Self Help Series: Headaches
By Dr Anna Staehli Wiser
Headaches are a very common problem. According to the World Health Organization, headache disorders were found to be the third highest cause worldwide of working years lost due to disability1. When headache pain becomes debilitating, people usually say they have a migraine. According to the International headache Society (IHS), the most common type of migraine is without aura and is classified as typically “unilateral in location, pulsating in quality, moderate to severe in intensity, aggravated by physical activity, and associated with nausea and light and sound sensitivity (photophobia and phonophobia)”2.
Tension headaches are a very common type of headache as well, and are classified by the IHS as bilateral in location, with mild to moderate intensity, with a pressing/tightening (non pulsating) quality3
Another common type of headache is one that arises from problems with the joints in the neck and is referred to as a cervicogenic headache (CH). This type of headache can be reproduced by certain neck movements, sustained postures, or deep palpation into the muscles around the cervical region4. A CH usually starts on one side at the base of the occiput and then radiates up into the forehead, temple, eye, or jaw5.
Many common causes of headaches are stress, dehydration, lack of adequate sleep, poor diet, or reaction to medications6. The first line of defense when dealing with a headache is to rest, drink lots of water, and stay away from junk food. However, if the headache persists, there could be something more going on. If headaches keep coming back despite changes to diet and sleep habits, you might consider looking at the cervical spine as a potential trigger. There can be muscle and joint imbalances leading to myofascial trigger points in the neck which can cause radiating pain up to the head7.
Why do problems in the neck cause pain in my temple, eye, and jaw? The answer has to do with the cranial nerves - in particular, the trigeminal nerve. The trigeminal nerve sends and receives sensory information between the brain and the face. It intersects with the upper cervical spinal nerves at the trigeminal cervical nucleus. The theory is that afferent pain signals coming from the upper cervical spine get some “cross talk” at the trigeminal cervical nucleus, and pain signals are then expressed along the trigeminal nerve pathway, causing the perception of pain in the face8. This is why many people with cervicogenic headache report pain in the forehead, behind the eye, in the temple, and sometimes in the jaw. As a side note, many cases of jaw pain have been misdiagnosed as “TMJ dysfunction” when really the problem is with the neck.
