Here at CSSM, we think it’s fair to say that lockdown number 6 has been an absolute headache….and apparently so do our patients! The constant uncertainty, lifestyle changes and stressors that come with these sudden lockdowns have increased the prevalence of headaches presenting to us at the clinic. In the first of a 3-part blog series, we will talk you through the most common headaches we see at the clinic, how to differentiate them, and how our osteopaths and myotherapists can help you tackle them.

WHAT IS A CERVICOGENIC HEADACHE?  
According to the International Headache Society, cervicogenic headaches account for up to 18% of headaches experienced. The pain is generally being referred from the first three vertebrae of the cervical spine and the nerve roots that exit from these segments. The joints, intervertebral discs, ligaments and muscles of the upper cervical spine can all be contributing to the patient’s symptoms.  

WHAT ARE THE SYMPTOMS? 
A Cervicogenic headache is classified as: 
-A unilateral headache of moderate intensity, usually non-throbbing in nature
-Pain starting in the neck, eventually spreading to the head  
-Pain episodes that vary in duration, with the intensity fluctuating
-Pain is triggered by neck movements and/or sustained awkward positioning (such as poor sleep position or workplace ergonomics) 
-May have had neck trauma prior to the onset 
-May experience symptoms such as nausea, vomiting, dizziness, light and sound sensitivity 

WHO IS LIKELY TO GET A CERVICOGENIC HEADACHE?  
The most common patients who present with cervicogenic headaches are aged between 30-45, with a relatively equal distribution between men and women. Patients who have a more sedentary life style and spend lots of time at a desk are also predisposed to this type of headache. Poor sleep ergonomics can also contribute…it may be time for a new pillow! 

HOW CAN CSSM HELP?  
There is considerable evidence to support that treatment to the cervical spine in patients suffering from cervicogenic headaches can lead to substantial long-lasting effects. Allied health professionals such as osteopaths and myotherapists will take a thorough assessment of the cervical spine and the surrounding structures. We aim to reproduce the patients headache to determine which tissues are likely contributing so we can treat them accordingly.  Treatment may include techniques such as joint manipulation and mobilization, dry needling, myofascial release, counterstrain, soft tissue massage, and muscle energy techniques.  We may also provide our patients with a home exercise program to assist in maintaining the changes we create in our appointment. Furthermore, we can assist our patients in identifying what lifestyle factors may be predisposing them to their headaches and then together, come up with a management plan to reduce the likelihood of reoccurrence.

Keep your eyes peeled for blog number 2 in the coming days…. 

About the author

CSSM Osteopath Nicole Owen-Tighe’s interests include the cervical spine, TMJ dysfunction and headaches. She also has a strong passion in working with amateur and professional dancers, understanding the physiological demands, the common musculoskeletal injuries, and how to support and manage these injuries when they arise. As a key driver of our Pilates classes at CSSM, Nicole often incorporates this expertise into the treatment and management of her patients.

References:  
Brukner, P., Clarsen, B., Cook, J., Cools, A., Crossley, K., Hutchinson, M., McCrory, P., Bahr, R., Khan, K. and Brukner, P., 2016. Brukner & Khan’s clinical sports medicine. 5th ed. New South Wales: McGraw-Hill Education Australia. 

International Headache Society. (August, 2021). 11.2.1 Cervicogenic Headache. IHS Classification ICHD-3. https://ichd-3.org/11-headache-or-facial-pain-attributed-to-disorder-of-the-cranium-neck-eyes-ears-nose-sinuses-teeth-mouth-or-other-facial-or-cervical-structure/11-2-headache-attributed-to-disorder-of-the-neck/11-2-1-cervicogenic-headache/