Physiotherapy Treatment Archives - Urgent Care Physiotherapy Clinic & Rehabilitation Center

What is a cervicogenic headache?

Firstly, the term “cervicogenic” means produced by the neck. Thus, cervicogenic headaches arise from structures in the neck. Namely, the upper cervical and atlanto-occipital joints are affected, and the resultant pain is perceived in the head and face.

The main symptoms of a cervicogenic headache are a combination of unilateral pain (more or isolated pain on one side), and diffuse shoulder and arm pain on the same side of the headache.

Why do these headaches happen?

A cervicogenic headache is thought to be a referred pain from irritation in cervical structures. Specifically, it is the structures that are supplied by the C1, C2, and C3 nerves. Therefore, any of the structures supplied by the C1–C3 spinal nerves could be the source for a cervicogenic headache.

Oftentimes, it is hard to pinpoint the exact structure. This may include the joints, disc, ligaments, and musculature. Additionally, the lower cervical spine may play an indirect role in pain production if it is dysfunctional, In fact, this finding is more common in patients with a history of whiplash.

How do we differentiate cervicogenic headaches from other types?

Stiffness and pain in the neck joint and musculature is found in cervicogenic headaches

Cervicogenic headaches usually have a unique set of symptoms and when tested in clinic, have a clear relationship with the neck. If you are interested in other headache types you may find more information at headache.org. The following is the clinical presentation of a cervicogenic headache:

Unilateral dominant headaches, usually start at the back and wrap around to the front
Decreased neck range of motion and reports of stiffness
Headaches are increased by neck movements or certain postures
Tenderness to the touch on the upper cervical spine
Weakness in the deep neck flexor musculature
Patients have increased tightness and trigger points in upper trapezius, levator scapulae, scalenes and suboccipital extensors

It is rare to have other symptoms with cervicogenic headaches like light and noise sensitivity, visual disturbances, or vomiting, which helps to differentiate it from other headache types like a migraine.

How do I treat my headache?

Luckily, Physiotherapy Treatment has been shown to be effective in managing cervicogenic headaches. The following are potential types of treatments and exercises that may be used during a session:

Cervical spine manipulation or mobilization
Strengthening exercises including deep neck flexors and extensors
Thoracic spine thrust manipulation & exercise
C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) shown to be effective for reducing cervicogenic headache symptoms
Re-education of good posture habits
Trigger point therapy

Having issues with headache and neck pain?

Look for relief with PhysioNow! With 10 locations across the GTA from Burlington, Oakville, Mississauga and Etobicoke, we have many experienced clinicians ready to help you feel better. Our Registered Physiotherapists and Massage Therapists are all experts at working with headaches and neck pain. Get started with your pain relief journey and book with PhysioNow today!

Benign paroxysmal positional vertigo(BPPV)

Vertigo

Vestibular Systems
• Comprises five sensory organs that provide your brain with information about head position and movements including head rotation, linear movements and static positions of the head relative to gravity
• Five sensory organs including 3 semicircular canals and 2 otoliths

BPPV is a mechanical problem in the inner ear. It occurs when some of the crystals that are normally embaded in gel in the ear become dislodged. They then can move into one or more of the 3-fluid filled semicircular canals.

Benign paroxysmal positional vertigo(BPPV) is one of the most common causes of vertigo. It creates a false sensation of spinning.
• Benign: it is not life threatening
• Paroxysmal: it comes in sudden, brief spells
• Positional: it gets triggered by certain head positions or movements
• Vertigo: a false sensation of rotational movement

Symptoms
a)      Dizziness
b)      Vertigo (sensation of spinning)
c)       Nausea
d)      Sense of imbalance or unsteadiness
e)      Poor gaze stability
f)       Vision disturbance

Visual Coordination screening

Diagnosis

• The relationship between the inner ears and the eye muscles are what normally allows us to stay focused on our environment while the head is moving. The dislodged crystals make the brain think you are moving when you are not. This mistakenly causes the eyes to move, which makes it look like the room is spinning. This is called Nystagmus.

• The Nystagmus will have different characteristics that allow the practitioner to identify which ear the displaced crystals are in and which canal is involved.
• The most common tests are DIX hall pike and Roll test.
• There are two types of BBPV. One type, where the loose crystals can move freely in the fluid of the canal(canalithiasis). The more rare type is one where the crystals are thought to be hung up on the bundle of nerves that sense the fluid movement(cupulolithiasis).

Physiotherapy Treatment
• One maneuver that is used for the most common location and type of BPPV is called the Epley maneuver. However , that will not work for all people . Often people have tried the Epley maneuver themselves or had it performed on them without success.
• In the vast majority cases, BPPV can be corrected mechanically by a Registered Physiotherapist. Once your provider knows which canal is involved and what type it is , we can take you through the appropriate treatment maneuver.

Check out this video for an example of the Epley Maneuver. Please do not attempt this yourself until you have been properly assessed and screened by one of our Registered Physiotherapists to see if this maneuver will be appropriate for your condition!

If you have any further questions, please call PhysioNow today! Our experienced Vestibular Physiotherapists would be happy to help you.

Urgent Care Physiotherapy Clinic & Rehabilitation Center – Physionow.ca

Tag Archives: Physiotherapy Treatment

Cervicogenic Headaches: Is your Headache Coming from Your Neck?