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Migraine, Cervicogenic Headache and Neck Dysfunction

As an osteopath my specialism is in musculo-skeletal problems and over the years I have seen many people who suffer from headaches and migraines and who have associated neck and back problems.
My interest in these conditions arose when I kept noticing that most headache sufferers had a very
specific upper neck dysfunction and my curiosity was aroused as to what was the physiological significance of this finding.

  • More recently I made a request through the Migraine Action website for volunteers who would be willing for me to examine their necks to assess;

a) Whether neck dysfunction was present,
b) If so, which neck vertebrae were affected and in what way.

  • I now have data on 71 people who suffer from migraine ;
  • 59 females and 12 males with ages ranging from 10-76.

Of these 71 people 67 had a well defined dysfunction in the cervical spine and nearly always it mainly affected the upper 3 vertebrae, C1-3.

What do I mean by dysfunction? It means that when I Palpate their necks I find strains, tightness and sensitivity in the vertebral joints and the tissues at the top of the neck and the base of the skull. Most of these people have neck symptoms such as pain, stiffness and clicking or grinding sounds of which are usually worse during an attack. A minority do not have significant pain or stiffness but examination still reveals the upper neck dysfunction. Others have significant problems thourought their cervical spine and frequently into the upper back/shoulder region. Nearly always the upper neck dysfunction is more marked on the side of the dominant headaches and always when I palpate the upper neck the person is aware that there is a problem there.

As well as studying migraine sufferers I have also collected data on 81 people who suffer from chronic headaches. Often these have been diagnosed as having tension-type headache. However, my examination have shown that well over 90% of them had a similar neck dysfunction to the migraine group, although often not as severe. This has led me to believe that there is an overlap between chronic headache and migraine. Indeed some people with chronic headache have severe one sided headache with nausea which could well be diagnosed as migraine. Also many migraineurs have a background headache between attacks which could be described as chronic or tension-type headache. I prefer to use the term cervicogenic headache which is listed as a secondary headache type in the classification of headaches and is the term used to describe headaches that have an obvious cause in the neck.

Written & sourced from Clifford Lomas

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