Tension headaches and migraines. What can be done?


Recurrent headaches such as tension type headaches and migraines lead to considerable impairment and days off work. It is often wondered what relation the neck has in relation to this most debilitating of conditions.

Neck pain often accompanies headaches and to be very technical this is a sign of an interaction between small nerves from the cervical spine and trigeminal nerve in what is called the trgeminocervical nucleus. This is located just outside the upper three neck (cervical) spinal segments, which means that any problems originating from cervical structures. Therefore pain originating from neck structures supplies by the upper neck nerves are perceived in areas supplied by the trigeminal nerve such as the front of the head, and the orbit

The spinal nucleus of the trigeminal nerve extends caudally to the outer lamina of the dorsal horn of the upper three to four cervical spinal segments. This is known as the trigeminocervical nucleus, which receives afferents from the trigeminal nerve and the upper three cervical spinal nerves. Convergence between these afferents’ accounts for the cervical-trigeminal pain referral. Therefore, pain originating from cervical structures supplied by the upper cervical spinal nerves could be perceived in areas innervated by the trigeminal nerves such as the orbit and the frontotemporoparietal region.

The main difference diagnostically between tension type of headaches from the migraine type is that ranges of neck flexion, extension and rotation are usually less in patients with tension type head than migraines, additionally there is a degree of neck tenderness with patients of tension headaches.

This helps in deciding what treatment protocols can be used to relieve your headaches.

Firstly, by palpating your neck we can identify trigger points, and use manipulative treatment to help restore mobility to your neck, additionally Acupuncture can be used to help reduce pain and muscle spasm often associated with headaches.

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