Headaches

For many people, headaches start as pain or tension at the top of the neck. As the pain worsens, it may spread to the back of the head, the temples, forehead or behind the eyes. Moving the neck or bending forward for a long time tends to make it worse. This happens because the nerves in the upper part of your neck are connected to the nerves in your head and face. A disorder of the upper neck joints or muscles can cause referred pain to your head.

Any of the following points could suggest that your neck may be causing the headache:

• Headache associated with neck pain. Does the pain radiate from the back to the front of your head?
• Headache with dizziness or light-headedness.
• Headache brought on or worsened by neck movement or staying in the same position for a long time.
• Headache which always feels worse on the same side of your head.
• Headache eased by pressure to the base of the skull.
• Headache which persists after your doctor has checked for other causes.

HEADACHES FROM OTHER CAUSES

If migraine, allergic reactions or other factors are likely to be causing or contributing to the headaches, your physiotherapist will recommend that you see a medical practitioner.

How PHYSIOTHERAPY CAN HELP

Physiotherapists are experts in posture and human movement. They will be able to determine if your neck is causing or contributing to the headaches. Physiotherapists may use:

• Mobilisation.
• Manipulation.
• Functional and rehabilitative exercises.
• Encouraging normal activity.
• Postural assessment, correction and advice.
• Relaxation therapy.
• Massage.

Your physiotherapist can also offer you self-help advice on ways to correct the cause of headaches, such as practical ergonomic tips for work and in the home; adjusting furniture, relaxation and exercise.

Manipulation can be an effective treatment for headache caused by neck problems, but may not be the best option in every situation. After a thorough examination your physiotherapist will discuss treatment options with you to ensure that your headaches are managed safely and effectively.

PREVENTING HEADACHES

Here is some useful advice to help you control and prevent headaches:

POSTURE
Think tall: chest lifted, shoulders relaxed, chin tucked in and head level. Your neck should feel strong, straight and relaxed.

WORK
Avoid working with your head down or to one side for long periods. Frequently stretch and change position. Your physiotherapist will show you how.

SLEEPING
Awkward sleeping positions will add load and strain to the neck. A down pillow or polyurethane moulded pillow is best for most people. Your physiotherapist will advise you.

EXERCISE
Keep your neck joints and muscles flexible and strong with the correct neck exercises. Your physiotherapist will assess for tight or weak muscles and show you specific exercises to restore normal function.

RELAXATION
Recognise when you are tense. You may be hunching your shoulders or clenching your teeth without realising it.

REFERENCES
1.Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, Emberson J, Marschner I, Richardson C. (2002). A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine.  Sep 1;27(17):1835-43; discussion 1843.
2.Karakurum B, Karaalin O, Coskun O, Dora B, Uçler S, Inan L. (2001). The 'dry-needle technique': intramuscular stimulation in tension-type headache. Cephalalgia. Oct;21(8):813-7.

For more information on treatment options please contact Shahab Rezania at seva physiotherapy 604 874 7382

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