Cervicogenic Headaches

What is Cervicogenic Headache?

Cervicogenic headache in simple terms means headache originating from the neck. Even though the pain you experience is in the head or part of the face, the actual problem lies in the neck. The possible pain generators in the neck include the joints, discs, surrounding tissues such as the neck muscles, coverings of the spinal cord and blood vessels. 

Headaches afflict people of all ages. The impact is variable from mild discomfort to severe incapacitation, depending on the severity and the frequency of headaches. Cervicogenic headaches are often easily overlooked and are underdiagnosed due to limited awareness about the condition. This is a treatable cause of headaches with the possibility of good relief. 

Signs & Symptoms:

Some of the pointers towards cervicogenic headache include: 

• Increase in headaches with neck movements such as nodding or neck rotation 
• Increase pain with pressure on certain sensitive points in the neck 
• Stiffness and reduced range of neck movements 
• Pain is generally one sided although can involve both sides 
• Generally described as a pressure sensation at the back, side or front of head or in the area around the eye. Pain may be episodic or constant. Nausea & vomiting, features similar to migraine can be present. 

Causes:

A number of neck conditions have been attributed to causing cervicogenic headaches including: 

• Degenerative changes in the neck joints e.g. osteoarthritis.
• Discs of the cervical spine.
• Whiplash injury/ neck trauma.
• Neck muscle spasms.
• Bad neck posture for long periods.

Diagnosis:

Diagnosing a cervicogenic headache can be challenging, as a number of headaches can present with similar features. Your doctor will obtain a detailed history often taking you back to when it had first started. Besides pain he may ask you about stress levels, work, eating and sleep habits, medication usage etc. This is usually followed up by examination. Diagnostic investigations such as X-ray, MRI, CT scans can help support the diagnosis. An injection is often used for confirmation of the diagnosis.

Management Options:

These include: 

• Lifestyle changes such as regulation of sleep cycle, workplace ergonomics
• Medication may include mild or potent pain killers 
• Interventions such as joint, nerve or muscle injections. These can help in confirming the diagnosis and provide relief. 
• Radiofrequency treatment can help relieve/ reduce these headaches for a prolonged duration
• Physical therapy can help to stretch and relax the muscles in and around your neck 
• Psychology input may involve biofeedback, relaxation therapy and cognitive behavioural therapy 
• Including meditation, yoga, TENS, acupressure and acupuncture 
• Surgery- reserved for cases with severe joint changes or nerve compression unrelieved by other modalities and is rare.