What is cervicogenic migraine? Cervicogenic headaches are a condition that causes one-sided headaches. They can be referred from bony structures or the soft tissues of your neck. What are the symptoms of cervicogenic headaches? Single-sided headaches are most common. They are side locked, meaning that the headache does not move between the sides. It can spread from the neck to where the skull is at the base and then around the front of your head.

Symptoms

The symptoms can be caused by neck movements and prolonged postures. They are usually described as dull or moderately intense and worse in mornings. The symptoms include a reduced range of motion in the neck, tender and sore neck muscles, reduced joint mobility, and poor motor control of deep neck flexors (stabilising endurance muscle). A physiotherapist can help you determine if your headache is cervicogenic and therefore treatable with physiotherapy.

How can cervicogenic migraine be treated? A physiotherapist can treat cervicogenic migraines by addressing the causes and creating a personalized treatment plan.

Treatments

• Postural assessment: Poor postures and prolonged use can lead to a ‘poked’ neck. This position can lead to stiffness in the upper cervical spine, which can cause neck dysfunction and cervicogenic headaches. A physiotherapist can assess your posture and provide the best advice for correction.
• Joint mobilization/ manipulation: To restore normal joint mobility, stiffened or dysfunctional neck joints can gently be mobilized and manipulated.
• Massage: Cervicogenic headache patients often experience muscle tenderness and spasm below the base of their skull in the sub-occipital muscles. Trigger point therapy and local massage can provide significant relief. A basic exercise program can also be designed to help with reactivating deep neck muscles and relaxing the superficial muscles to restore equilibrium.
• You can also get immediate relief from headaches with simple, effective exercises.

Conclusion

What evidence is there? Strong evidence supports the effectiveness of physiotherapy in managing cervicogenic headaches. It has been proven that the simple addition of manipulative and exercise therapy over a 6-week period can reduce the frequency and intensity of cervicogenic migraines. These benefits last for a long time and don’t return after the treatment has ended. This is the most important outcome.