Treatment for Headaches

Headaches and migraines are a frequent complaint, however not something for which one would often see a physiotherapist, rather seeking medical management or putting up with the pain and symptoms. At Body Mechanics however, treating headaches is a core part of our business, and something we do (successfully) every day.

While cervicogenic headache is generally (and etymologically) associated with neck dysfunction, there is growing evidence that other types of primary headache are neurologically intertwined with the upper neck. This includes tension and cluster headache, and the various migraines. How can this be the case?

The nerve that supplies most of the sensation of the head, mouth and jaw is the fifth cranial, or trigeminal nerve. At the same time, information from the first three joints of the neck, including the articulation between the skull and the spine, comes into the spinal cord and meets up with the trigeminal nerve in a sexy little bundle of grey matter called the cervicotrigeminal nucleus. From here the tracts head north together for processing by the brain.

Dysfunction of the upper three vertebrae can sensitise the cervicotrigeminal nucleus (CTN) which has an end result of a lot of non-noxious (i.e not normally painful) information being amplified as threatening. This information going through the nucleus, whether it’s from the face, sinuses, or even cranial blood vessels, gets tagged with with a danger message as it’s sent upstairs for processing.

Ultimately, pain is an output of the brain in the presence of a perceived danger or threat, and that action must be taken. Much of the time, despite the barrage of loud and angry information (nociception) coming up from a sensitised CTN, it may deem it as non-threatening and push it aside. At other times however, with say a hormonal shift or sudden increased stress or fatigue (long week at work?), the brain’s interpretation will register danger and, as such, outputs a pain message. Something must be done!

The problem is, the brain must decide where the pain is for something to be done and, given the torrent of information, it is hard to be specific. As a result the pain is represented where you are most likely to appreciate the danger - thus it is represented in the head.

The representations and behaviours of head pain are thankfully fairly predictable which enables the physios to do one of two things. Firstly it enables us to easily diagnose the sensitising segment or segments and treat the underlying dysfunction. Secondly, in extremely rare cases, it enables us to quickly identify secondary or malignant causes and refer appropriately. As a result physiotherapy is a safe and effective intervention for head and face pain, and the physios at Body Mechanics take great pride in having it as their concentration.

 

Please contact us on (07) 3862 6238.