Migraine headaches can be crippling and affect your quality of life. While migraines can be caused by a wide variety of things, there are a few related to issues in the cervical spine that might be treated or see improvement in symptoms via physical therapy.
The cervical spine region of the neck can be linked to symptoms of what is called a Cervicogenic headache. To understand if physical therapy is a good idea for your headaches, it first helps to get a better understanding of the cervical spine and how it can influence other parts of your body.
The Anatomy Of The Cervical Spine
The cervical spine region of your neck consists of seven cervical vertebrae. Each is stacked on the other with a semi-pliant, spongy intervertebral disc cushioning the relationship between the bones. Each vertebra has joints on each side where the bone articulates with another. The cervical vertebrae serve a dual function in protecting the spinal cord while also allowing your neck to move, flex, extend and do things like side bending.
The upper cervical vertebrae also help to support the skull, which has a significant mass of its own. On each side of the cervical level, there is an occiput of the skull which allows for a degree of motion.
If you were to take a close look at this suboccipital area you would see a variety of muscles that both support and move your head. It includes nerves that travel from the neck, through the suboccipital area, into the head itself. The nerves and muscles in this area can become strained, pressured, or impinged in a way that can put you at increased risk of suffering from a Cervicogenic Migraine.
What Are The Symptoms Of A Cervicogenic Migraine?
There are a few common symptoms of a cervicogenic migraine to be concerned about. This includes:
- Pain originating on one side of your upper neck
- Pain that radiates from your to your temple, forehead, and eye
- A noticeably reduced range of motion in your neck
- Pain on both sides of the back of your head
- Pain in the back of your head and radiating to one shoulder
- Nausea that is not related to a digestive reason
- Increased sensitivity to light
- Increased sensitivity to sound
- Problems with dizziness or vertigo
It’s also worth noting that sometimes sudden motions in the neck can trigger symptoms of cervicogenic migraine. Though some may come on during sustained unhealthy neck postures and worsen over the course of several hours.
If you have started having headaches with symptom patterns like this, you might be experiencing cervicogenic headaches, and need to schedule an appointment with your primary care physician. They can assess your symptoms and help identify associated factors.
How Are Cervicogenic Migraines Diagnosed?
Your physician will likely use a multi-stage approach to determine if you are indeed suffering from cervicogenic migraines. This might also include diagnostics to eliminate other potential sources. The diagnostic process often includes:
- A physical examination of the range of motion in your neck
- Palpation of your neck and skull
- A short-term diagnostic nerve block injection
- A CT scan
- An MRI
Most of the time a confirmed diagnosis of cervicogenic headache is made when there is one-sided headache pain, without throbbing, which is also coupled with a loss of neck range of motion. In a case like this, there might also be a known lesion seen on your neck imaging studies. This could be an overt sign of a bulging or herniated disc, disc degeneration, or arthritic changes that have directly affected the nerves and other structures of the cervical spine.
Physical Therapy For Cervicogenic Migraines
Your physical therapist will first need to assess specific factors, such as your range of motion and the functional strength of your neck muscles to help develop a personalized physical therapy treatment plan. This will likely include diagnostics like:
- Palpation of your neck and skull
- Measures of neck range of motion
- Strength measurements
- Postural assessment
The physical therapist will then take this information and the diagnostic images gathered by your primary physician to develop a customized treatment strategy. The plan they put forward might include one or more of the following physical therapy techniques
- Cervical retraction
- Cervical flexion
- Cervical side bending
- Cervical rotation
These measures will typically be reinforced with special exercises and stretches that you can perform on your own at home. They can also help reduce or alleviate symptoms should you experience another Cervicogenic Migraine. Just remember to perform the specific neck exercises slowly, even if you are in distress. They need to be slow, steady motions and you need to avoid sudden or jerky movements.
Physical Therapy For Postural Correction
Many Cervicogenic Migraine cases also have postural issues associated with them. In this instance, your physical therapist will factor in other exercises and possible lifestyle changes to help gradually improve your cervical posture. With time, this can also be a major factor in reducing your symptoms or reducing the frequency of your Cervicogenic Migraines. A postural correction treatment plan might include:
Using a lumbar roll when sitting
Performing the slouch-overcorrect exercise to find an optimal posture
Using a supportive neck pillow when sleeping
Apply Hot or Cold Packs
Hot or cold packs can often be applied to your neck and skull to help decrease pain or inflammation. Heat tends to help relax tight muscles and improve local circulation. This might prove to be an effective treatment to do just before performing your neck stretches.
Targeted massage can help to address tight muscles that are limiting your neck motion and causing headache pain, they can also help improve mobility. In some of these cases, a special technique known as the suboccipital release can be used to loosen the muscles that attach your skull to your neck, allowing for improved motion and decreased nerve irritation.
If your Cervicogenic Migraines are causing dizziness or vertigo vestibular therapy might be able to help. It is a specialized form of rehab that involves performing specific neck, head, and gaze stabilization exercises to improve the way your vestibular system functions.
A physical therapist might also use electrical stimulation, such as transcutaneous neuromuscular electrical stimulation to help decrease pain in the neck muscles as well as improve your headache symptoms.