Specific Treatments for Cervicogenic Headaches

Cervicogenic headaches is a common type of headache that arises from the upper cervical spine. This type of headache is only on one side of the head and does not shift sides. Symptoms can occur with a “ram’s horn” pattern, in the back of the head and/or around the eye depending on the cervical spinal level involved. This type of headache is usually reoccurring with episodes that last between one hour up to weeks. Patients often describe their headaches as moderate-to-severe in intensity and as non-throbbing/non-lancinating pain that usually starts in the neck. Symptoms are often made worse by neck movements, sustained postures and provocation over the upper cervical spine. If the upper cervical spine (C1-C2) is the culprit, neck rotation to one side will be more limited and symptom-reproducing compared to the non-effected side.  

Primary physical therapy interventions for cervicogenic headaches include: 

• Upper Cervical mobilizations and/or manipulation to reduce tension and increase mobility of the spine
• Soft tissue techniques to the muscles where the skull meets the neck 
• Other manual therapy techniques to reduce stiffness and increase mobility
• Strengthening exercises to muscles close to the Cervical vertebrae 
• Dry needling to the muscles in the neck to reduce tension and increase mobility 
• Stretches for the upper neck 
• Upper back manual therapy and exercises

References:

1. Fritz, J. M., & Brennan, G. P. (2007). Preliminary examination of a proposed treatment-based classification system for patients receiving physical therapy interventions for Neck Pain. Physical Therapy, 87(5), 513–524. https://doi.org/10.2522/ptj.20060192
2. Luedtke, K., Allers, A., Schulte, L. H., & May, A. (2015). Efficacy of interventions used by physiotherapists for patients with headache and migraine—systematic review and meta-analysis. Cephalalgia, 36(5), 474–492. https://doi.org/10.1177/0333102415597889

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