Headaches

Headaches are often a result of multiple factors such as posture, stress, sleeping position, work, and exercise habits.

Recently we have seen an increase in clients seeking treatment for headaches due to the amount of time spent looking at computers, phones and other digital devices. Australians spend an average of 5.15 hours on screens per day (3.25 hours on desktops/laptops, and 1.9 hours on phones). This substantial screen time, combined with stress and poor posture, places a lot of load on the neck, which causes muscle tension, pain and headaches.

When you seek treatment for headaches it is important that your physiotherapist determines what type of headache you are experiencing, as this will change the treatment approach.

Headaches can be classified into two main categories:

• primary (migraines and cluster)
• secondary (tension and cervicogenic)

Primary headaches are treated with medication. They tend to be felt through the front and top of the head. They are not associated with technology usage or poor posture.

Secondary headaches (which are most common) can be treated with physiotherapy. This includes tension headaches or headaches from referred pain (i.e. Cervicogenic headaches).

Tension-type headaches are caused by muscular tension in the neck and around the base of the skull, usually triggered by emotional or physical stress. They are bilateral (both sides of the head), feel like a dull ache, typically last several hours, are mild-moderate in intensity and you may experience them more than 15 days per month.

Cervicogenic headaches arise from nerves in the neck referring pain into the head. The area responsible for this is the merger of the spinal nerves C1, C2 and C3, as well as a branch of the 5th cranial nerve, the trigeminal nerve. This merger of nerves makes it possible for cervical (neck) pain to radiate to regions of the head.

Cervicogenic headaches usually start in the neck, they are unilateral (one side of the head), a non-throbbing pain, moderate-severe in intensity and last anything from hours to weeks,.

Treatment for both of these headaches involves manual therapy, activity modification, stretches and usually some strengthening. Cervicogenic headaches require more specific manual therapy and home exercises, so as discussed earlier, it is important that we distinguish between the types of headaches you are experiencing.

In rarer cases, a certain type of headache may be a red flag indicating a more serious issue. Significant and sudden onset of pain, visual disturbance or unrelenting headaches can all be signs that further investigation is required.