Neck pain and headaches. Do they come together?
Neck pain commonly accompanies headache. It is fundamental to know whether such neck pain is related to a local cervical musculoskeletal cause or whether it is part of the headache symptom complex, if understanding is to be progressed of the role of cervical musculo- skeletal disorders in cervicogenic and other headache types and to offer patients appropriate treatment. Cervical musculoskeletal disorders are clearly linked to cervicogenic headache (or a neck-related headache as an alternate term).
Neck pain is a frequent symptom of headache. The critical question is: “Does the presence of neck pain with headache implicate a cervical musculoskeletal cause?” It is invalid to assume that the site of pain always overlies its source, for example, intense forearm pain may be a symptom of a centrally located cervical radiculopathy, anterior knee pain may have its origin in the hip. Similarly, headache-related neck pain may have a local or remote source.
In short, pain in a local region may not be truly reflective of what the cause of pain might be.
Why is there a headache when there is neck pain?
The mechanism underlying the relationship between head and neck pain involves convergence between cervical and trigeminal afferents in the trigeminocervical nucleus in the brainstem. Nociceptive afferents from the upper three cervical nerves (C1, C2, C3) converge onto common second-order neurons that also receive afferents from the trigeminal nerve. The pathway is bidirectional. It not only explains how nociception from the upper three cervical segments can refer pain into the frontal region of the head, but also in the presence of central sensitization and increased excitability to converging synaptic inputs, how nociception from trigeminal afferents can refer pain into the neck. Because of the nerves in the neck and head, pain can be experienced in both directions. Pain in the head can cause pain in the neck and vice versa.
What can cause a headache in the neck?
Any structure innervated by the upper three cervical nerves is capable of referring pain into the head via common neurons in the trigeminocervical nucleus. Nevertheless as per the classification criteria for cervicogenic headache, articular dysfunction and movement impairments are fundamental to defining cervicogenic headache or a cervical role in headache. Painful joint dysfunction does not occur in isolation and will always be associated with changes in the neuromuscular system. The nervous system and sensorimotor system may also contribute to the pain syndrome. The question is: “Which impairments are fundamental to define a cervical musculoskeletal cause or contributor to headache?”
What are the treatment options for headaches?
Because of the varied sources and causes of a headache, it is important that you seek the input of a Physiotherapist who will be able to ascertain if the cause of the headache from a musculoskeletal source or of another cause. If the source of the headache is from the neck, your Physiotherapist will be able to assess and determine the structures or regions of problem, address them and allow you to be more comfortable.
Contact us to find out if we are able to give you some relief from your neck pain or headache!
