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Cervicogenic Tension Headaches Physiotherapy
In today's break-neck speed in life, work, societal demands, we notice that there is an increasing trend of people reporting and suffering from headaches.
These patients often report two types (or reasons) for their headaches:
The mental, emotional and physical stress from the type of lifestyle they have or want to pursue
The nature of work that
requires an individual to be in a prolonged static position working on
devices such as computers and smart phones
not all headaches are migraine
Sometimes patients naturally call their
headaches as migraine, but it can be inaccurate because there are a few
types of headaches.
We recommend that patients who often suffer from headache to understand and identify the type of headache that they have, so it'd help to:
- identify the specific triggers
- be able to sense if there is a headache coming soon
- be able to seek appropriate management
all to pre-empt to reduce the intensity and duration of the headache.
Cervicogenic headache is in fact one of the common type of
headaches and good news is that it can be treated with physiotherapy, whereas the main
treatment for migraine is medication.
Cervicogenic Headache Versus Migraine
Migraine refers to a
neurovascular disorder with signs of
- mostly one-sided (half) throbbing head pain
- lasting 4-72 hours and
- a group of neurological
symptoms including increased sensitivity to light, sound and smell,
nausea, and a variety of autonomic, cognitive, emotional and motor
Triggers of a migraine attack are frequently associated
with a wide variety of internal and external triggers such as
- hormonal fluctuations
- sleep disturbances
- skipping meals
Cervicogenic headache on the other hand refers specificly to
pain referred from a source in the neck that presents itself higher up, in the head. It is
caused by another illness or physical issue usually due to a neck
disorder or lesion.
In the upper neck area there is a region called the
trigeminocervical nucleus which interacts with the sensory fibers from
the upper cervical neck.
This allows pain referral between the neck,
face and head, explaining why when there is a headache the source of
pain may be in the neck instead.
Signs and Symptoms of Cervicogenic Headache
signs of people with cervicogenic headache:
- Altered neck posture
- Restricted cervical range of motion
cervical joint dysfunction assessed by manual examination are
This cervicogenic tension headache can be
reproduced or triggered by active and/or passive neck positioning and/or
movement, or by pressure application to the affected regions.
points (tight and sometimes sensitive knots in muscles) are usually found in the
- cervical and
which can cause headache when manually or physically
Physiotherapy Treatment for Cervicogenic Headache
There is a variety of
- nerve blocks
- physiotherapy and exercise
- and medications
The most common treatment for cervicogenic headache should
target the neck as it is the cause of the pain and varies from patient
Physiotherapy interventions depends on the outcomes and conclusions our senior physio reach after assessing your cervicogenic headache, understanding your pain, work and exercise history, before creating a you-specific physio program.
Physiotherapy and an ongoing exercise regimen often produce the best
outcomes with low recurrence rate of tension headaches BUT we still recommend that patients have
medications or anesthetic injections for temporarily pain reduction especially for days and events that the pains seems very intense.
This will allow:
- you to get short term pain relief for you to be still functional eg go to work, participate in life events etc
- be able to participate effectively with physiotherapy for even more positive long term pain relief
Physiotherapy treatment involves three main components:
Pain relieving physiotherapy treatments
Manual therapy can be
done, such as low-velocity cervical joint mobilization techniques (in
which the cervical segment is moved passively with rhythmical
movements). and high-velocity cervical manipulation techniques (cracking of the joint in a controlled, clinical and safe manner for the relief of tight joints).
approach encourages the body to modulate the pain level.
Next we will always work on soft tissue works joint manipulations are quick and effective, but short term, and soft tissue though slower outcomes, are medium to long term in benefits - hence combining these two is ideal.
release is another essential tool to help relieve tight connective
tissues or muscle knots that can be irritating the nerves causing
Physiotherapy modalities such as
- electrical therapy
- ultrasound therapy to accelerate soft tissue healing
- heat therapy to increase circulation as well as joint and soft tissue flexibility
- cold therapy are also commonly used to
complement the hands on techniques in pain relieving and facilitate the
Reconditioning of muscular imbalances
Reconditioning of muscular
imbalance includes low load endurance exercises to train muscle control
of the cervicoscapular region.
The first stage consists of specific
exercises to address the impairment in neck flexor synergy found in
cervicogenic headache and other neck pain disorders.
Neck flexors have
an important supporting function for the cervical region. Shoulder blade
muscles, particularly the lower trapezius and serratus anterior, are
also trained for a better postural control.
of the neck flexors and extensors is performed to increase the general
strength at the cervical region. Muscle stretching exercises are also
taught as necessary to optimize the loading at the cervicoscapular
Postural and ergonomic correction
Postural correction of the
daily activities is crucial to optimize loading on the spine and
overlaying muscles preventing unnecessary fatigue or stress on the
supporting muscles. Use of mirror for visual feedback and tactile
feedback such as tape application may be used to aid with posture
Rearrangement of layouts and work process advices are given
to minimize undue strain obtained from prolonged posture especially
people who have deskbound jobs.
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Phoenix Rehab Physio Services
Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
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See all the conditions our principal physiotherapists treat.
HAND THERAPY & CUSTOMIZED SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, usually will benefit / require Hand Therapy to
- manage and decrease hand pains
- improve range of motion, strength and dexterity
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following injuries or post-operations
Commonly treated hand pain injuries includes
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Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to accelerate recovery and shorten downtime / recovery period required.
It also prevents
muscles from scar tissue micro-tears (and potential ruptures), and increases muscle
performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.
Read the benefits of regular deep tissue release therapy here.
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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