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Cervicogenic Headache Referral Patterns

Migraines and Cervicogenic Headaches


Headaches or migraines can come in different forms. The three most common types of headaches are

- Tension: Tightness from muscles causing a headache at the base of the skull and referring out onto the skull

- Migraine: A neurological disorder that causes nausea, sensitivity to light and sound

- Cervicogenic: Headache that is usually felt on one side of the head and accompanied by neck pain

Physiotherapy has the best results with Tension and Cervicogenic headaches

What Causes a Cervicogenic Headache?

These types of headaches are caused by irritation of the upper joints of the neck. This can happen over time through less than ideal postures/positions when sleeping, sitting, standing or working in cramped spaces that force the neck into an awkward position. Alternatively sudden impact in sports, hobbies or motor vehicle accidents can also irritate these joints. As people get older the joints in the upper neck can be affected by osteoarthritis which can also cause a cervicogenic headache. 

Cervicogenic Headache Symptoms

- Neck pain

- Stiffness in the neck with movement

- Pain referral into the temples, forehead, eye or behind the eyes

What Causes a Tension Headache?

The main difference in the causes of a tension headache versus a cervicogenic headace are the affected structures. Instead of the upper neck joints becoming irritated, it is the suboccipital muscle group +/- the upper trapezius muscle which tightens and becomes irritated. This can happen through the poor posture/positions when sleeping, sitting and standing, working in awkward positions, and sudden impact in sports, hobbies or motor vehicle accidents. 

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Tension Headache Referral Patterns


- Pain, pressure, or discomfort that is felt at the base of the skull

- Neck pain

- Headache referral into the top of the head or forehead

- Scalp sensitivity to touch

Cervicogenic and Tension Headache Treatment

These types of headaches respond quickly to hands on physiothearpy  treatment. This is achieved through a combination of massage, mobilisation of the neck and the provision of a stretching program. 

If these types of headaches are frequent physiotherapy can also help with identifying the cause and assist in correcting any problems with posture, technique or workplace and pillow arrangement to help prevent it occurring again in the future.