Neck pain and restriction, accompanying recurrent headache.  🤕

Headache is a very common presentation in my practise. They are a hugely important part of clinical work as headaches carry along with them such a high scale of reported disability. Not only is the pain very overwhelming but according to the British Association for the Study of Headache (BASH, *1) it is a problem at some time in the lives of an estimated 40% of people in the UK!

This is important for Chiropractors as musculoskeletal care providers to know and understand. Headache symptomology may either be as a direct result of restriction within soft tissue and bony structures in your neck. Moreover the muscle guarding and stress response that accompanies all pain syndromes can further exacerbate the issue of head pain.

One particular type of secondary headache that is treated frequently within clinic is known medically as cervicogenic headache. Cervicogenic means that the pain within the skull is actually derived from your cervical spine or neck region. This is known as referred pain, or in this case "convergence." The current theory is that the headache follows a referred pattern of pain from soft tissue and articular structures within the neck. The pain often builds around the top of of the head (known as the vertex) with increasing neck tension. It may also affect an area that is known as the sub-occipital region (below the bony protuberance at the back of the skull).  Cervicogenic headaches are commonly found in desk and laptop workers with habitual patterns of poor, seated posture.

So what can Chiropractors do to help?

As healthcare professionals we can aid in the management of the headache condition through lifestyle and exercise advice.  This can range from ergonomic, postural advice to incorporating cardiovascular activity into our weekly schedules.  Moreover it might be logical to keep a headache journal, or to keep track of hours slept per evening.  These are all techniques in which we can spot patterns of pain meaning we are better positioned to mitigate any potential sources of onset. 

 

Multifaceted healthcare that encompasses pain relieving medications, practical ergonomic modifications, home-stretches and exercise, alongside soft tissue mobilisation and joint manipulation within clinic ensures the best chance to improve the quality of life in patients.  When suffering with tension-type headache, cervicogenic and migraine headache (primary headaches) it is important to assess all components of the disorder.

A recent meta-analysis (Aug 2019, *2) of 7 RCTs looked at manual therapy versus placebo treatment for these headache conditions.  Analysts found that for the Headache Impact Test (HIT-6) manual therapy showed statistically significant differences to placebo, both after treatment and at follow up.  📚

This is great news if you are looking to better your management of episodic headache and thus decrease their impact on life!  😃
 

A final word. Please, always be sensible: If you have had recent changes to your medications, a new onset of severe headache or exertion/activity-related headache. Seek medical advice or visit and update your regular healthcare provider.

*1 British Association for the Study of Headache 3rd edition (1st revision) 2010, www.bash.org.uk
*2 Falsiroli Maistrello, L., Rafanelli, M. & Turolla, A. Curr Pain Headache Rep (2019) 23: 78. https://doi.org/10.1007/s11916-019-0815-8