Headache can often be coming from the upper cervical spine, commonly called cervicogenic headache. The pain is usually associated with some degree of pain and stiffness in the neck. A common cause of headache is poor posture especially when the head is held in protruded positions for long periods such as in sitting using a computer. As the spine is designed to be in an upright position, long periods of sitting with the head forward can stress upper cervical spine segments and refer pain into the head.
The pain is usually one-sided and commonly at the base of the skull but can also be felt in the forehead. Headache is usually associated with movement loss in the neck, with movements of the cervical spine having a direct effect on the pain. In fact, this is the predominant factor in determining whether the pain is coming from the neck or not. Cervicogenic headaches will usually be worse in some postures or movements and better with others. In general, cervicogenic headaches will be worse with rest and better with movement whereas “other headaches” will often be worse with movement and better with rest.
Headache that is cervicogenic can often be treated with posture correction and specific exercises. This can only be determined after a comprehensive assessment which will give the experienced therapist a directional preference on which to base the exercise prescription. Expensive tests are usually not necessary unless, on assessment, it is concluded that the pain is not mechanical.
Dizziness may also be cervicogenic. Again this will vary with postures and movement of the head and can be treated with education and specific exercises. Dizziness may also be due to vestibular or vascular dysfunction and is not suited to mechanical therapy.
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