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Cervicogenic headache

Cervicogenic headache is analogous to sciatica which is often due to an irritation or "trapping" of the sciatic nerve in the lower lumbar spine causing referred pain into the leg.With neck dysfunction there can be nerve irritation, particularly in the upper cervical spine, resulting in referred pain to the back of the head and the trigeminal nerve which refers pain to the front of the head.
People who have cervicogenic headache on the whole respond very well to osteopathic treatment simply because by treating the neck, and also the back, it helps to relax the muscles, tease out the tight tissues and ease the joint dysfunction. Pressure is thus eased off the nerves of the neck resulting in a reduction or elimination of the headaches. When a patient has a course of osteopathic treatment the osteopath will re-assess the vertebrae and tissues at each visit and with cervicogenic headache the easing of symptoms corresponds to the progressive normalisation of the tissues.

But what about, can this too be caused by a neck problem? Most neurologists would say it cannot, instead modern research suggests that migraine is caused by an inherited brain function disorder with neck pain and stiffness merely one of the myriad of migraine symptoms.

However, to understand migraine pain it helps to know a little of the anatomy of the trigminal nerve. This is the nerve mainly responsible for conveying headache pain. Its nucleus lies in the base of the brain and trigeminal nerve fibres innervate the majority of the pain-sensitive tissues in the head. It also has links to the upper cervical spine through the so called Trigeminocervical complex.
Current thinking is that abnormal brain activations affect the trigeminal nerve nucleus which results in abnormal nerve activity to pain-sensitive tissues such as the blood vessels and dura mater(brain lining) resulting in severe headache pain. Because of the link to the neck, symptoms are felt there as well. It seems therefore that neck dysfunction may result from abnormal nerve activations in the brain. However, it has been shown conclusively in experiments, and born out of my own observations, that neck dysfunction itself can cause nerve irritation in the neck and result in cervicogenic headache. Since the neck dysfunction in migraines is similar to that found in cervicogenic headache, logic dictates that there ought to be asimilar nerve irritation in the necks of people with migraine.
it may be that the background headache which occurs between attacks in many people has its cause in neck dysfunction. People with migraine almost certainly have a hypersensitive trigeminal nerve and I suspect that the chronic neck problems perpetuate and aggravate this hypersensitivity. In this state attacks are easily initiated by a variety of triggers. The cycle of brain function disorder resulting in neck pain through the Trigeminocervical complex and the aggravation of this hypersensitivity in the other direction from the neck to the brain is like a vicious downward spiral. Physical treatment, particularly  to the neck, is a way of helping to break that cycle.

So can osteopathy, chiropractic physiotherapy treatment help migraine? read more from Cliff Lomas

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