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December 14th 2016

Headaches are such a common complaint, we normally just pop some Panadol and hope they go away but is that just a bandaid solution to the problem?

Are you one of the many people who suffer from headaches? Not the ones created by school holidays or Christmas with the in-laws, the ones the sneak up on you on a Wednesday and your head feels like it’s going to explode. Did you know the second most common medical condition reported to GP’s is headaches. 18% of people suffer from cervical (neck) generated headaches, with females suffering 4 x more frequently than males. There are many different types of headaches, occurring for many different reasons, and they can be very debilitating. So why do they occur? You always start thinking that maybe you should have drunk more water, had more sleep or slept the wrong way or another simple cause. But it is possible that there was nothing you could have done differently. There are many types of headaches such as tension type, migraine, cervicogenic, cluster and menstrual.

The main type that we see as Physios are cervical generated headaches. It is a headache that arises from structures of the neck, such as the spine, ligaments or muscles, causing head pain. The first 3 vertebrae and soft tissue around the head and neck (the ones at the base of the skull) can send pain signals to the brain, which can then send these signals to the face and head (behind the eyes for example). Often people clench or grind their teeth at night, but also sometimes during the day, and this can also be another cause of headaches. This increases tension in the joint muscles and upper neck, easily aggravating headaches. An occlusal splint (supplied by your dentist) can significantly help with symptoms (I have one) and they are easy to wear and very effective.

How do headaches present?

  • Pain may be gradual in onset or from acute trauma such as whiplash
  • Stiffness & restricted movement with muscular tightness and/or spasms
  • Radiation from back to front and usually appears worse on one side
  • In reality, many headaches overlap. Cervical generated headaches are often misdiagnosed as migraines

Clinical examination:

  • Thorough assessment of range of movement, posture and strength
  • Tightness in soft tissue of neck and base of skull
  • Headaches usually provoked by sustained posture or neck movement


  • Identify causes and any underlying issues
  • Release soft tissue
  • Mobilisation of joints – because headache’s can be easily triggered, these techniques need to be gentle
  • Dry needling can be very effective to increase blood flow and cause muscle relaxation
  • Posture retraining – strengthen muscles of neck and upper back

It is important to work as a team with cervical generated headaches, as often headaches can continue unless the cause is treated. I get asked about pillows all the time from those suffering with headaches. It is a very tricky question to answer as it might help but not be the answer to stopping the headaches from occurring. The bottom line is that a good pillow should support the neck and keep your spine straight. Tummy sleeping is out! If headaches are ongoing, talk to your GP and often a referral to a neurologist is appropriate.

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