Is your headache also a pain in the neck?
By Tanya Ruddy, MPT, MTC
A headache is one of the most common pains experienced by the general population. They can range in intensity from mildly annoying to completely debilitating, and can last a few hours or months at a time.
The World Health Organization estimates that 47% of the adult population has had at least one headache within last year. The lifetime prevalence of having a headache is 96%, and is a bit more common in women than men. Aside from the pain they create, headache disorders are associated with pain, disability, decreased quality of life, and significant financial cost. In fact, in the US alone, it is estimated that migraine headaches result in a loss of $5-17 billion annually. And that’s just one type of headache. When physicians diagnose headaches, they try to classify them into one of 5 categories: tension, migraine, cluster, sinus, and mixed. Once the type of headache is determined, several interventions may be used. These interventions may include medications, injections, food elimination diets or allergy testing, and physical therapy.
Most of the separate types of headaches often co-exist with neck pain. Headaches which begin in the neck and radiate into the skull are referred to as cervicogenic headaches. These types of headaches can be either the primary source of pain or can co-exist with one of the other types of headache. Cervicogenic headaches are the most common type treated by physical therapists, who use a combination of pain-relieving modalities, hands-on techniques, and targeted exercises to reduce pain.
So, how can one tell if your headache has a cervicogenic component? If you have any of the following symptoms, your headache may be triggered or exacerbated by your neck:
- Neck or shoulder pain
- Decreased neck range of motion (E.g., difficulty turning your head to back up your car)
- Pain that starts in the neck and travels up the back of the skull
- Head pain brought on by neck movement, a prolonged awkward position such as reading, or by pressure to the base of the skull
Physical therapists usually advise a multi-pronged approach to reduce headache frequency, intensity, and duration. First, patients are often asked to keep a headache diary, documenting the time, intensity/duration, and activity associated with the onset of a headache. Sometimes it is noted that headaches occur consistently with a certain activity, such as reading in bed at night. If that is the case, the first thing that should be addressed is the position of the head and neck in reading. People who work at computers all day frequently report working as a common trigger. The best way to address this is by examining the fit of the worker to the workstation and making modifications that can alter the position of the head and neck to alleviate stress on these areas.
After possible headache triggers have been addressed, treatment focuses on pain reduction, correcting posture, and improving range of motion and muscle function. Weak muscles in the shoulder blades and neck are often discovered, as well as overactive muscles in these regions. Both hands-on techniques and exercises are utilized to restore the balance between tight and weak muscles.
Another tool used by physical therapists is kinesiotaping. Kinesiotaping is a special type of tape used by physical therapists, physical therapist assistants, and athletic trainers with advanced training. This taping technique is used to assist with posture correction, decrease myofascial tightness, decreasing swelling, and strengthen or lengthen muscles to improve muscle balance.
Headaches can have a huge impact on an individual’s quality of life and finances, and are more successfully treated the sooner they are reported. If you’ve been experiencing any of the following see your medical provider:
-An extremely intense headache
-A headache that wakes you from sleep
-A headache that is associated with nerve symptoms such as weakness, dizziness, loss of balance or falling, numbness or tingling, speech difficulties, mental confusion, personality changes/inappropriate behavior, or vision changes
-Headache with a fever, trouble breathing, stiff neck, or rash
-Headaches with severe nausea and vomiting
-Headaches that occur after a head injury or accident
Tanya Ruddy is a Physical Therapist and Certified Manual Therapist at Northern Michigan Sports Medicine Center in Indian River. This information is not to be considered medical advice and is not intended to replace consultation with a qualified medical professional.