Headaches can be a chronic, debilitating condition which affects multiple aspects of one’s life including personal relationships, work, and/or your desire to attend to hobbies with enjoyment. A neck headache (cervicogenic headaches ) is one form of headaches successfully treated by a physical therapist, and can provide you not only short-term relief, but also strategies to help keep headaches gone long after being discharged from therapy.

Neck headaches are a referred pain from a painful structure in the musculoskeletal system innervated by the nervous system, such as a muscle, joint, ligament, or neural structure. Typically, these headaches have an insidious onset, and worsen with various postures or activities. Their onset can also be traumatic in nature from falls, direct impacts of the head or neck, or motor vehicle accidents. It is important to recognize a musculoskeletal pattern to the symptoms, as it is this pattern that makes physical therapy becoming helpful for this condition more likely.

At Life’s Work Physical Therapy (LWPT), we pride ourselves in the ability to differential diagnose our patients, and design an individualized treatment plan to address their specific goals and needs. We block hour-long evaluation time-slots, allowing us to spend the time necessary to learn about the condition, past medical history, past treatments for the condition, and gain an understanding of what activities the problem affects and what things appear to make it worse or better. With neck headaches, we are looking to find postures, positions, or activities which may be contributing to the symptoms, and associate an increase of neck pain with the increase in intensity of the headache. We perform a thorough scan of the upper quadrant, looking at the movement patterns of the neck, thorax, upper extremities, and then perform a biomechanical examination looking at specific joint mobility of the neck, thoracic spine, ribs, and shoulders. We assess muscle flexibility of the neck and upper back, as well as neck, shoulder and scapular strength and endurance. We are looking to change the symptoms, either by making them worse or better, through the initial evaluation. Ideally, we are looking to alter the neck headache through movement or assessment of the cervical spine, showing a musculoskeletal nature to the condition.

After the evaluation, we provide extensive education about what we feel is causing the patient’s pain, what contributing factors are influencing it, and what we feel we can do to help. If the patient’s work environment (sitting posture, repetitive activities) is felt to be a factor, we will perform a thorough ergonomic assessment to improve those activities to help with long-term headache success. Treatment typically consists of: manual therapy to the head, neck, and thorax; postural education; progressive strengthening of the neck, shoulder, core, and scapular musculature; and functional activities to help with succeeding towards the patient’s long-term goals.

If you are experiencing headaches, and are wondering what the cause is and how to treat it, contact your physical therapist today. Gaining an understanding of why you are experiencing neck headaches is empowering, and allows you to immediately start self-management of the symptoms with the guidance of the therapist. Though headaches are common, they do not have to be chronic, and they do not need to control your life. Let physical therapy help YOU get back in control!