Misdiagnosis of Headaches, How Can Physiotherapy Help? – By Physio4Life Senior Physiotherapist, Victoria Samson

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Headaches

Something I’ve noticed anecdotally, and possibly more so recently is the misdiagnosis of headaches.  There are many causes of headaches but the two that Physiotherapy can help with are tension headaches and cervicogenic headache.  The latter seemingly the more commonly misdiagnosed, often as migraine or other forms of headache.  The thing about Cervicogenic headache is that it can be really successfully treated with Physiotherapy if diagnosed correctly, instead of taking unnecessary medication.  This type of headache originates from the small joints of the upper neck (facet joints) and often comes with associated muscle spasm of the neck muscles, hence treatment is directed at theses structures to alleviate the headache.  The most distinguishing feature of the cervicogenic type headache is that it is always one sided, and the side of the headache rarely or never changes.  The headache is also felt that it starts at the base of the skull/top of the neck and radiates around the back of the head to the front of the head and face (on one side remember).  These headaches, like many, can be severe in nature and last for days if not weeks, however nausea and visual disturbance is not usually experienced as it is with migraine type headaches.  It’s worth bearing in mind if you have had recurrent episodes of unilateral headaches that it may be this type that stems from the upper neck and will really benefit from Physiotherapy input.  With treatment, the symptoms usually reduce quite quickly and with postural correction and exercises along side the hands on input it can eradicate the headache for good.

So why do they get so easily confused with migraines?  Because migraines are also almost always one sided and are also severe, however, there are a few differences.  Migraines can and do shift to the other side between episodes, the pain usually lasts up to 3 days not weeks and finally, there is usually no associated neck movement impairment which you do see with the cervicogenic headache, because migraine does not originate from the joints or muscles of the neck.

Possible pain distribution of a cervicogenic headache:

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