DocA cervicogenic headache is, simply put, a headache thats origin is rooted in the nerves, muscles, and bones of the neck.
You’ve heard of migraine headaches, tension headaches, and stress headaches, but you may not have heard ‘cervicogenic headache’ being thrown around too often in casual conversation. However, cervicogenic headaches are just as common and just as painful as any other headache, though the symptoms, causes, and treatment are slightly different.
Patients often describe a cervicogenic headache as a dull, pain that radiates from the lower neck to the back of the head. From here, it may spread to the forehead, temples and surround the eyes. Doctors refer to cervicogenic headaches as secondary headaches. It occurs when underlying pain elsewhere is felt in the head. Common causes of cervicogenic headaches are an injury, trauma, spine damage, rheumatoid arthritis, cancer, and certain types of infections.
What Causes a Cervicogenic Headache?
Though a cervicogenic headache will eventually produce pain in the skull area, it begins with neck pain. Different conditions based in the neck area can cause this type of headache, such as:
- A prolapsed disc in the neck
- Trauma in the neck area, such as a sports injury
- A pinched nerve in or near the neck
More often than not, poor posture causes headaches and neck pain.
For instance, if you are someone who sits at a desk for most of the day, or someone who drives for long periods of time like a mailman or a diesel driver, you may unconsciously push your chin forward, holding your head in front of your body. This position is called cervical protraction, and it places the weight of your entire skull solely on your neck. Sitting or standing like this for long periods of time can place too much strain on the muscles in your neck, causing uncomfortable neck pain, and eventually a cervicogenic headache.
Falling asleep in an awkward position, like with your head to one side, can have the same effect. This can happen if you fall asleep in a chair, or while sitting up in bed.
What are the Symptoms of a Cervicogenic Headache?
The most common symptoms of a cervicogenic headache are, obviously, head pain, which is usually described as throbbing or pulsing. Neck pain is another common symptom. Other symptoms include:
- Pain around the eyes
- Cervicogenic headaches can also often mimic the symptoms of a migraine, such as light sensitivity, noise sensitivity, or blurry vision.
- Pain originating at the back of the neck and radiating along the forehead
- Pain along the shoulder
- Reduced flexibility of the neck
- Swollen eyes
- Blurred vision
- Pain while coughing or sneezing
- Pain Radiating to Other Areas of the Body
- Light Sensitivity
- Pain on one side of the head or face
- Chronic Headache
Neck Pain with Cervicogenic Headaches
Cervicogenic (CGH) pain often starts in the neck. Patients commonly describe this as a dull ache that may worsen with certain types of postures, similar to a “crick”. CGH pain is also typically worse on one side, but with worsening conditions can move to the other side, as well. This type of pain may lead to neck stiffness and temporarily limits the range of motion.
Headaches without neck pain can also occur with cervicogenic headaches. When this happens, the source may not cause neck pain but will cause the neck to be sore. Sudden head movements or pressure on the back of the neck will still trigger CGH.
How do I Treat a Cervicogenic Headache?
If left untreated, cervicogenic headaches can become recurrent, and rapidly grow to debilitating levels. But there are multiple techniques to manage the symptoms, as well as preventative measures you can take to stave off future cervicogenic headaches.
To confirm that your headache is cervicogenic in nature, a doctor may apply pressure to various points on your neck. Your doctor may also move your head into various positions to determine which if any particular movement provokes neck pain and a headache. If pressure on the neck or any one posiyion of the neck provokes a headache, this means that the headache is cervicogenic.
CGH Treatment: Manual Therapy
Manual therapy involves manipulation and joint mobilization for CGH. In this method. procedures are focused around massage, physical therapy or other types of manipulation. When combined with exercise, manual therapy has shown to provide great outcomes. Spinal manipulative therapy may relieve pain by relieving some of the pressure from the joints and thus, improving nerve function.
CGH Treatment: Transcutaneous Electrical Nerve Stimulation (TENS)
Transcutaneous electrotherapy technique involves a device that produces a very low voltage electric current to stimulate the nerves. Dr. Rodrigues passes electric currents through electrodes via sticky pads in the localized pain areas. This treatment is meant to stimulate the sensory nerves, and it is possible to control the frequency of the current in order to suit individual needs.
CGH Treatment: Instrument-Assisted Soft Tissue Mobilization (IASTM)
The IASTM technique involves an assessment into the deeper layers of tissues to identify restrictions within these tissues. This is performed using handheld instruments and running the affected area using different but specific massage techniques. These restrictions may form due to the development of scar tissue, fibrous muscle tissue, chronic inflammation or degeneration. Once Dr. Rodriguez identifies the restrictions, he then mobilizes them by gently pulling or stretching with the help of special instruments that use traction force.
CGH Treatment: Medications
Inflammation tends to be at the bottom of a cervicogenic headache, and if this is the case: inflammation in the muscles, nerves, tendons, or joints in the neck area. Dr. Rodriguez may prescribe an oral over the counter medication to reduce inflammation, or to help manage pain. Some of these include:
- Aspirin or ibuprofen
- Muscle relaxants
- A corticosteroid
Dr. Rodriguez may choose to prescribe medications used for tension-type headaches, migraines, or neuralgias, otherwise known as nerve pain, to review cervicogenic headache pain. Some of the commonly used medications for CGH are:
- Botulinum Toxin
- Muscle Relaxants
- Anti-Epileptic Drugs
- Tri-Cyclic Antidepressants
While these medications do no cure CGH, they may provide enough relief to help the patient comply during therapy sessions, such as manual therapy or other rehabilitation programs.
CGH Treatment: Physical Therapy
Sometimes, neck pain that stems from muscle imbalance, bad postures, etc. may be treated with special therapeutic exercises that focus on stretching and strengthening the neck muscle and surrounding muscles. Dr. Rodriguez may design a program specifically for your case.
If your doctor believes that your neck pain and cervicogenic headaches originate from weak muscles in the neck, physical therapy may be their solution of choice. Physical therapy can strengthen those weak muscles and improve mobility in the joints.
Some alternative therapies may include chiropractic therapy, massage therapy, or acupuncture to lessen nerve and joint pain in the neck area.
Other options for managing pain include:
- Avoiding activities that worsen pain
- Applying ice or heat for 10 to 15 minutes
- Using a neck brace while sleeping to prevent your neck from falling forward or to the side
- Being conscious of your posture while sitting, standing, or driving.
CGH Treatment: Injection and Surgical Procedures
If your cervicogenic headaches originate with nerve compression or a pinched nerve, there are some rare cases where spinal surgery may be needed. This is, however, incredibly uncommon, and Dr. Rodrigues only uses this as a last resort when all other remedies have failed.
More likely, your doctor may treat a cervicogenic headache with a nerve block. A nerve block involves a numbing agent or a corticosteroid being injected into the nerves in the back of the head or the neck. Dr. Rodriguez also sometimes uses this as a diagnostic procedure; if a nerve block stops a cervicogenic headache, this confirms a problem with the nerves in the back of your head or neck.
Common Injections for Cervicogenic Headaches
- Radiofrequency Neurotomy
- Cervical Epidural Steroid Injection
- Cervical Intra-Articular Steroid Injection
Surgical Options for Cervicogenic Headaches
- Decompression and Microsurgical Neurolysis of the Nerves
- Arthrodesis of Atlanto-Axial Joints
- Anterior Cervical Discectomy and Fusion (ACDF)
- Cervical Disc Arthroplasty (CDA)
Prevention of Cervicogeinic Headaches
Unfortunately, not all cervicogenic headaches can be treated. Cervicogenic headaches that result from osteoarthiritis, for instance, can usually only be managed with some of the alternative relaxation therapies listed above, and not treated.
However, there are general preventative measures regarding cervicogenic headaches. For instance:
- Don’t sleep with your head propped up on a pillow
- If you are sleeping in a chair or sleeping upright, use a neck brace to keep your neck straight
- Practice good posture while sitting for any lengthy period of time, like at a desk during the workday or while driving
- Protect your neck and head from collisions while playing contact sports like football and soccer
The outlook for cervicogenic headaches varies greatly, depending on the underlying neck condition. However, by consulting a doctor, it is entirely possible to manage your pain and maintain an active lifestyle.
Contact The Pain Relief Center in Plano, Texas
Don’t let cervicogenic headaches and neck pain stop you from living your life. Dr. Rodriguez and his team at the Pain Relief Center are dedicated to the eradication of pain. Contact The Pain Relief Center today for more information about cervicogenic headaches and neck pain.