Many patients present at the clinic with neck pains, back pains and related headaches and migraines. We are lucky to be able to help many of our patients to overcome and prevent the onset and recurrence of some headaches and migraines by addressing the root causes. We hope the following article may help patients to determine if they may self help or seek our assistance.
Before the various causes are discussed an example of a patient presenting in the clinic may be useful:
‘Miss P is a 27 year old lady who arrived in dire straits having suffered continuously from a headache for over two years. She had exhausted many sources of help and was currently under the care of a Consultant Neurologist. The treatment was heavy duty analgesics which were helping slightly but reproduced side-effects of drowsiness. Sadly this should have been the prime of Miss X’s life, however she was avoiding socialising and understandably so. After an in depth consultation it was decided that the root cause of these headaches was coming as a result of poor seating posture at the desk causing restriction of the joints in her neck with contraction of the posterior musculature of the neck. A treatment plan was put together and commenced immediately. Miss X was treated weekly for 4 sessions and by this time the headaches had resolved by 60%, a further 2 treatments reduced the headaches to background annoyance. Regular check ups every 3 months have resulted in analgesics not being necessary. The last visit Miss X had was for knee pain and has no reported headache for 3 months’.
Headaches originating from the Neck (Cervicogenic-Cephalgia)
These are benign headaches unrelated to increased inter-cranial pressure, infection or haemorrhage. They usually begin as a vague ache in the base of the head (occipital area) or top of the neck. Within hours, it progresses over the top of the skull to involve the entire head. People may complain of pain behind the eyes on one or both sides. The headache usually worsens as the day progresses yet improves with lying down and sleeping. If severe it may trigger Migraine style symptoms of nausea, photophobia or vomiting. There are a number of trigger areas for the onset of this these forms of headaches.
- Muscular attachments from Cervical or Thoracic Spine to the periosteum of the occiput
- Restricted Facet joints in the cervical spine
- Restricted function of the Cervical or Thoracic Spine
- Restriction of blood supply
- Poor venous drainage from the Intracranium
- Dural restrictions within the Cervical Spine and internal cranium
- Restricted function of the joints of the various yet distinct 29 bones of the skull
The causes are often a combination of poor seating postures, weak abdominals, long hours in front of a computer and also stress.
Treatment of patients with headaches takes a whole body approach. A combination of soft tissue techniques, articulation, manipulation, stretching and gentle cranial Osteopathy plus advice on stretching exercise and correct posture and seating positions.
A full discussion of headaches in their various forms would fill an extremely large textbook. It is well beyond the scope of this article to encompass all the causes of headaches and or migraines. Therefore this presentation is limited to the poorly understood but surprisingly common phenomenon of headaches originating from the neck.