Cervicogenic Headache Exercises

Physical Therapy for Cervicogenic Headache

What is a cervicogenic headache?

A cervicogenic headache is the type of headache that stems from the upper area of the cervical spine (neck). There can be involvement from the joints, discs, and/or muscles of the neck. These types of headaches are unilateral in nature (they present on one side of the body). They can be aggravated by neck movement and sustained postures.

Cervicogenic headache trigger points

Cervicogenic headache trigger points within some of the muscles around the neck have specific referral patterns. This helps us to determine if you truly have cervicogenic headaches, or another type of headache. Due to how close certain nerves are at the upper neck area, clients with cervicogenic headaches sometimes complain of symptoms such as ear fullness or jaw TMJ (jaw) pain.

Drawing of head and upper neck with red coloring showing the points of the head and two X's at the base of the head to show the trigger points.
 
Drawing of head and upper neck to just below the shoulder with red coloring showing the points of the head and two X's at the base of the head to show the trigger points.
 

Trigger Point Referral Patterns

 

What causes cervicogenic headaches?

Cervicogenic headache causes include sustained poor posture (especially posture related to ergonomics), stiffness of the upper cervical spine (C1 & C2 vertebrae), and decreased muscular strength/coordination/endurance of the neck muscles.

How do you diagnose cervicogenic headaches?

We diagnose clients with cervicogenic headaches based on the subjective history they provide to us, and the objective tests we perform to confirm the diagnosis.

Does heat help cervicogenic headaches?

The use of heat may help to transiently alleviate neck pain symptoms (if there is neck pain). Heat can help to relax some of your neck muscles, which can help with headache relief as well (if the muscles are the culprit in your case). If joint mobility restrictions or muscular endurance is the problem, then heat will not help. Ultimately, heat will not resolve your cervicogenic headaches long term. That will require hands-on manual therapy and proper neck exercise prescription by a skilled physical therapist.

Treatment for cervicogenic headaches

Best treatment for cervicogenic headaches will include both manual therapy and exercise, as supported by this research study.

We start our manual therapy with soft tissue mobilization (massage) on the tight muscles around the upper neck to break up rigid muscle tissue, relax muscle tension, and allow for better movement of fluids. The tight muscles that typically need to be targeted are the suboccipitals, upper trap, levator scapula, and cervical paraspinals.

Once we relax the tight muscles, we follow up with joint mobilization techniques to the upper neck segments to regain normal joint mobility. Our physical therapists specialize in these types of manual therapy techniques.

Once we improve the joint mobility of the upper cervical spine with manual therapy, we follow up with exercises for the neck and shoulder blade region to build flexibility, strength, endurance, and neuromuscular control in the new range of motion. This will help to maintain proper posture for longer periods of time and decrease the frequency of headaches.

 
3D anatomy model showing the skeleton and supporting muscle, viewing the back of the head down to upper back. Green arrows are pointing at the suboccipitals, which are connected from the base of the skull to the spine.

Suboccipitals

 
 
3D anatomy model showing the skeleton and supporting muscle, viewing from the back. The levator scapula is highlighted in orange and located a the back, side, of the neck.

Levator Scapula

 
3D anatomy model showing different muscle groups, viewing the back. The trap muscles are are highlighted in orange and a green arrow is pointing to the upper traps.

Upper Trap

 
3D anatomy model showing the skeleton and supporting muscle, viewing the back. The cervical paraspinals go from the upper neck down to the upper back connecting to the spine.

Cervical Paraspinals

 
 

Exercises for cervicogenic headaches

Chin Tucks (supine)

 
 
 

Chin Tuck with Rotation with Towel Overpressure

(Both Sides)

 
 
 

Prone A’s

 
 
 

Quadruped T

(Both Sides)

 
 
 

Cervicogenic headache stretches

Upper Trap Stretch

(Both Sides)

 
 
 

Levator Stretch

(Both Sides)

 
 
 

Chin Tuck with overpressure (seated)

 
 
 

Closing Remarks

If you are experiencing cervicogenic headaches and would like to work with us, contact us below to speak with a physical therapist.

Disclaimer: This is not intended to be formal medical advice. Your individual needs should be met by the appropriate health care practitioner. Please consult with a trusted provider.

Dr. Paul Nasri PT, DPT, OCS, COMT

Dr. Vincent Liu PT, DPT

Doctor of Physical Therapy

The Game Plan Physical Therapy

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