Headaches – A Pain In The Neck!

Posted by on Sep 30, 2011 in Physiotherapy, Spinal Physiotherapy | No Comments

Headaches are a particularly commonly occurring problem we see as Physios here at Bend + Mend, and it can be sometimes hard for the suffering individual to understand why they have a headache, and, if and why a Physiotherapist can help.

There are two general types of musculoskeletal (read: bones, joints, muscles) related headaches, and these are generally related to dysfunction around the neck, shoulders or upper thorax.  The two types are:

  1. Tension Headaches, which can be defined as a muscle issue/tightness/trigger point which refers pain into the head region; and
  2. Cervicogenic Headaches, which relate directly to dysfunction in the top three neck joints (including the skull/C1 articulation).

You can get picky and strictly define each of these as they present, however, as is the case with most spinal pain scenarios, there is usually an element of both involved, and it doesn’t help management too much if you give it a name.  What’s important is understanding the postural or movement problem that is causing the issue.

So why is it making my head hurt and how do I know it is coming from my neck?  There are a lot of neck structures that can refer pain into the head.  The upper trapezius (traps) and levator scapulae, which insert into the base of the skull and first few vertebrae, can develop trigger points and refer pain into the head.  These are often the cause of tension-type headaches.

The structures around the first couple of neck joints (i.e. C0-3) and their muscles are innervated spinally by their respective levels.  The sensory components of these spinal nerves interact with the trigeminocervical nucleus, a lovely little bundle of grey in the upper spinal cord/medulla which is linked to the trigeminal nerve.  The trigeminal nerve has a whole heap of functions including the sensation to the face.  It is in this little bundle of grey matter that the signals have a little crosstalk and the representation of the pain is mixed up.

There are a lot of other pathways and occasions where musculoskeletal issues are part of a pain experience in the head, but you can be fairly sure that the neck is the culprit in a headache with a number of symptoms. Generally if the pain is only on one side, or is particularly aggravated by specific movements, you can again be fairly certain of it coming from your neck.

If you experience headaches, and are not sure if they are neck-related, we can help! Book in to see one of our Physio’s at Bend + Mend in Sydney’s CBD and get your headache assessed so you can get it cured.

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