Treating headaches caused by neck pain
I’ve been suffering from headaches for a while now and it’s reached the point where I need to find out what’s causing them, rather than just trying to ignore the issue and hope it goes away.
I’ve had my eyes checked already. This was my first thought actually, as I’m in my forties and as much as I don’t like to admit it, things don’t work like they used to. Luckily, my eyes were fine, more than fine for my age, so I was told. I won’t go into how smug that made me, but let’s just say, I was happy to cross that one off the list.
A number of different things working together can cause headaches. This can make the root cause difficult to diagnose.
An obvious thought was could it be migraines? I’ve never suffered from them, so I can’t imagine just how debilitating migraines can be when they come on. My headaches can feel severe at times and the pain presses down on my forehead like a vice. Sometimes, it can make focusing difficult, but I wasn’t sure if what I was feeling was akin to a migraine. I suspected not because I was still able to function, I didn’t shy away from bright light or feel nauseous. There had to be another reason.
I get a lot of pain in the back of my neck and in my shoulders. Whatever I do, I can’t seem to stop this area of my body from tightening. It stems from an injury, 14 years ago, that was enough to damage my shoulder ligaments and put my left side at a disadvantage to my right even to this day.
It made sense to me that this old injury could the source of all my aches and pains, going one way, up into my neck and the other way, down into my middle back. I exercise with specialists who know about this injury and my limitations because of it and as much as this helps keep my body from seizing up completely, it doesn’t stop my headaches. In fact, sometimes, it can make them worse.
The type of headaches I suffer from are known as cervicogenic headaches, the source of which is a combination of the neck and shoulder blades becoming knotted or in spasm.
The upper three joints of the neck, C1, C2 and C3 share a pain nucleus with the trigeminal nerve. This trigeminal nerve is the main sensory nerve that carries messages from your face to your brain. When the neck and scalp muscles become tense, or equally, if they move around too much (hypermobile), pain radiates from the back of the head to the front causing a dull, vice-like pain. This can sometimes feel like pressure on the head. The top of the neck and base of the skull can feel tender and it can be painful around the temples, side of the face, or behind the eyes.
Many people suffer from tension headaches caused by physical or emotional stress, excess alcohol or caffeine, eyestrain or fatigue. Cervicogenic headaches, however, are much less common, with an estimated 0.4-2.5% of the population suffering from them. According to the Journal of the American Osteopathic Association, the mean age of patients presenting with cervicogenic headaches is 42.9 years and they are four times more prevalent in women. Studies show cervicogenic headaches affect physical functioning of patients to a greater extent than other headache disorders.
I can certainly identify with this and when my headaches began to affect my everyday life, I knew it was time to do something about the problem.
I’m not the sort of person to rely on medication, BUT I will reach for the paracetamol if it gets bad enough. This only treats the symptoms though and I wanted to get to the root of my pain and sort out my headaches once and for all.
Massage can help, particularly when you massage the base of the scalp, but although this does alleviate the pain to an extent, I felt I needed more intervention. Time to call in the professionals!
Osteopathic treatment, combined with an exercise programme can be an effective treatment for headaches caused by neck pain. Studies also show the effectiveness of spinal manipulation and/or mobilisation to help.
Osteopath, Vladimir Levachyov has been interested in treating headaches ever since he saw his first headache patient in student clinic. When treating a patient, his first task (primarily based on the case history) is to ascertain whether the headache is primary or secondary, followed by diagnosing (or at least classifying) the headache type. To help with this, Vladimir regularly makes use of the ICHD-3 (The International Classification of Headache Disorders 3rd edition).
“There are various factors that affect headaches, especially cervicogenic headaches. The common/close neurological link is one contributing mechanism, another is when the range of motion in the upper thoracic spine (the top of the ribcage) is decreased. The neck compensates by developing increased range of motion and when this happens, the ligaments around the joints can become slightly strained.
As a result, the muscles around the joints tighten up to protect the neck from further (perceived or otherwise) damage. The suboccipitals muscles (where the neck meets the skull), when overly tight, will press on whole nerves or branches of nerves that travel underneath these muscles; such as the greater auricular nerve (innervating the skin above the ear and the forehead) and the greater occipital nerve (innervating the skin at the back of the skull).”
The rationale for osteopathic treatment in the case of cervicogenic headaches is:
• To decrease the muscle tone (tightness) in the suboccipital and other neck muscles and hence relieve pressure on the nerves. This can be done in a number of ways, from soft tissue massage techniques, to using dry needling techniques with acupuncture needles, and of course home advice to stretch the suboccipital (and other appropriately chosen) muscles.
• To increase the range of motion of the thoracic spine; as this is increased the range of motion of the neck will normalise, meaning that the muscle tone should normalise, too.
Once you’ve embarked on an initial course of treatment for your cervicogenic headaches, there are a number of things you can do to help prevent them from re-occurring.
Your osteopath will give you lifestyle advice to help avoid the muscles getting tight.
• Check your everyday posture – excessive forward neck motion (such as bringing your head close to your phone or other screen) for extended periods will undoubtedly contribute to hypertonicity (tightness) of the suboccipital muscles.
• Invest in a good pillow and mattress.
• Invest time in daily neck and shoulder stretches
• Don’t sleep on your front
Treating and managing cervicogenic headaches is an on-going process and one I will have to pay close attention to in order to make sure I’m consistent with my exercises and that I re-visit an osteopath for regular check-ups. It’s not something I expect to cure overnight, but I’m relieved to have a professional diagnosis and a plan of action for tackling them.