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Physio Penrith Neck Pain With Headache Treatment

Treatment of Neck Pain with Headache at Sydney Muscle & Joint Physio Penrith

What is neck pain with headache?

Neck pain or cervical pain with headache can also be referred to as cervicogenic headaches and is defined as pain that develops in the neck, though a person feels the pain in their head. Cervicogenic headaches are secondary headaches, meaning it is caused by an underlying condition such as a neck injury. Bogduk et al. has proposed that the pathophysiology of cervicogenic headaches results from a convergence of sensory input from the following anatomical structures:

  • Upper cervical facets

  • Upper cervical muscles

  • C2-3 intervertebral disc

  • Vertebral and internal carotid arteries

  • Dura mater of the upper spinal cord

  • Posterior cranial fossa

What are the common symptoms of neck pain with cervicogenic headache?

Common symptoms of cervicogenic headaches include intermittent, unilateral (one sided) neck pain and associated (referred) headache. The headache is precipitated or aggravated by neck movements or sustained positions/postures. The diagnostic criteria for cervicogenic headaches include headache associated with neck pain and stiffness. Cervicogenic headaches are unilateral, starting from one side of the posterior (back) head and neck, migrating to the front, and sometimes are associated with ipsilateral arm discomfort. Some researchers identified another type of cervicogenic headache with bilateral (both sides) head and neck pain, aggravated by neck positions and specific occupations such as hair-dressing, carpentry, and truck/tractor driving. The neck pain precedes or co-exists with the headache, and is aggravated by specific neck movements or sustained postures.

How does a physio know if the headache is coming from the neck?

The physiotherapists at Sydney Muscle & Joint Clinic Penrith use guideline-based protocols in the assessment and diagnosis of neck pain and cervicogenic headaches. During physical examination the head pain can be triggered or reproduced by active neck movement, passive neck positioning especially in extension or extension with rotation toward the side of pain, or on applying digital pressure to the involved facet regions or over the ipsilateral greater occipital nerve. Muscular trigger points are usually found in the sub-occipital, cervical, and shoulder musculature, and these trigger points can also refer pain to the head when manually or physically stimulated. There are no neurologic findings of cervical radiculopathy.

What is guideline-based physiotherapy treatment for neck pain and cervicogenic headaches?

For patients with acute neck pain with headache the physiotherapists at Sydney Muscle & Joint Clinic Penrith provide evidence-based passive and active interventions to reduce pain, improve joint stiffness and improve headache symptoms. This includes joint mobilisation/manipulation, soft tissue work and supervised instruction in active mobility exercise, including McKenzie method repeated movements such as chin retraction exercises. Further, our physiotherapists may provide C1-2 self-sustained natural apophyseal glide (self-SNAG) exercise. 

For patients with subacute neck pain with headache, generally there may be less pain irritability and techniques can be applied with increased pressure to elicit increased range of motion benefits. Our physiotherapists can provide cervical manipulation and mobilisation techniques, as well as McKenzie method and C1-2 self-SNAG exercises.

Similarly, for patients with chronic neck pain with cervicogenic headache our Penrith physiotherapists can provide cervical or cervicothoracic manipulation or mobilisations combined with shoulder girdle and neck stretching, strengthening, and endurance exercises in the management of associated pain and stifffness. 

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