It is estimated that up to 7 million Australians experience tension headaches and 4.9 million suffer from migraines. For many headache and migraine sufferers, neck dysfunction is a major contributing factor to ongoing pain. When this dysfunction is identified as the main cause of pain, they are considered cervicogenic headaches.
At Village Remedies in our Sydney CBD and Balmain clinics, we see many clients who suffer from headaches and when assessed, find the neck to be a major causative factor to their pain. In this article, we’ll look at what cervicogenic headaches are, how conventional medicine may approach treatment, how acupuncture is used for cervicogenic headaches and how we approach treatment in our clinics.
WHAT ARE CERVICOGENIC HEADACHES
The atlanto-occipital and upper cervical joints are most commonly implicated in cervicogenic headaches. These joints are responsible for the majority of our head/neck movement with 33% of neck flexion and extension (forward and backward movement of the head) arising at the first C1 joint and 60% of rotation coming from the mobility of C2. When the movement of these upper neck joints are affected by injury, chronic tension, overuse and/or instability they can impair neck movement and cause headache symptoms.
Some common symptoms of cervicogenic headaches include:
- One sided head pain (though can be both if both side of the neck are affected)
- Pain exacerbated by head and neck movement or posture
- Neck pain, tension and/or reduced range of motion
- Muscle tenderness in the neck and shoulders
- Sometimes pain radiating into the shoulder and/or arm
These symptoms are also often common in cases of chronic tension headaches and migraines. If you have headaches of any kind, it is important to have your neck properly assessed by a health professional (such as your friendly Village Remedies acupuncture team!).
IMPORTANT: If you have been experiencing chronic or worsening symptoms, it is worth checking in with your doctor. If at any point your symptoms are abrupt and severe, and/or involve any other symptoms of fever, stiff neck, confusion, seizures, double vision, weakness, numbness and/or difficulty speaking, then you should seek emergency medical care. This also goes for a worsening headache after any head injury. When in doubt, see your doctor.
HOW ARE THEY NORMALLY TREATED
See your doctor and you’ll probably be prescribed pain relief and/or muscle relaxants. You may also receive a physiotherapy referral where the focus will be on corrective exercises. More extreme treatments can include anti-seizure medications, antidepressants, injections of corticosteroids, nerve blocks or botox.
While these treatments can help manage symptoms, there are many people who continue to suffer from chronic headaches.
ACUPUNCTURE FOR CERVICOGENIC HEADACHES
Acupuncture has been shown to be an effective treatment method for tension headaches and migraine. Treatments can be split between two main approaches: distal acupuncture where points are selected distant to the affected area in order to trigger the body’s innate healing capacity; and local acupuncture (similar to dry needling) where points are needled in and around the affected area in order to directly affect the tissues. The benefit of distal acupuncture is that there is less risk of irritating already inflamed areas and in many cases can offer fast pain relief. Local treatments may be required to fully restore mobility and function of the affected tissues. Your qualified acupuncturist will know when and how best to use these approaches for you.
WHAT TO EXPECT AT VILLAGE REMEDIES
With Chinese medicine, everyone is treated as a whole person, not just a sore head or tight neck. This means that at Village Remedies we conduct an in depth physical assessment of the neck and related areas, along with an overall health assessment to identify other contributing factors that may be affecting your recovery. Here are some of the key areas that we look at to best help with cervicogenic headache:
Range of motion of the neck, as well as palpation of neck joints and muscles - often muscular tension or imbalance that contributes to headaches can be identified here.
Palpation and movement of other areas such as upper back, shoulders and even hips - the neck does not act in isolation of the rest of the body, imbalances in these other areas can contribute to neck dysfunction.
Assessment of posture - often the way we hold our body reveals and contributes to areas of imbalance.
Assessment of breathing - it is very common to breathe too much in our upper chest which overstains our neck muscles and overstimulates our sympathetic nervous system (i.e. our stress response) which increases our sensitivity to pain and tightens muscles in general.
Quality of sleep - without enough quality sleep your body does not receive adequate recovery time allowing for daily tensions to build up. Your sympathetic nervous system will also be stimulated, increasing pain sensitivity and overall tension.
Regularity of digestion - a healthy digestive system is key for overall health and the absorption of nutrients that you need for healthy muscle and nerve function. Inflammation in the gut has also been linked to systemic inflammation.
Overall stress - this doesn’t necessarily mean “bad” stress, because when there’s a lot going on, even when we’re busy with good things, our body will respond with our stress response, exacerbating pain, inflammation and tension.
Once we have figured out what we need to focus on, we come up with a treatment plan designed for you. Initially this may include acupuncture treatments closer together to build up effect, as well as Chinese herbal medicine where appropriate. Your practitioner will also help you with corrective exercises to address any postural and movement issues. We monitor your progress carefully and as you progress, treatments can be spaced out further and further until you either don’t need us anymore or we’re there for maintenance.