Cronulla clinic: (02) 9527 4099
Headache and Vertigo management service photo

Headache and Vertigo management

Available at: Cronulla clinic


Why do we get headaches?

The nerves that relay sensation in the head and face send information to a part of the brain called the brainstem. The brainstem also receives information from nerves in the upper neck. If joints in the neck are not functioning properly, they will send pain messages to the brainstem. There can then be confusion in the brainstem, and it sends exaggerated pain messages to the head and face; this is what we feel as a headache.

In patients who regularly experience headaches or migraines, the brainstem becomes over-sensitised. This means that normally non-harmful stimuli or messages through the brainstem can be interpreted as harmful and can produce a headache or migraine.

What can physiotherapy do?

Research has shown that specific manual therapy applied to the upper neck can de-sensitise the brainstem, and hence reduce the tendency for nerves to produce a headache or migraine.

Treatment always starts with an interview and detailed assessment of the neck. Any other, more serious causes of headache must first be excluded. Once it is established that the neck is contributing to headaches, treatment generally involves gentle pressures to the top of the neck to selected joints. Your physiotherapist will give you some exercises to do at home to maintain the gains you make at your treatment sessions.


What is vertigo?

Vertigo is a type of dizziness that gives a false sensation of motion. You may feel dizzy, off balance, nauseous, or like the world is spinning around you.

What causes vertigo?

There are a number of common causes of vertigo. The first is a sensitised brainstem, very similar to the mechanism above which causes headaches. A second and perhaps more common cause of vertigo is a condition called benign paroxysmal positional vertigo (BPPV). This originates from the inner ear and affects the vestibular system, which is responsible for balance. Canals in the inner ear are filled with fluid. In BPPV, a small crystal (usually located in a different part of the ear) can fall into one of these canals and cause vertigo.

Symptoms are often triggered by changes in head position such as looking down or looking up or rolling over in bed.

Physiotherapy for Vertigo                                 

Just as we can treat your neck for headaches or vertigo, we can also treat the
inner ear for BPPV. Treatment techniques involve putting the head in certain
positions which target the inner ear and allow the crystals to move back out of
the canals. These include but are not limited to the Epley manoeuvre. For true
BPPV, this will allay symptoms of vertigo.

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