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Are Migraine Headaches Really a Neck Issue?
This week a new patient came to our office that has been suffering from headaches for years and has tried every drug available, and is still having headaches.
Researchers have known for a long time that the first 3 cervical vertebrae carry nerve signals via the trigeminal nerve, which is the nerve typically associated with migraine headaches. So, would it surprise you to know that patients with loss of cervical curve due to whiplash type injuries are the most common patients who report chronic headaches and migraines?
Headaches originating from the cervical spine are also called cervicogenic headaches.
Early diagnosis of this condition is rare, unfortunately. This leads to a lot of unnecessary consumption of medications, some with a list of side effects a mile long that can cause worse issues than the migraine itself.
Today, I will examine the cause of chronic cervicogenic headaches in patients who develop them without trauma, but rather from posture issues.
The most common presentation is a patient with anterior head carriage and forward rolled shoulders. Below are two pictures one is a normal cervical curve and the other is a loss of cervical cure due to posture.
We all have phasic and postural muscles.
Postural muscles are designed to sustain long periods of contraction and are considered slow twitch muscle fibers. Phasic are muscles that move us and perform quick movements, but they cannot sustain long periods of contraction.
In the cervical spine when a person develops anterior head carriage the weight of the head and neck become too much for the muscles to support them.
In the illustration above the head and neck, when in an anterior position, can weigh as much as 42 lbs. In these cases, phasic muscles get recruited to help support the head and neck and phasic muscles are designed for gross motor movement. Ultimately, they tighten and fatigue much more quickly and that puts more tension on the base of the skull and more pull on the upper cervical spine. This can cause minor shifts in the cervical vertebrae and compression on nerves in the neck that route to the trigeminal nerve. The result is a migraine.
How is this condition treated for the best outcome?
If you are suffering from chronic migraines it is worth scheduling a consultation with a provider who specializes in physical medicine.
Chiropractors and Physical Therapist are a good start, but ideally you want a provider and practice that can look at you from several sides of the spectrum and provide a combination of medical and functional rehabilitation treatments.