> Using very precise techniques to assess
the upper cervical spine, our specially
trained Physios can assess if these levels
are a contributing factor to the patient’s
headaches and migraines, or not.
> During an Initial Headache Consult,
(45mins) and screening questionnaire,
we can assess if this approach will be
appropriate and effective for the client.
> Even if the patient has been suffering for
many years, we should know by the end
of the second consult whether continuing
treatment is warranted, and see
significant improvement in 5 sessions.
> With 25 years experience in treating only
headache and migraine patients,
Physiotherapist Dean Watson has
developed the Watson Headache
Approach, and has demonstrated great
> It all sounded too good to be true, but at
FLEX Headache Clinic we are excited to be
seeing the same amazing success, and
the change it's making our patients' lives.
> World leading neurologists and
headache specialists are acknowledging
the role of upper cervical spine sensory
input, and sensitization of the lower
brainstem (TCN) in both headaches and
> Triptan medications offer short term,
symptomatic relief to some migraineurs,
but no change in the frequency or
duration of migraines.
Previously triptans were prescribed for
their vascular effects, however research
has now shown them to have a
desensitising effect on the
lower brain stem (TCN).
> Emerging research offers us new
insights, that support this approach.
Below are some excerpts from research
articles and a list of related articles.
"One of the confusing phenomena
about the Cervicogenic Headache
is that its symptoms can present as
migraine headaches, tension-type
headaches, or even cluster headaches."
Dr Peter Rothbart
Anaethetist and Internationally
recognised pain researcher
(Rothbart P. The cervicogenic headache: A pain in the
neck. Canadian Journal Diagnosis 1996; 13:64-71)
"For the clinician, pain presentations
in the headache patient are frequently
a diagnostic challenge."
"Headache of cervical origin and
migraine often show similar clinical
Dr Peter Goadsby, internationally
(Goadsby PJ, Bartsch T. Anatomy and physiology of pain referral patterns in primary and cervicogenic headache disorders. Headache Currents 2005; 10:42-48)
> "Cervicogenic headache has been
described by many professions and
specialities. Most authorities agree that
many patients experience neck symptoms
associated with headache.
Whether the neck is the cause
of, or part of, another headache type,
careful attention to the neck and its
relationship to headache are extremely
Gallagher R, Cervicogenic Headache: A Special Report. Expert Review Neurotherapeutics 2007; 7 (10) 1279-83)
> To find out more, please book an
> Karrie is happy to meet with health
professionals to answer questions,
explain the mechanisms and underlying
theory behind this approach, and explain
more about what we assess and treat.
"Cervicogenic headache" is simply a term for a headache that originates from the neck – it's one of the most common types of headache, and a Physiotherapist skilled in headache assessment and treatment can help.
Joints and muscles in the upper neck can refer pain into the head, temples, ear, forehead, face, sinus, jaw or base of skull – becoming a headache. It is often but not always associated with pain or stiffness in the neck, and occasionally associated with dizziness.
For some people who are prone to migraine headaches, they may experience cervicogenic headache in the lead up to a migraine, and treating it early and effectively may prevent migraine onset.
There are several factors that predispose patients to developing cervicogenic headaches. These need to be assessed and corrected where possible with direction from a physiotherapist. These include:
> Neck and upper back stiffness
> Muscle imbalances around the
neck and shoulders
> Whiplash, neck injury or trauma
> A sedentary lifestyle
> Stress or fatigue
> Poor ergonomic setup
> Inappropriate pillow or sleeping
> Excessive slouching or perching,
(eg. mobile phone or tablet use
looking down, or computer use whilst
slumped are common culprits!)
Your GP may prescribe pain killers, anti-inflammatories, or “migraine” medications for symptomatic relief.
They will also ask questions and if required, do tests to rule out your headaches being a symptom of more sinister medical pathology.
Typical Physio treatment may include:
> Restoring more comfortable neck
movement and joint mobility using
gentle manual therapy.
> Assess if postural habits and/or muscular imbalances like muscle weakness or muscle overactivity is contributing to your headaches, and set specific exercises to retrain them.
> Joint mobilisation and/or manipulation of thoracic spine and ribs if stiffness or "squashedness" is relevant
> Taping or short term use of a postural
> Advice about ergonomics, pillows
and activity modification
> Exercises to improve posture,
flexibility, control and strength around
the neck and shoulders
> Discuss other possible headache
triggers and management strategies
> Test and treat causes of dizziness
including cervicogenic and vestibular
In rare cases manual therapy may initially stir up your symptoms. If this occurs, please discuss with your Physio so they can adapt treatment accordingly.
Do you know someone who suffers with headaches or migraines?
FLEX Headache Clinic in Hobart is here to help.