Cervicogenic headaches, a common type of headache, originate in the base of the skull, affecting that area and possibly radiating to one side of the head. In a paper for the University of Medicine and Dentistry of New Jersey, physical therapist Eileen Gurgone provided a review of studies prior to 2004 investigating the role of exercise and manipulation in treating this condition. Although few studies address exercise by itself as a treatment, the overall available information shows encouraging findings. Patient improvement was noted with therapy including posture education, stretching and strengthening, and manipulation.
Posture Therapy
You can often improve your posture with increased education about workplace and lifestyle positions. Avoid the slumping posture associated with computer and desk work, and work to keep your head centered over the tops of your shoulders. Use a keyboard shelf to prevent shoulder and neck fatigue from holding your arms over a keyboard on a desktop. Substitute a hands-free phone for one that would require your head to tilt to the side to hold it.
Stretching and Strengthening
Stretch the muscles in the base of the skull with chin tuck exercises. Pull your chin in without tilting your head forward, hold for two seconds, and repeat 10 times. Next, pull your shoulder blades back as though you were trying to touch them together over your spine and hold the contraction for five seconds, repeating 10 times. Rotate your head as far as you can over your shoulder and then back to the other side. Repeat this movement five times to each side. Don't do any of these exercises if pain increases.
Mobilization and Manipulation
A therapist can apply traction to stretch and lengthen the muscles in your neck. You can also mobilize your neck by turning and stretching through the normal ranges of motion. Manipulation, usually performed by a chiropractor, has also shown benefits. Massage of the deep muscles in the base of the skull and tops of shoulders helps reduce trigger points in the muscles there that can start a headache.
Using a Therapist
You can perform most of the conservative care approaches at home using posture awareness, stretching and strengthening. If your headaches are not responding to these therapies, consider seeking an evaluation by a physical therapist or chiropractor. Combinations of stretching with manual therapy show better outcomes than either approach by itself.
