Cervicogenic Headache (Neck Pain with Headache)
What is a cervicogenic headache?
Cervicogenic headaches originate in the neck, most commonly from the upper three cervical facet joints (C1-2, C2-3, C3-4), upper discs (C2-3 and C3-4) and the C2 and C3 cervical spinal nerves. This condition can be caused by work or sports trauma, whiplash injuries and arthritic changes which can damage one or more of these structures. Cervicogenic headaches are felt in the upper neck and beneath the skull (occiput) and often radiate to the forehead, eye or temple. This type of headache is worsened by neck movement and/or maintaining a fixed head position. The headache can involve one or both sides.
The facet joints and discs below the level of C3-4 are the most common source of chronic neck pain without headache. As with cervicogenic headache, trauma and arthritic changes are the most common cause of chronic neck pain.
Cervicogenic headaches vary in intensity and are often described as aching, throbbing, sharp, catching and are almost always worse with head movement. There can be referred pain into the temples, behind the eyes and the frontal region. While the neck component of the headache is always present, the referred pain into the front of the head may come in episodes, which could last from a few hours to a few days. There can be significant overlap in the symptoms of cervicogenic headache and certain primary headaches, such as migraine and hemicrania continua. At times, this can make an accurate diagnosis of cervicogenic headache more difficult and potentially prolong the initiation of effective treatment. These headaches often become chronic but can still be successfully treated if the underlying cause is accurately identified.
Symptoms more specific to cervicogenic headaches
- Onset following neck trauma
- Pain worsens with neck movement
- Neck pain and stiffness with or without frontal /orbital or temporal headache
- Neck pain that remains focal over time
Symptoms shared by cervicogenic and migraine headaches
- Pain in the back of the head, upper neck and shoulder
- Sensitivity to light
- Throbbing pain in the forehead, eye and temples
How are cervicogenic headaches diagnosed?
The diagnosis of cervicogenic headaches starts with a detailed physical examination and a careful history. Often, the headache can be linked to a specific event, such as an auto accident, sports injury or simply arthritic changes. Neck mobility is usually restricted and painful. There is often pain when pressure is applied to the symptomatic structure. The anatomic source of the cervicogenic headache may appear normal or abnormal on X-ray, CT scan or MRI. None the less, these studies are useful to exclude underlying conditions which may mimic a cervicogenic headache. Diagnostic injections of the suspected pain generator are the only definitive test to determine the origin of a cervicogenic headache. Once the source of the headache has been determined, radiofrequency procedures can be used to provide long term relief.
What are some of the conservative treatments for cervicogenic headaches?
Conservative treatment of cervicogenic headaches includes medications (both over the counter and prescription), physical therapy, chiropractic, massage, yoga and acupuncture. Relaxation techniques such as meditation and biofeedback may also be helpful.
Can Interventional Headache Treatment help with cervicogenic headaches?
If you have had conservative treatment and cervicogenic headaches continue to disrupt your regular daily activities, then Interventional Headache Treatment may be an effective way to diagnose and successfully treat your headache and improve your quality of life. By identifying the structural source of the headache, radiofrequency procedures can then be used to provide long term relief. This and other treatment options will be discussed as part of your initial consultation.