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How neck tension can cause headaches

by Carmen Andrews - Physiotherapist

It is very likely that you will suffer with headaches at some point in your life. Headaches can be caused by many different things, including hormone imbalances, food intolerances and stress. Some people will experience ‘migraines’ or ‘cluster headaches’; these are thought to vascular events (related to blood supply) and have a typical group of symptoms. Before a migraine people will often experience a type of ‘aura’, and while experiencing a full-blown migraine they may be sensitive to light or sound, notice visual disturbances, and / or experience nausea. Additionally, a significant percentage of headaches are caused by ‘referred pain’ from the neck.

How the neck can cause a headache:

The nerve pathways in your neck, head and face are complex. The nerve group that supplies sensation to the top two vertebrae in your spine, and a few of the muscles in your neck and shoulders, also supplies sensation to parts of your face and scalp. When the muscles or the joints in the top of your neck (upper cervical spine) send signals to the brain which the brain interprets as pain, because of the overlap of the group of nerves, your brain may misinterpret the information from your neck and you feel this as a headache. This kind of headache is sometimes called a ‘cervicogenic headache’. Cervicogenic headaches can usually be treated very successfully with physiotherapy.

Causes of problems in the upper neck:

  • Your neck is the top-most part of your spine. Your body needs to balance your head in the perfect horizontal position for your eyes. This means that any asymmetry below your neck will be corrected in your neck, which can cause dysfunctional movement or overload in the joints and muscles in your neck.

  • You may develop posture and movement habits that overtime can cause cervicogenic headaches. This can be as simple sitting with your ribcage dropped to one side or slouched forward (see more on this in our previous post). It could also be the result of walking with a limp or compensating for a shoulder problem by moving your shoulder blade in a different pattern. Stress and fatigue due to long working hours can also cause poor posture habits.

  • Other: Breathing through your mouth (rather than your nose), TM joint dysfunction (clicking and / or locking in your jaw or only chewing with one side of your mouth), and weakness around your pelvis (which changes back posture and the way you hold your head up) can also lead to imbalance in the upper cervical spine.

If you think you might be having cervicogenic headaches, especially if you have tension in your neck going up into your head or related to your headaches, try to understand what is causing you headaches. Keep track of what you are doing when you first notice the headache, and what you were doing in the hours before the headache started. Also keep track of how often you need to take medication to relieve the pain and allow you to keep working – the frequency may surprise you. This information will be very helpful to your physiotherapist in working out what is driving your headaches and will help you to work together with them to address the cause rather than simply treating the symptoms.

Sometimes apparent ear problems can be caused by your neck. ENT’s (Ear, Nose and Throat Specialists) will refer for physiotherapy management if your ear symptoms are being caused by neck dysfunction. Some of these symptoms can be: blocked ears, ringing in the ears, and ear pain. If you have symptoms like this, it is best to have them checked by a doctor before trying physiotherapy.

Always check with your doctor if you are unsure what is causing your headache. We work closely with GP’s and refer for further management and investigations when we feel the neck may not be the source of your pain.

Other factors to consider:

  • Have your eyes tested annually

  • If you find you have to take a specific brand of tablet to treat your headache and nothing else works for you, you could be experiencing withdrawal from an ingredient in that medication. [See Note 1 below]

  • Check your blood pressure

Note 1: These headaches are sometimes called ‘medication overuse headaches’ or ‘rebound headaches’. This can happen when your body gets used to a regular dose of a certain medication, especially when the medication contains more than one drug and codeine or caffeine. The regular use of the same medication increases the intensity or frequency of your headaches, driving a cycle of pain and medication use. Examples of combination drugs include Grandpa or Compral. These drugs can be effective if used correctly for short periods of time. Always read the package insert before using a drug and don’t use it for longer than the period recommended without consulting a suitably qualified medical professional such as your GP or a pharmacist.

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