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Cervicogenic Headache Assessment & Treatment

What if, I Tell you by treating your cervical Spine will relieve your chronic headache...?

The answer is Yes. read the entire blog to find out intimately.


 Headache 


Definition - A pain within the head with the pain being above the eyes or the ears, behind the top (occipital), or within the back of the upper neck.



What Is Cervicogenic Headache...?

  • Headache Which Has origin from the cervical region is named Cervicogenic Headache.

  • There are majorly three muscles (Sternocleidomastoid, scalene, upper trapezius) that may end in Cervicogenic headaches. Any issue during this muscle can cause you referral pain in your Head.

Assessment for Cervicogenic Headaches.


  • As we all know cervical spine is extremely delicate because a small mistake may result in quadriplegia or maybe cause the death of the Patient. So, it’s necessary to see red flags before treating cervicogenic headaches.

Red flags 

 (1). VBI (Vertebrobasilar insufficiency)

  • Vertebrobasilar insufficiency may be a condition characterized by poor blood flow to the posterior (back) portion of the brain.
  • To Rule out this, we'd like to perform an EXTENSION ROTATION TEST 
  • If The test is positive immediately refer the patient to a Specialist.


- Previous research shows that inpatient with cervicogenic headache has following positive findings

  1. Reduced cervical ROM
  2. Weak deep flexors muscles
  3. The tightness of upper trapezius, scalene, or Sternocleidomastoid
  4. Facia tightness in Cervical muscles.


Note - in some cases putting pressure on C2 (axis spine) results in worsening pain in the head.


How to differentiate Cervicogenic Headaches from other Headaches.?

  • As we all know by taking history you'll get the most idea about the condition and just in case with cervicogenic Headache patient typically gives a history of taking medicines and not relived in pain. whereas in normal Headaches pain relives after taking medicines.
  • in cervicogenic headache, there's continuous pain whereas in migraine there'll be a Thrombing sort of pain
  • Cervicogenic headache (CeH) may be a secondary and sometimes unilateral that's known by referring pain from soft or hard cervical structures to occipital, temporal, frontal, and sometimes pre-orbital regions.
  • positive upper cervical flexion-rotation test which is very vulnerable to diagnose cervicogenic Headaches.


The treatment plan for Cervicogenic Headaches


  • Myofascial release of tight structures
  • Stretching of tight muscles (for example SCM, Scalene, Upper Trapezius)
  • strengthening of weak muscles (for example Deep Flexors of the Cervical)
  • Posture correction (Patient may have increased lumbar lordosis thanks to that gently develop a cervical issue and can end in cervicogenic headache)


Myofascial release & Stretching for better cervical mobility


  • Research shows that patients who are given Mayo facial release have better outcomes in pain Reduction.
  • For Mayo facial release you'll use Techniques like IASTM, Facial Gun, myofascial release Balls.
  • Mainly release of SCM, Scalene, and upper Trapezius Stretching for Same.


 Note - in some cases researchers have found that thoracic mobility also can cause cervical issues which end in cervicogenic headaches.so, it's better to assess it, and if restriction present also adds thoracic mobility Exercises.


Strengthening Exercises.

  • If there's Tightness of some muscles, there'll be Weakness of opposite muscles (Neurokinetic Therapy). So, we'd like to strengthen Deep cervical Flexors.

    • Exercises for Deep Flexors
    1. Chin Tucking
    2. Tung Press Against hard Pallet


Posture Correction Exercises 

  • As our body is one unit, problems in one area will cause pain in other parts of the body.
  • If the patient has excessive lordosis, it's going to cause neck issues and end in Cervicogenic Headaches. 
    1. Static abdominals
    2. crunches
    3. Leg raises
    4. glutes kicks
    5. Hamstring curls
    6. Stretching of hip flexors and back extensors.

Note - if you do not treat lumbar lordosis the patient will develop symptoms again & again after a few months or weeks.


 


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