Is your headache coming from your neck?

When headaches come from the muscles in the neck, we call it a 'cervicogenic' headache. There's a myriad of causes for headaches - cluster, migraine, dehydration, sinus, hypertension, tension and the list goes on. It can be hard to process it all and work out where it's coming from but it's often from the neck. People with neck driven headaches often say things like:

• "My headache starts after I've been sitting."

• "My headache starts after using my arms (hanging washing, washing dishes etc.)"

• "My headache starts after using the computer."

• "My headache starts after looking up."

• "My headache comes on when I sleep."

• "My headache comes on when I go up stairs."

What all of these things have in common is that there is a movement or action that will trigger the headache it rather than an infection, a stressful event or a medical issue. If this sounds like you, keep reading (even if the headache is severe or has migraine related symptoms).

There are muscles that attach from the base of your head into the upper neck. These muscles are much more sensitive than normal muscles. The muscles here do so much more than stabilise and move your head on your neck (which in itself is quite impressive). They also work with your eyes to tell your brain where the position of your head is in space and also connect with the 'dura' that goes all the way from your eyes to the bottom of your spine (this is where the cerebral spinal fluid runs). They also have one of the highest densities of muscle spindle fibres of all the muscles in the body. These little muscles aren't to be ignored! For such a small part of the body to do so much there's bound to be occasional problems. The referral can feel behind the eyes like this:

When these muscles become sensitive, they typically trigger a headache and a pretty bad one at that. This can cause all sorts of issues in addition to the headache including blurred vision and dizziness. There are a few pretty common reasons why these muscles become problematic, I'll run you through the main causes I've seen through my career, and you can see if any sound like you.

1. WHIPLASH

This may sound obvious, but whiplash doesn't need to be recent for it to trigger chronic headaches. Whiplash (even if it happened years ago) can strain the ligaments in the neck and result in a change in muscle recruitment around the neck over the long term. Think of the neck muscles as having little stabilising muscles and big power muscles. What often happens after an injury is the body will 'lock down' with whatever it can to protect in the short term. This tends to help heal the main injury (often the ligaments and spinal joints) but in the long term it can lead to faulty muscle patterning around the neck. This has actually been proven (I used to work for the lady who did the research - Carol Kennedy). If this sounds like you, what you often will need to do is learn how to use the deeper neck muscles and then train them into your neck posture and lifestyle. Typically, the longer you leave it the harder it is to change because of muscle memory and neuroplasticity but I've worked with people who had headaches for 20 years and changed it in 8 weeks! Persistence really does pay off if you're motivated and have a good physio.

2. POOR DESK POSTURE

This is more common than you think. Getting your ergonomics right can play a huge role in addressing neck problems. If you spend 5-8 hours of the day at your desk, your body will learn ways of doing things that can cause problems over time. The three biggest things are having your monitor at the right height (so your chin isn't poking forward) and close enough that you're not having to strain. Stick your hips as far back in the chair as you can (so your chest isn't slumped) and do regular stretches for your mouse arm.

3. POOR LOADING THROUGH YOUR PELVIS

Headaches in mums are common - young or old. Believe it or not, your neck and pelvis share common connections through the nervous system. The ligaments in the pelvis blend with the sacrococcygeal ligament which is at the very bottom of your spine and if they're under tension (can be from changes in pregnancy or postpartum), it can irritate the tail end of your nervous system which then makes the muscles at the base of the skull sensitive. This is more common than you think. This might be why a massage every week or two can help your headaches, but it will just come back (sometimes worse than before). What you often will need to do is work out why the ligaments in your pelvis are under tension and make the change here for long term resolution. The common story here is when you get headaches after lying on your back or going up stairs.

I hope I've given you something to work with. Once you work out your neck is causing your headaches, you're halfway there! This can be considered general advice but remember that everyone is different, so you'll often need an individualised approach with a good physio.