The connection between neck pain and headaches is a topic of ongoing debate in the medical and physiotherapy communities. While many experts agree on the importance of treating the neck for certain types of headaches, like cervicogenic headaches, the relationship becomes more complex when considering other headache disorders with associated neck pain. As a physiotherapist, I see these issues daily, and it’s crucial to understand how different headache types respond to neck treatment.
Understanding Cervicogenic Headaches (CGH)
Cervicogenic headaches (CGH) are a type of secondary headache where the pain is referred from a specific source in the neck. This type of headache is characterized by pain that typically starts in the neck and radiates upwards to the head. CGH often presents as a steady, dull ache, but the intensity can increase, causing more severe discomfort. One of the hallmark features of CGH is that the symptoms are usually side-locked, meaning the pain is felt on only one side of the neck, head, and sometimes even the face.
I frequently treat patients with cervicogenic headaches, and through targeted physiotherapy interventions, we often see significant improvements. By addressing the underlying neck issue—whether it’s poor posture, muscle tension, or a cervical joint problem—the associated headaches often subside or become more manageable. In cases of cervicogenic headaches, treating the neck is clearly beneficial, and there’s little debate among healthcare professionals on this point.
The Complexity of Primary Headache Disorders with Neck Pain
While cervicogenic headaches are directly linked to neck issues, up to 80% of headache patients presenting to physiotherapy actually suffer from primary headache disorders that include neck pain as a symptom. These headaches, such as migraine, tension-type headaches, and cluster headaches, are not caused by neck problems but may still be associated with neck discomfort.
For these patients, it’s essential to understand that neck pain is not necessarily the cause of the headache, even though it’s often present. The difficulty lies in accurately diagnosing whether neck pain is contributing to the headaches or if it’s a co-occurring symptom that doesn’t necessarily require targeted neck treatment. In cases of primary headache disorders, palpation alone (feeling the muscles and joints of the neck) is not a reliable method to determine whether neck treatment will relieve the headaches.
The Importance of a Multidisciplinary Approach
In my practice, I have found that collaboration with other healthcare professionals is crucial when treating patients with headaches and neck pain. Since headaches can have a wide range of causes—including vision problems, poor posture, diet, stress, and musculoskeletal issues—a holistic approach to treatment is often required. Working closely with professionals such as opticians, GPs, personal trainers, and dietitians can lead to better outcomes for headache sufferers. This multidisciplinary approach allows us to tackle potential triggers from all angles, whether it’s poor vision, nutritional deficiencies, or stress-related muscle tension.
For example, many patients suffering from tension headaches may benefit from seeing an optician to rule out eye strainas a contributing factor. Others may find that lifestyle changes recommended by a dietitian—such as avoiding certain foods or staying hydrated—can significantly reduce headache frequency and intensity. Meanwhile, a GP can rule out underlying medical conditions that might be contributing to the headaches, such as high blood pressure or sinus issues.
Physiotherapy’s Role in Headache Diagnosis and Treatment
Physiotherapy can play a pivotal role in both the diagnosis and treatment of headaches, particularly when neck pain is involved. Through a thorough assessment, physiotherapists can help identify whether the neck is contributing to the headache and develop a personalized treatment plan to address the issue. Common treatments for neck-related headaches may include:
- Manual therapy: Hands-on techniques such as joint mobilizations and soft tissue massage to release tension and improve neck mobility.
- Postural correction: Many patients with neck pain and headaches have poor posture, particularly those who spend long hours sitting at a desk or looking at screens. Improving posture through targeted exercises can alleviate neck strain and reduce headache symptoms.
- Exercise therapy: Strengthening and stretching exercises aimed at the neck and upper back can improve muscle balance and reduce pain.
- Education: Providing patients with advice on ergonomics, stress management, and lifestyle changes can help prevent recurrent headaches.
Why Neck Pain is Linked to Headaches
Neck pain and headaches are closely linked because of the complex anatomical and neurological connections between the neck and head. The cervical spine (neck) is connected to the brain via nerves, muscles, and joints. When the neck is stiff, strained, or injured, these connections can send pain signals to the head, causing headaches. In particular, poor posture—often seen in those who work long hours at a desk or spend too much time looking at their phones—can lead to neck tension and muscle strain, which contributes to headaches.
When Should You Seek Help for Headache-Related Neck Pain?
If you experience headaches accompanied by neck pain, it’s essential to seek professional help. Persistent headaches, especially when accompanied by neck stiffness or discomfort, may indicate an underlying issue that requires treatment. A physiotherapist can evaluate your posture, assess your neck’s range of motion, and determine if manual therapy or other interventions are needed.
Getting the Right Support
As physiotherapists, we work as part of your healthcare team to assist in the diagnosis and treatment of headache disorders, especially when neck pain is involved. Although headaches can be challenging to diagnose, particularly when multiple factors are at play, physiotherapy can be an essential part of your treatment plan.
If you’re experiencing headaches with neck pain, don’t hesitate to reach out. For more information on how I could support you or to book an appointment, please get in touch at 07813 912 313 or email tors@stoneystrettonphysiotherapy.co.uk. Together, we can help alleviate your pain and improve your quality of life.