Physiotherapy for Headaches & Migraines
Do you suffer Headaches and/or Migraines?
Headaches and Migraines are debilitating conditions, which are estimated to affect half of the adult population, at least once a year. Among those which are affected, approximately 30% or more have also reported migraine.
How common are Headaches and Migraine?
According to the WHO, chronic headache on 15 or more days every month affects 1.7-4% of the adult population. In the US, studies have shown that severe Headaches and Migraines affects roughly 1 in every 6 males and 1 in 5 females, over a 3-month period.
What are some of the different types of Headaches?
A secondary headache disorder which is linked with discomfort and/or stiffness in the neck. This type of headache can affect one side, both sides, or alternate sides. Triggers for the cervicogenic headache tend include: awkward, sustained postures, post head and/or neck injury.
Tension Type Headache
Mild-moderate severity headache often affecting the whole head. TTH’s are often described as pressure or tightness around the head.
Severe headache which may be stronger on one side of the head than the other. Migraines have associated symptoms which may occur in the lead up. These symptoms are known as “Auras”. Migraines are often associated with pulsating head pain, nausea, vomiting, and sensitivity to light.
Trigeminal Autonomic Cephalgia’s (TACs)
There are three main types of TACs, all presenting quite similarly. The most common and well-known TAC is the Cluster Headache. These headaches arise in severe, short lasting, frequent attacks, or “clusters” of headaches.
The cluster headache lasts for a brief period of time before easing. This occurs in regular intervals of time and then may ease for weeks – years before occurring again.
The cluster headache occurs more commonly in men, with a similar presentation – Paroxysmal Hemicrania occurring more commonly in females.
Most people do not directly associate Headaches and/or Migraines being connected to the neck; however, there is a big relationship between the upper cervical spine and different types of headache.
The underlying principal for headache is increased sensitisation of the nervous system in the lower brainstem. This area is situated in the upper neck and information from the neck and the trigeminal nerve (one of the nerves in the face) converges here. Painful stimuli from the upper neck is then mis-interpreted as coming from the facial nerve, therefore resulting in the head pain. This overly sensitised area occurs not only in Cervicogenic Headache (secondary headache), but also in primary headache disorders such as migraine and tension-type headache.
How can Physiotherapy help?
A thorough assessment of the upper cervical spine is crucial to correctly identify and confirm which segments are involved and referring pain into the head. Correct diagnosis allows for direct management in moving forward to resolving chronic headache.