Headaches & Migraines

What are headaches?

Headaches and migraines are debilitating conditions that affect the nervous system. Headaches affect a large portion of the adult population and each individual can have a unique set of symptoms. According to a study completed by the World Health Organisation in 2013 headache sufferers have been ranked the third highest cause of disability in the world.

There are almost 300 classifications of headaches including;

  • Cervicogenic
  • Tension-type
  • Chronic daily
  • Cluster
  • Hormone
  • Occipital neuralgia
  • Sinus

The impact headaches can have on each individual are underestimated, under recognised and under treated.

How can I tell if my neck may be contributing to my headaches?

  • You have neck pain or stiffness before, during, or after a headache episode (the neck symptoms you feel can be very minor)
  • Your headaches started or got worse following injury or trauma
  • The medication you use for your headaches is no longer as effective as it used to be
  • Your headache is usually worse on one side or swaps sides during or between episodes
  • Your headaches often come on after prolonged periods of sitting, being sedentary, or when in certain postures

How can my neck cause my headaches or migraines?

With expert training in the Watson Headache® Level 1 & 2, our physiotherapists can determine whether there is an imbalance within the top three joints in your neck.

Your upper neck is a very sensitive part of your body and overstimulation of this part of your neck can cause sensitivity to a part of your brain called the brainstem, along with the central nervous system (CNS). This sensitivity process is often referred to as ‘sensitisation’.

Sensitisation can over-excite the nerves to your face and head causing your head pain or headache. As the central nervous system is also involved in regulating your flight or fight response this sensitisation can also be responsible for your additional headache symptoms such as;

  • Nausea
  • Vomiting
  • Light sensitivity

What causes an imbalance in my upper cervical spine?

This imbalance can be caused by several things most of us do daily ranging from;

  • Forward head posture
  • Poor desk set up
  • Prior whiplash injury
  • Chronic neck pain
  • Chronic upper back pain
  • Poor eyesight leading to forward head positioning
  • Posturally loaded activities e.g doing a puzzle, sewing, reading, computer work, cycling, sit-ups
  • Weakness in the muscles in the front of your neck
  • Excessive tension in the upper back/shoulder muscles – commonly secondary to stress
  • Sleeping in different beds/on different pillows

During your initial consult, your Physiotherapist will take a detailed history of your headache symptoms and assist in finding the likely underlying postures and/or activities contributing to your symptoms. Your therapist will then teach you ways to continue with your activities, but in a position that minimises the risk of compromising your upper cervical spine.

Image of female with poor posture working on laptop potentially contributing to her headaches
Image of female with poor posture working on laptop potentially contributing to her headaches

I don’t have neck pain, so my neck still be related to my headaches or migraines?

Absolutely! While most people suffering from cervicogenic headaches do experience some degree of neck pain and/or stiffness either between or during headache events, not everyone who presents to the clinic has neck pain.

Headaches at ‘that time of the month’?

Headaches can be caused by several different factors including;

  • Stress
  • Depression
  • Hormonal changes
  • Sustained poor postures
  • Degenerative changes
  • Eye strain
  • Food intolerances
  • Other significant pathologies

So how can these be related to my neck?

As explained above, when there is an imbalance in the top 3 joints of your neck it can cause overstimulation of your brainstem and sensitisation of your central nervous system (CNS).

The CNS has many functions and is responsible for processing sensory information and responding accordingly. If your CNS is sensitised it perceives normal body changes such as stress and hormonal fluctuations as ‘harmful’ and triggers a headache. For example your hormonal headaches, most women are under the belief that their monthly headaches are caused by the hormonal changes they experience during that time of the month. And they are correct. To a point. However, have you ever wondered why you experience monthly headaches and your friends do not? If you have the exact same change to your hormones and the exact same dilation of your blood vessels, why do you get a headache? If you have a sensitised central nervous system, from overstimulation from your upper cervical spine, your body will perceive your hormonal changes as harmful and trigger a headache.

Treating the source of the problem, your neck, will aid in desensitising the central nervous system so you can still experience the same hormonal changes each month, however, without your body processing the change as harmful and without the resulting headache

How can the Queensland TMJ & Headache Centre help me? What can I expect during the treatment process?

With expert assessment from clinicians at the Queensland TMJ & Headache Centre we will perform a thorough examination to determine exactly what structure/s are contributing to your headaches.

We will assess how your neck and back are moving to determine whether there is an imbalance in your upper neck or elsewhere down your neck and back that might be contributing to your symptoms. The assessment process can involve temporarily reproducing your headache/facial pain symptoms to help us determine the exact structures involved. The reproduction of your headache symptoms is temporary and eases immediately following treatment.

We will provide you with a full explanation of our assessment findings and answer any questions you may have. There is NO cracking, NO jolting, and NO fast movements of your neck during treatment. A full safety assessment of all ligamentous and arterial stability is performed at the start of every initial consult. All assessment is undertaken in a slow, controlled manner as it is vital you feel comfortable and in control throughout the entire process.

Treatment is varied depending on the individual’s needs, symptoms, and assessment findings, however often includes;

  • Spinal joint mobilisations
  • Upper neck joint desensitisation
  • Muscle release
  • Motor relearning and muscle activation
  • Postural awareness and positioning exercises
  • Individualised home exercise programs

Initial treatment usually involves one appointment/week for 3-5 weeks for those suffering from chronic headaches. We expect to start seeing a change to your symptoms within the first 4 sessions to warrant any further ongoing treatment. If we are not seeing the changes we except we will not keeping treating you, and instead look at alternate treatment options and refer you to an appropriate specialist as required.

Had your eyes tested, but still getting headaches or migraines?

Often we associate our afternoon headaches with eye strain, but what happens after you’ve been to your local optometrist and your eyes are in the clear? Or after you were prescribed new glasses, but are still suffering from headaches?

Too frequently do we see forward head postures, upper neck stiffness, and poor desk setups contributing to daily headaches. As experts in the treatment and rehabilitation of all neck and headache conditions at the Queensland TMJ & Headache Centre we will perform a full assessment and treatment plan tailored to you. This includes education on desk set up and seating posture to ensure we not only achieve short term relief of your symptoms but give you the tools to continue to self manage your condition into the future.

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