Roughly 47% of the global population suffers from headaches and 20% of that population suffers from cervicogenic headaches (CGHs). That is roughly 750 million people globally! CGHs can be defined as chronic neck and head pain originating from the neck region, unilateral in nature and aggravated by certain neck motions or sustained postures. The etiology of CGHs may be complex, however with proper assessment, this is a highly treatable diagnosis.
Anatomy
The cervical spine contains 7 vertebrae and has 8 nerves arising from it. The first two vertebrae are of most importance due to their sensory innervation. The C1-3 nerves, by pathway of the trigeminocervical nucleus, relay pain signals to the head and neck. The facet joints of the upper cervical spine can play a critical role in creating discomfort along the neck and head, as well.
Treatment
Physical therapy can be an effective treatment option for reduction of headache symptoms. The use of manual therapy such as cervical or thoracic spine mobilizations and manipulations have been shown to dramatically decrease CGH symptoms, short term, in combination with therapeutic exercise, rather than just exercise alone. Mobilizations targeted at addressing the area of stiffness such as the atlantoaxial and atlanto-occiptial joints are favored over lower cervical mobilizations. Retraining musculature that is overused or underused is critical in maintaining long term benefits. Due to the muscular imbalances and sensorimotor impairments associated with this diagnosis, a multimodal approach is imperative for returning to a pain free life as soon as possible. If you are in the Mission Viejo area and think you, or someone you know, might benefit from physical therapy, please don’t hesitate to reach out!
Image 1: https://images.squarespace-cdn.com/content/v1/5ecfed0a7e1e5028aacc8e18/1590702731442-35FNIIBKWNF51R4T85JQ/apnea-and-stroke.png?format=750w
Image 2: https://northernpaincentre.com.au/wp-content/uploads/2020/03/Occipital-neuralgia-nerves-e1584511191936.png
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