervicogenic headaches are a type of secondary headache and may manifest as the result of neck pain.
There are a number of pain-sensitive structures in the head and neck which may cause pain in the presence of an underlying issue – these structures include the joints, ligaments, nerve roots, and muscles of the neck (1). The way these structures cause pain/headaches is summarised below:
Features of cervicogenic headaches are typically similar to that of tension (most common) headaches and so it can be tricky to differentiate between the two. A physiotherapist will be able to assess your symptoms by asking a series of questions and performing physical assessments to determine the cause of your headache.
What can physiotherapy do to help with headaches?
Physiotherapists can implement a variety of active and passive techniques to not only alleviate symptoms of cervicogenic headaches but work to treat the cause (1). This typically involves restoring proper movement to the cervical spine and jaw joints and muscles.
Poor postural ergonomics may contribute to the onset of cervicogenic headaches whilst working, sitting or sleeping (2). A physiotherapist can assess your ergonomics for work and home activities and make recommendations for adjustments that may improve your posture and reduce your likelihood of developing headache symptoms (2).
Gentle mobilisation of the joints in the neck and jaw and muscles may help to relieve the headache symptoms and/or treat the underlying cause (2).
Stress management may help to relieve muscle tension that is contributing to cervicogenic headache symptoms. Examples of such management strategies include relaxation and breathing techniques, and lifestyle management.
More complex and advanced techniques may also be implemented as indicated, including dry needling or acupuncture, Botox injections, low-level laser therapy and spinal taping (2).
Key points of advice to help prevent and manage common underlying causes of cervicogenic headaches include:
- Posture – changing your posture is important (try to avoid sitting in the same position for hours). The shoulders should be relaxed, with the head level and chin tucked in.
- Work – try to avoid working with your head down for long periods of time. This can also link to changing posture, as it is important to try and frequently stretch and change positions.
- Sleeping – this may include finding an optimal sleeping position, including choice of pillow.
- Exercise – physiotherapists can prescribe exercises that will help with any muscles that are tight and/or weak.
- Relaxation – relaxation techniques can help to prevent or manage the onset of cervicogenic headaches.
Written by Jacinta Maxwell