How does physiotherapy treatment work to reduce my headaches?
In order to understand this, we must understand the anatomy of the nerve supply to the upper neck and head. The nerve that supplies sensation to most of the head and face is called the trigeminal nerve. The input from this nerve is processed in the same area of our brain that processes sensory information from the upper three segments of our cervical spine. This area is called the trigeminocervical nucleus and is found in the brainstem. Often a patient with tightness or injury in the neck will experience head pain because of cross talk between the nerves that come from the neck and the nerves that come from the head. This is called referred pain and is common in many circumstances throughout the body.
In addition to this mechanism, physiotherapy treatment of the upper cervical spine often works well in headache patients that do not even have neck pain or stiffness. This is because in patients who suffer headache and migraine, the trigeminocervical nucleus becomes over-sensitive, which is often the reason why small triggers such as certain foods, alcohol or hormonal changes can be enough to tip it over the edge and cause a headache or migraine. It has been shown in physiological studies that specific manual therapy techniques of the upper cervical spine can desensitise the trigeminocervical nucleus, which is why many patients who suffer headache and migraine get good results with physiotherapy.