Over the coming days I will go into some detail about 5 Reasons to have your neck examined in relation to your migraines/headaches.
Reason 1: Diagnosis
Did you know that according to the official diagnostic guidelines from the International Headache Society (IHS), the diagnosis of primary headache (migraine, tension type or cluster headache) can only be reached once other known causes of head pain have been excluded.
The neck is officially accepted as a cause of headache under the IHS classification, yet the description of its symptoms are almost identical to migraine and some types of tension headache. As Professor Goadsby (IHS president) explains "Headache of cervical origin and migraine often shows similar clinical presentations".
So if we can't distinguish them based on how they present, how has your neck been excluded?
Frese indicates that "In most cases imaging techniques of the cervical spine are not helpful for the diagnosis of cervicogenic headache."
So how then should your neck be excluded? Manual examination using techniques developed specifically to test he relationship between your neck and your head pain.
It is not enough to say it looks like a migraine, or tension headache therefore it is. The neck must be examined and thoroughly tested first before a lifetime of pharmaceutical intervention is considered.
This is not to say that ALL head pain is coming from the neck. It doesn't. A significant proportion does though, and for those people, the use of anti-depressants, beta blockers, anti-epileptics, narcotics, injectable toxins, other neural activity depressors (triptans) and implanted stimulators should be considered a last resort, not the first line of treatment.
Check you neck today. (Melbourne) 03 8648 6487
Goadsby PJ, Bartsch T Anatomy and physiology of pain referral patterns in primary and cervicogenic headache disorders. Headache Currents 2005;10:42-48.
Frese A, et al. Biological markers of cervicogenic headache. Cephalalgia 2008;28:Suppl 1:21-3.
Roger O'Toole is the Director and Senior Clinician of the Melbourne Headache Clinic and has over 10 years experience as a physiotherapist.