This information has been prepared to help you fully understand your condition so you will be in the best position possible to work with your physio and follow the steps to your full recovery. Understanding the goals of your treatment and having complete confidence in your physio are vital elements of your recovery plan, so if you have any questions then please feel free to ask your physio.
There are over 67 different types of headache, one of which is cervicogenic headache. This type of headache is due to pain referred from the upper part of your neck and is relatively common in desk workers, people who have to lift frequently and in those who get stressed a lot. Physiotherapy can provide effective and lasting relief from cervicogenic headaches and importantly can stop reliance on the regular use of medications.
Your neck is made up of 7 vertebrae (bones), and its anatomical name is the cervical spine. There is a disc between each vertebra and nerves that leave your spinal cord and exit at each level. Cervicogenic headaches are due to referred pain from irritation of the upper 3 cervical spinal nerves or the structures they supply (including muscles, joints and discs in the upper neck). Sitting with a poked-chin posture, as is common when at a desk for long periods, puts more stress on the upper neck and is the most common reason for cervicogenic headaches.
Cervicogenic headaches often start as pain in your neck that gradually spreads upwards and progresses from the back of your head to then reach your temples, face, forehead and eyes. They may be associated with dizziness or nausea. The headache may be on one side of your head or both, but will not swap sides during the headache. Headaches will be brought on or worsened by certain neck movements or sustained postures such as desk work, driving, repeated lifting or carrying. They are more common after neck trauma such as whiplash injuries or falls which jar the neck and head.
Due to the nature and causes of cervicogenic headaches they are unlikely to resolve without treatment. They will continue to have a negative impact on your quality of life and they often gradually get worse the longer they are left untreated.
Depending on their severity, cervicogenic headaches may take several weeks to several months to resolve. After your headaches have subsided it is vital to undergo a period of strengthening to minimise the chance of a recurrence. Generally the earlier you begin treatment, the quicker your recovery will be.
Your physio has been extensively trained to thoroughly assess and diagnose your injury. They will give you a step-by-step recovery plan to make your treatment easier for you to understand. The most common phases, or steps, that you will go through during your recovery plan are outlined below. The order and timing of the phases are tailored individually for you and so may vary form this list. Please feel free to ask your physio if you have any questions about your recovery plan.
Often the range of motion in your neck will be reduced due to decreased movement in your upper neck joints. You may notice this as difficulty turning your head to reverse the car. The first part of treatment will be focussed on restoring this lack of movement and many clients notice an improvement in their headaches as soon as this starts to occur. If you have had your symptoms for a long time then we have to mobilise very gently initially to avoid stirring your headaches up.
Techniques your physio may use to increase range of motion include joint mobilisations, specific muscle releases and heat. You will also have home exercises to do to keep you improving between your sessions.
Another major contributing factor in the development of cervicogenic headaches is tight muscles in your neck and across your shoulders. Restoring their full length is vital to help your current pain settle down, and is also an important factor in minimising the chance of problems in the future.
Techniques your physio may use to restore your muscle length include specific muscle releases, stretches and heat. You will also be given quick and easy specific stretches to do at home, because sustained increases in muscle length rely on regular stretches initially.
If you work at a desk then it is very important that your workstation is set up correctly for you. If your chair doesn’t support your back, or your keyboard, screen or mouse is not correctly positioned, then it is very likely you will be spending a lot of time in poor postures and your headaches are likely to continue or recur in the future.
Your physio will discuss correct set-up of your workstation and also give you a sheet to take to your work so you can check that it is the best it can be. Often improvements don’t involve buying new equipment, just correctly adjusting the things you already have.
Often if you work at a desk and or have a slouched posture you will have changed the way you move your neck. This will be putting increased strain on areas that aren’t designed to handle it and contributing to increased muscle tightness. If your movement patterns are not corrected then even if the muscles are stretched out they tighten up again due to the continued abnormal way you move your neck.
Poor posture makes the stabilising muscles at the front of your neck and your upper back become weak, leading to continuation of poor posture and headaches. Now that your muscle length and movement patterns have been corrected it is important to strengthen these muscles to make sure you keep correct posture and minimise the risk of future problems.
Your physio will guide you through a graded exercise program to specifically strengthen your postural muscles. These exercises are light and don’t take very long, but you really have to focus on using the right muscles at the right times so you may find them hard at first. Many clients find that progressing to our Clinical Pilates or Exercise Physiology programs is ideal at this stage.
As you return to your normal activities and sport it is important to strengthen you in the positions required for these activities. It may be as simple as strengthening in the sitting position to allow you to work at a desk more comfortably, or adding in weights and more complex exercises if you play a specific sport.
Many clients find that seeing one of our Exercise Physiologists, Strength and Conditioning coaches or Personal Trainers is a great way to build strength, ability and confidence for a smooth return to full sporting activity. If Pilates is more your style then our great Sports Pilates program is an ideal way for you to continue to build your stability and strength. As well as being an important part of your rehab program these services can help you lift your sports performance whilst staying safer and reducing your risk of future injury.