Physiotherapy     Massage     

Pilates & Classes

Our Team       Headache Clinic

>   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

      renowned researcher

(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.

Contributing Factors

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!)

Medical Treatment

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.

Physiotherapy Treatment

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

         support brace

>      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.

Cervicogenic Headaches

Do you know someone who suffers with headaches or migraines?

FLEX Headache Clinic in Hobart is here to help.