A Headache That’s a Pain in the Neck

| Posted On Feb 14, 2018 | By:

computer work and headachesIf you sit at a desk all day working at a computer and start to notice frequent headaches, you may have what’s known as a cervicogenic headache. These headaches have nothing to do with eye strain but rather are caused by nerves and muscles of the neck and spine that have been aggravated by posture or perhaps an injury.

The source of a headache can sometimes be tricky to pinpoint given there are more than 150 unique kinds of headaches, but there are distinct hallmarks of cervicogenic headaches, namely:

 These headaches are caused by structures in the neck – muscles, nerves, the joints of the cervical (upper) spine, disks, and the muscles at the back of the head – that, when irritated or strained in some way, send a pain signal to the brain. What’s interesting is that most people who develop cervicogenic headaches don’t complain of neck pain and aren’t aware that their neck is stiff until we begin exercises to remedy the problem.

While a sports injury to the neck or shoulder or a fall or any accident that abruptly jerks the head backward or forward (whiplash) can cause cervicogenic headaches, sitting at a desk all day is one of the worst culprits. Specifically, if you slouch forward or hunch over your keyboard while working at the computer, this poor posture compresses the joints at the base of the neck and strains the muscles to support your head, leading to cervicogenic headaches.

It’s hard to say how long it takes before poor posture may trigger cervicogenic headaches. I see people of all ages, some as young as their early twenties. In particular, I’ve noticed a rise in cervicogenic headaches among people who do a lot of computer work with two screens. Oftentimes, the placement of the screens requires people to swivel their heads, precipitating neck strain.

If you experience headaches at work that sound like cervicogenic headaches, try the following:

If the headaches persist or worsen, schedule an appointment to see your primary care doctor. If your doctor suspects your headaches are caused by a neck issue, you’ll probably be referred to a physical therapist. At your first appointment, a physical therapist will ask you questions about the severity and frequency of the headaches, what you’ve tried to do to address them, and then do a physical exam of your neck – range of motion, mobility, etc.

Treatment involves correcting the ergonomics of the work space as outlined above, but also providing at-home and at-work exercises to strengthen the muscles as well as some mobilization of the neck during your PT visits. Initially, I see people 2x per week to give them education and thorough exercise instruction and also to loosen the muscles of the neck slowly and safely. Within just a few weeks, many people notice a lessening of the severity of their headache, then frequency of the headaches follows. About 3-4 weeks into treatment, we decrease the PT visits to 1x per week. The total treatment time is about 8-10 weeks.

There are four primary exercises we teach people to use at home or at work to stretch and strengthen the muscles of the neck. Consult with your own doctor or physical therapist to make sure these will be beneficial for you, but I have illustrated and described them below:

The Upper Trapezius stretch

The Sternocleidomastoid stretch

The Levator Scapulae stretch

The Pectoralis Major stretch

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About Scott McDonough, PT

Scott McDonough is a Physical Therapist who joined Atrius Health in 2015 and currently works at the Harvard Vanguard Kenmore (Boston) practice. He earned his PT degree at the MGH Institute of Health Professions in Boston, MA. Prior to joining Atrius Health, Scott worked in an integrated health care center for 10 years and a private practice clinic for 3 years. He enjoys treating chronic injuries, sports injuries and helping people return to their prior activity level, hobbies, or sport. In his free time, Scott enjoys traveling and watching all the local Boston sport teams.

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