Cervicogenic Headache And Migraine Treatment in Islamabad

Cervicogenic Headache And Migraine

Cervicogenic headache is defined as a chronic headache occurring in one or multiple areas of cranium or face originating from upper cervical spine or neck. Mostly, the headache of this type occurs due to lesion of cervical spine or a neck disorder.

According to International Headache Society (IHS), headache of this type is recognized as a secondary headache that is suspected to occur as a result of physical matter, another illness or nociception (which is nervous system response whenever it feels threatened) of cervical spine.


Headache of cervicogenic type accounts for 14-18% of all chronic headache. However, its prevalence rate is 2.2% according to recent study. 

Neck Pain Treatment In Islamabad
Neck Pain Treatment In Islamabad
Neck Pain Treatment In Islamabad

Cervicogenic Headache Symptoms

Most of the time it is not easy to diagnose cervicogenic headache. Its normal presentation is dull persistent ache with centralized pain to rear of head. Sometimes pain occur behind temples or eyes, forehead, top of head or ear region. 

Other symptoms of cervicogenic headache include:

  • Dominant unilateral headache.
  • Pain and tenderness of muscles in cervical region.
  • Neck movements causing inflammation and aggravation due to poor posture.
  • Difficulty while turning your head.
  • Tenderness of joints in cervical region.
  • Generalized symptoms occurring because of dysfunction or neck pain.
  • Majority of patients experience trigger points and tightness in levator scapulae, upper trapezius, suboccipital extensors and scalene in patients with migraines and cervicogenic headache.
  • Deep neck flexors weakness.
  • increased activity of superficial flexors of neck

Causes Of Cervicogenic Headache

Cervicogenic headache originate in upper region of cervical spine. Illness and disorder or lesion of neck and some other injury like whiplash can lead to cervicogenic headache. Activities that put excessive stress on neck and upper joints of cervical spine can cause cervicogenic headache.

Some causes of cervicogenic headache include,

  • Slouching or poor posture
  • Lifting or carrying heavy weight
  • Excessive twisting and bending of neck
  • Prolonged mobile and computer use
  • Activities in which your arms are held in front of your body for long time.
  • Whiplash injury.
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Contributing Factors Of The Cervicogenic Headache

There are different factors that increase the occurrence of cervicogenic headache. These contributing factors should be corrected to reduce risk of developing cervicogenic headache.

  • Poor and bad posture.
  • Muscular imbalance
  • Stiffness and tightness in upper back muscles
  • Muscular weakness
  • Trauma or injury of neck such as whiplash
  • Desk or workstation that is not ergonomically fit.
  • Poor pillow and bad sleeping position.
  • Increase stress level
  • Sedentary lifestyle
  • Dehydration
  • Activities that involve forward shoulders and excessive forward bending.

Diagnosis Of Cervicogenic Headache

Appropriate clinical examination and assessment is important for diagnosis of cervicogenic headache. Usually, physiotherapist conduct objective and comprehensive examination to properly diagnose the cervicogenic headache. In some cases, diagnostic tools such as MRI, CT scan or X-ray are needed for accurate diagnosis before any treatment.

Treatment Of Cervicogenic Headache

Mostly, the following protocols are used for treatment of cervicogenic headache:

  • Manual therapy to reduce spasm and pain.
  • Cervicogenic headache exercises that include strengthening of upper quarter muscles and flexors of neck.
  • Manipulation of thoracic spine.
  • Self-sustained natural apophyseal glides (SNAG) of C1 and C2.
  • Cervical spine mobilization and manipulation.
  • Strengthening exercises.

There Are Certain Educational Tools That Will Help In Reduction Of Cervicogenic Headache

  • Educating patient on flexor muscles of craniocervical spine. 
  • Neck extensors and flexors co-contraction.
  • Strengthening and retraining of deep and superficial flexor synergy.
  • Scapular muscles retraining
  • Maintain proper posture
  • Sensorimotor training that progressive training and exercises

Physical Therapy For Cervicogenic Headache

At IPRC, we use sensible and comprehensive treatment approach to treat your cervicogenic headache. We conduct appropriate structural and functional diagnosis to determine the exact cause of your headache to determine the best treatment course.
Our physical therapists are well trained in manual therapy, neurological, orthopedic and sports rehabilitation. Our vast experience taught us that successful treatment can be performed by combining a mixture of different treatment styles in our protocols.
We use advanced technology and proper examination to eliminate the source of your pain instead of treating only symptoms. Our custom design and one-on-one treatment approach is very effective in the treatment of your cervicogenic headache.

Migraine Headache Specialists At Islamabad Physiotherapy and Rehabilitation Center

The leading edge and unique treatment protocols of cervicogenic headache include:

  • Dynamic neuromuscular stabilization (DNS)
  • Sensory motor training 
  • Proper posture training
  • Soft tissue mobilization
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Migraines And Headache

There are different type of headaches. Tension headache, cervicogenic headache, migraine and cluster headache are most common type.
In most type of headache, cervical components are involved. The only type of headache that can be managed without drugs by chiropractic and physical therapy is cervicogenic headache. This type of headache is common among children and adolescents. Lack of different functional diagnostic skills lead to mismanagement of this type of headache. This can cause unnecessary overuse of multiple pain medications and cervical spine degeneration. Dysfunction of cervical spine leads to cervicogenic headache. This dysfunction includes hypertonicity of soft tissues and neck muscles, poor posture of cervical and thoracic spine, dysfunction of TMJ, abnormal motor control of locomotor system, poor patterns of breathing all leads to irritation of joints in upper cervical spine. Cervicogenic pain syndrome is also called cranio-cervical syndrome and vertebrogenic headache.

Features Of Cervicogenic Headache

  • Pain on one side without shift to another area.
  • Reduced neck mobility.
  • Production of pain by movements of neck, sub occipital pressure or bad positioning of head and neck.
  • Associated shoulder and neck pain.
  • Radiating pain to front part of head especially behind eyes and to the forehead.
  • Pain has usually mild or moderate intensity.
  • Fluctuating pain
  • Vomiting, nausea, dizziness, photophobia and blurring of vision are rarely found but it they are present are usually mild.

Functional approach is the best treatment for cervicogenic headache. This approach will address the root cause of your pain. Without treatment, cervicogenic headache can cause difficulty in swallowing or chewing, spinal degeneration and difficulty in breathing. Alteration of posture will affect the rest of your spine. All these problems can be prevented by establishing timely and appropriate diagnosis and undertaking proper functional treatment.

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Dr. Aleem Certifications In Physical Therapy

Certified Spinal Manual Therapist

Dr. Aleem has done various certifications in the field of physical therapy. He is Certified Spinal Manual therapist (Manual concepts, Australia). Spinal manual therapy is used to relieve neck pain, back pain and other musculoskeletal conditions by application of forces at joints of spine. These treatments are helpful in restoring spine dysfunctional areas.

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Dr. Aleem also delivers lecture on ergonomics at corporate sector in whole Pakistan including Telenor, PTCL and Ufone.