Cervicogenic headache is a chronic headache that arises from the atlanto-occipital and upper cervical joints, especially C2-3 vertebra. It is commonly being confused with migraine headache due to theirs similar characteristics. Cervicogenic headache is caused by structural problems in the neck including nerves, bones and muscles.

Signs & Symptoms:

  • One sided pain on the affected side
  • Diffuse shoulder and arm pain
  • Reduced cervical ROM
  • Tenderness at the upper neck

Physiotherapy Management:

Most of the cases can be treated with physiotherapy management including:

  1. Manual therapy

Hands-on techniques such as soft tissue manipulation (STM) and joint mobilization technique can be performed on the patients with muscles tightness or cervical joint stiffness. Manual therapy aims to (i) relieve pain; (ii) improve range of motion; (iii) induce relaxation and etc.

2. Dry needling

Dry needling (DN) is an invasive approach where a fine needle is inserted into the muscles to release the myofascial trigger points (MTrP). Taut bands in the tightened muscles will reduce blood flow in the trigger points, and therefore develop local and radiating pain to the side of the head.

3. Postural corrective exercises

Improper posture is one of the risk factors that will lead to cervicogenic headache. Therefore, physiotherapist will look into postural corrective exercises as well as the patient’s working ergonomics. Stretching and strengthening exercises for imbalanced muscles will be prescribed to the patients based on the findings after the assessment.

Article by Yong Hok Nian

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