There is widespread support in the literature that headaches are often multifactorial in their origins. If your assessment reveals poor posture, limited range of cervical spine movement, palpatory tightness or a reproduction of symptoms on cervical palpation you may consider referring to physiotherapy. Even a short trial period of treatment is often useful to help with differential diagnosis provided medical review is arranged if symptoms remain unchanged.
Treatment is guided by signs and symptoms but the literature supports a 2 phase programme:
1) Mobilisation of the upper cervical spine
Improvement in symptoms of cervicogenic headache have been shown with attention to pain provoking structures (Edeling 1994, Jull 1994b, Schoensee 1995). However, whilst improvements were gained in the short term there was a plateau after mobilization.
2) Muscle Re-Training
Specific exercises isolating the deep flexors and addressing postural dysfunction. In a study by Beeton and Jull(1994) it was found by incorporating these into a more comprehensive programme that improvements were maintained six weeks after treatment had ceased.
Edeling J (1994): Manual Therapy for Chronic Headache (2nd ed.) Oxford: Butterworth- Heinemann.*Jull GA(1994b): Headaches of cervical origin. In Grant R(Ed.): Physical Therapy of the Cervical and Thoracic Spine (2nd ed.) New York: Churchill Livingstone).
Schoensee SK, Jensen G, Nicholson G, Gossman M and Katholi C (1995): The effect of mobilization on cervical headaches. Journal of Orthopaedic and Sports Physical Therapy 21(4): 184-196.
LifeCare Physiotherapists are involved in a comprehensive ongoing education programme including the management of acute and chronic headaches.
FOR MORE INFORMATIONsee your local Lifecare Practitioner.
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