Does Your Headache or Migraine Swap Sides?

July 3, 2009 by dean · Leave a Comment 

If headache or migraine swap sides it is a cervicogenic (neck) headache

If headache or migraine swap sides it is a cervicogenic (neck) headache

The traditional medical model of headache defines cervicogenic headache as a side-locked headache i.e. it is always on the same side. However if a headache alternates or shifts from side to side, either between (attacks), or within the same attack, then it is migraine.

My experience of over 21000 hours with headache and migraine patients contradicts this view - if your headache or ‘migraine’ swaps sides, it is a cervicogenic (neck) headache – no doubt. A significant majority of migraine headaches swap sides – does this mean I am saying that a significant majority of migraine headaches are cervicogenic headaches – yes, this is my experience!

These alternating headaches are usually triggered by neck flexion (forward bending) and in those who have had a neck X-ray 75% have a decreased neck lordosis (the naturally occurring inward curve). Neck flexion decreases the lordosis even further ….



(Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004; 24(suppl.1):1-151

Sjaastad O, Fredricksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache 1998; 38:442-5)

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About dean
Consultant Headache & Migraine Physiotherapist; International Teacher; Director, The Headache Clinic & Watson Headache Institute; PhD Candidate Murdoch University, Western Australia; Adjunct Lecturer, Masters Program, Physiotherapy School, University of South Australia; MAppSc(Res) GradDipAdvManipTher Experienced health practitioners trained in the Watson Headache Approach perform the examination and treatment techniques developed by Dean Watson. These techniques are based on his extensive experience of 7000 headache patients (21,000 hours) over 21 years and are now taught internationally. For your nearest practitioner who has completed training in the ‘Watson Headache Approach’ please refer to the ‘Practitioner Directory’.

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