Cervical headaches, also known as cervicogenic headaches or “Rams Horn” headaches, plague a huge number of people with limited benefit through medications such as anti-inflammatory drugs, muscle relaxers, and migraine medications. They typically present with pain starting the back of the head that can then wrap up or around the skull and typically end behind the eyes.

The cause of these types of headaches can be multifactorial, but usually it is caused by compression of the suboccipital space between your second cervical vertebrae (C2) and the base of the skull. On either side of there are 4 muscles (see figure below) that help control the movement of the skull, C1, and C2. Also in this area is a nerve called the suboccipital nerve the travels up the back of the head and refers in the “Ram Horn” pattern. The nerve can be trapped by these muscles as well as by the upper trapezius. Furthermore, restrictions through this area can create blood flow impingement for the brain and contribute to headaches.

The good news is that there can be simple muscle energy techniques to help reduce and possibly even eliminate your headaches. One such exercise called a neck retraction can be found through a previous post that I wrote. Now, onto the good stuff.

First, you have to do a quick assessment. Easiest way to determine how to treat the headache is by feeling which side the pain is on. Many times these types of headaches will pick a side to affect. If you have only one sided pain or pain is worse on one side, jump right to Step 1. Otherwise continue reading here.

If you cannot determine which side is the primary source of pain or the feeling is like a metal band or vice on the base of your skull, you can assess with movement. Start with your head in a neutral position. Turn your head to one side and then look down as if you are trying to smell your own arm pit (breathing optional). While keeping your head in this position turn your head and look up toward the ceiling without letting your head move away from the shoulder. Feel for how far you are able to turn your head away from your shoulder. Now, repeat this to the opposite side. Most likely you are going to find that there is one side more limited. Great! That means you have the information on which side to start treating.

The side that you want to treat is the direction (left or right) that had more difficulty looking up toward the ceiling. So, if you had more difficulty when turning to the right toward the ceiling, that is the side to start treating.

Step 1: Lay on your back with a thin pillow under you head and your shoulders.
Step 2: Place two fingers on your temple of the side that you are treating.
Step 3: Place the other hand on the side of the head above the ear.
Step 4: Without moving your head, look with your eyes only as hard as you can as if you are trying to see your fingers on your temple. Hold for 3 seconds.
Step 5: Without moving your head, tip to the left against your other hand. Hold for 3 seconds

Repeat Step 4 and 5 for 3 repetitions each and then retest your motion and see how your headaches feels. Hopefully, your motion will be better and your headache will be reduced. If there is no change, repeat this to the other side by looking and tipping in the opposite directions as before. Repeat up to 10x to the affected side to alleviate headaches and follow up with neck retractions from this post. This is effecting the suboccipital muscles (top left of the picture) to decrease pressure over the nerves causing the headache.

In case the above exercise didn’t work, try laying on a hard floor and place a golf ball under one side of the base of the skull. This may be a little tender to start with, but allow the weight of your head to sink into the golf ball. The goal of this is to slowly gap the space between the top vertebrae and the skull. Allow at least 3 minutes in this position, and its probably good to do this on both sides. You can also try this with two golf balls, but this gets a little uncomfortable.

Now, here is the last quick trick to try to alleviate those painful tension headaches. Feel on the back of your neck just below the base of the skull. You should feel a bump right in the center, that is C2. Trace down the center of your neck with your finger until your get to a second bigger bump. This will likely be C6 or C7. While laying down gently stroke downward from C2 to C7 with two fingers. Repeat this process for 2-3 minutes. This is working to decrease tension through a structure called the ligamentum nuchae that attaches to the base of the skull.

Hopefully one or all of the tricks above can help you to alleviate your headaches. If you have any questions feel free to contact me anytime.

Cheers to your health,

Lynk