Headache and Migraine Area of Pain

Where do You Feel the Pain of Your Headache or Migraine?

This is a really important question for us because the area of your headache or migraine can give us a really strong indication as to which spinal segment is primarily responsible for your head pain.

For example if the pain of your headache or migraine is behind your eye this suggests very strongly that the spinal segment at fault is that one which lies between the second and third cervical vertebrae (C2-3 segment). Along with this you are likely to feel accompanying neck stiffness or discomfort and if it is on the same side of your headache this is relevant.

Sometimes this neck discomfort or pain may travel up and over the top of the head, fairly close to the midline to end behind your eye. Once again this demonstrates that the spinal segment at fault is the C2-3 segment. By the way if your headache is accompanied by significant nausea this provides further evidence of C2-3 involvement – and your pain is likely to be throbbing or pounding in nature.

The Area of Pain Suggests the Spinal Segement at Fault

If your pain is more across the forehead above your eyebrows, this suggests very strongly that the spinal segment at fault is that joint which lies between the skull and first vertebra (CO-C1 segment).

Similarly, if the pain of your headache or migraine is around the side of your head around your ear, this also indicates that the spinal segment most likely to be at fault is CO-C1. Some headache sufferers experience a band around their head as if a hat they are wearing is too tight – this is more like an ache, pressure or tightness. Often this type of presentation is misdiagnosed as a ‘tension-type’ headache – it really is an unrecognised cervicogenic (neck-related) headache.

My experience comprising 23000 hours with over 8000 headache and migraine patient indicates that for many of you (90%), both C2-3 and CO-C1 segments are involved.

Confirmation occurs when a skilled examination gently stresses each of spinal segments individually resulting in temporary reproduction and lessening of your typical head pain.

 

Until next time

If you are new to Watson Headache®, welcome to the Watson Headache® Approach, an evidence-informed practice when considering the role of the neck in Cervicogenic and Primary Headache.

Watson Headache
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