Headache from the neck

Headache that can be solved through neck treatment? Is not that a gossip from the .... Migraine is the best known of the main headache types. The most common one is the tension headache. Less well known is that a few percent of people have headaches from the neck.

Cervicogenic headache

This headache is called 'cervicogenic headache'. In the high neck region there are a number of structures that can give headaches in different areas. It is mainly about joints and muscles. Irritation of these can give the complaints by a complicated mechanism. The pleasant message for people with this type of headache is that it can be discovered with relatively simple physical examination and (usually) easy to treat.

But how do you know whether you are dealing with this headache? The headache is usually one-sided. Often there are neck complaints from which the radiation to the head, shoulder or arm is felt. Neck movements or postures can trigger the headache. In some of the people an accident with the head-neck region is the reason for the complaints. Some of these complaints are similar to migraine and tension headaches and sometimes they occur at the same time.

With a good examination, more clarity can be given: a conversation and an assessment of the neck. Then in about 8 out of 10 people the diagnosis of cervicogenic headache can be reliably determined. It also means that this does not work for 2 out of 10. The treatment consists of careful mobilisations of the high neck region and exercises. Usually improvement can be achieved within 2 to 3 treatments.

Tension type headache

Depending on the cause of the tension headache, something can be done from the musculoskeletal medicine. Example: many people with sitting and/or screen profession have an attitude where the middle back is curved and head-neck are protracted. This gives extra tension to the muscles that keep the head-neck area upright. The muscles themselves can cause pain, but also nerves that run through these muscles. A few of these nerves serve the back of the head and can cause tension headaches.

Here, too, good examination is needed to recognize this. The treatment is more difficult than with cervicogenic headaches because the postural behavior has to be changed. That takes time and effort but is not impossible.

References

Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders. Cephalalgia. 2018; 38 (3rd edition): 1-211.