Millions of people are suffering from chronic headaches across the globe. Many of them would be suffering for many years. These patients are commonly diagnosed as migraine and would be taking medications for the same. The severity and intensity of the headaches varies from patient to patient.

For example, some will get a headache once in every week and some will get every alternative day. The locality of the pain would range from pain all over the skull to pain only to one side of the head, around the eyeballs, the vertex of the head, temple region or back of the skull etc.

These patients might have tried and tested various forms of treatment and finally would have reached a conclusion that they must learn to live with that. Often, investigations like MRI, CT wouldshow no serious brain, nerve or blood vessel pathology.


Hence these patients will be branded as Migraine sufferers and they will try and adopt a certain lifestyle that help minimizes their symptoms. However, most of them are still suffering from this debilitating condition, which they are unable to sort it out, despite that they had seen multiple doctors. Just because these patients were not found to have any problem in the scans and none of the medications was giving a long-term solution, they should not be diagnosed as a migraine.

Your Headaches can emanate from the neck structures too, which we term it as Cervicogenic Headache. The cervical spinal nerves (especially C1, C2, C3) has its connection to one of the cranial nerve nucleus (Trigeminal Nerve). On the virtue of this connection, problems in upper cervical nerves, cervical disc and upper cervical joints can stimulate the Trigeminal nerve pathways that can result in headaches that mimic a migraine. Additionally these patients might get vomiting sensation and giddiness too.

Owing to our modern lifestyle, more and more, including young population are suffering from neck pain. In such people, the neck pain can extend upwards too to cause a headache. Headaches are broadly classified as primary and secondary headaches according to International Headache Society. Secondary headaches are due to numerous reasons and one of the major reasons is neck related headaches. Even in Primary headaches like a Migraine, neck issues can still contribute to the severity. But, none of these patients is being evaluated to rule out or rule in the neck related headaches otherwise called as cervicogenic headaches.

How do you know your headaches are from the neck?

These are Trigger point induced headaches. Muscles that connects the head and neck, if affected by trigger points, can cause headaches. If any of these points apply to you, it is a good news. Because it is possibly neck related headache that can be treated easily. Your diagnosis of a migraine must be reclassified, and you don’t have to take lifelong medications. Or if you already had MRI taken for the neck pain and if there is significant disc bulge in C2-C3 or C3-C4 level, then there is a greater chance that you get a headache because of that.

In such cases, a systematically given physiotherapy that includes exercises, education, posture correction, manual trigger point release, dry needling will resolve your headache once for all. There are promising scientific evidence showing the efficacy of Physiotherapy in Headache management.

Even in a tension-type and migraine headache, Physiotherapy treatment will work towards reducing the frequency and intensity of the attacks. If it is cervicogenic headaches, physiotherapy can give permanent relief without any reliance on medications.

There is a caveat here. Not all Physiotherapists are trained in managing headaches. So, make sure that your physiotherapist is properly trained in headache management.

Dr.Rajkannan.P, PT

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