Headaches can be caused by many different factors such as tension, fatigue, eyestrain, sinus pressure or hormones, and the pain can range from slightly annoying to downright debilitating. Also, anyone who suffers from migraine headaches knows just how bad they can really get. Thankfully, over-the-counter pain medications such as acetaminophen and ibuprofen can control the pain of standard headaches. Rest, ice or heat, and prescription medications can help more severe headache pain.
As stated, the cause of most headaches can usually be determined, and even those who deal with migraines know their triggers. However, there are chronic headache sufferers who struggle, not only with determining the source of their pain, but also with how to treat it. The severity, for example, may mimic that of a migraine, but traditional migraine treatments won’t completely reduce the symptoms or alleviate the pain. If this sounds familiar to you, you may be suffering from cervicogenic headaches.
WHAT IS A CERVICOGENIC HEADACHE?
The pain of a cervicogenic headache (CGH) is very difficult to distinguish from that of a migraine – which is why it may be diagnosed as one. The main difference between the CGH and the migraine, however, is where the pain originates. A migraine stems from the brain and a CGH stems from the cervical spine or base of the skull. Although a migraine may cause neck pain, a cervicogenic headache is neck pain that causes the headache. In fact, a CGH is considered a secondary headache – or referred pain – because, even though you feel the pain in your head, it starts in another part of your body.
WHAT CAUSES A CERVICOGENIC HEADACHE?
Cervicogenic headaches result from structural problems in your neck and are often due to issues with the cervical vertebrae at the top of the spine, specifically the C2, C3 and C4 vertebrae. Because a CGH comes from problems in the neck, different conditions can cause the severe pain:
- Prolapsed discs in the spine
- Compressed or pinched nerves
- Whiplash from a car accident
- Sports injuries
- Serious falls
- Cervical protraction – poor posture from sitting or standing in one position for long periods of time,
putting pressure or stress on the neck and base of the skull.
- Falling asleep in an awkward position causing your head to fall too far forward, back or to the side for long periods of time.
- Nerve damage from cancer treatment
WHAT ARE SYMPTOMS OF A CERVICOGENIC HEADACHE?
In addition to throbbing head pain, people with a CGH you will also experience neck pain and stiffness. Also, certain neck movements can provoke a cervicogenic headache. In most cases, they will develop on one side of the neck or head, starting at the back and radiating toward the front. Other symptoms of a CGH include:
- Reduced range of motion of the neck
- Pain on one side of the face or head
- Pain around the eyes
- Shoulder pain or pain or down one side of arm
- Head pain when coughing or sneezing
- Head pain that is triggered by certain neck movements or positions
- Sensitivity to light and noise
- Blurred vision
HOW ARE CERVICOGENIC HEADACHES TREATED?
Because the pain originates in the bones, muscles, ligaments or nerves of the neck or shoulder area, a CGH may not respond to standard headache pain medications. Treatment focuses on removing the cause of the pain. Treatment may also vary depending on the severity of the symptoms.
And, although the prevalence of a CGH is much lower than a tension or migraine headache, people who suffer from them have a substantially lower quality of life due to the chronic pain. So, doctors who diagnose and treat cervicogenic headaches should go beyond traditional medications and use different methods to help heal their patients. Some treatments for cervicogenic headaches may include:
- Non-steroidal anti-inflammatories (NSAIDs), such as aspirin or
- Muscle relaxers
- Anti-seizure medications such as Gabapentin
Transcutaneous Electrical Nerve Stimulation (TENS)
- The use of small electrodes that are placed on the skin to send small electrical signals and stimulate nerves near the source of the pain.
- Also called radiofrequency neurolysis, radio waves are used to heat the tip of a needle. The needle is then applied to the pain-causing nerve. The heat effectively deadens the nerve and interrupts its ability to send pain signals to the brain.
- Pain-numbing medicine that is injected into nerves or joints in the neck.
- Surgical procedure involving electrodes placed on the back of the head or neck. The electrodes stimulate the occipital nerve, which runs from the top of the spinal cord to the head.
- Neck adjustment and spinal manipulation – used to help decrease disability and pain, as well as improve function.
- Trigger point therapy – used to relieve specific points or hyperirritable spots of pain located in tight bands of skeletal muscles.
- Conservative physical therapy treatment techniques are effective aids to help decrease the intensity and frequency of a CGH. This therapy should combine mobilization, manipulation, cervical soft tissue work and strengthening exercises.
- A physical therapy technique called “sustained natural apophyseal glide” (SNAG). Taught by a physical therapist – and performed at home – it involves the use of a towel to manipulate the areas of the neck that are causing the painful symptoms.
- Relaxation techniques such as yoga, meditation and deep breathing.
- Posture improvement exercises.
PREVENTATIVE TIPS FOR CERVICOGENIC HEADACHES
Not all cervicogenic headaches can be avoided, but helping to improve your posture is one way you can keep yourself free from neck and spine pain that would lead to a CGH. Maintaining good posture is not only great for preventing cervicogenic headaches, but also for overall musculoskeletal health. Here are a few exercises to help you practice good posture:
- If you sit at a desk all day, one of the best things to do is get up, stretch and move every 30 minutes. When seated back at your desk, complete five, slow repetitions each: Nod your head up and down, stretch your neck side to side, and roll your shoulders forward and backward as far as you can. Repeat every half hour.
- For your upper back: While seated, place both hands on your desk. Straighten your arms and round your back. Gently press your hands into your desk as you try to expand your upper back with your breath inhales. Exhale and repeat five to 10 times.
- At home, try the Cat/Cow exercise: Get on all fours with your wrists aligned below your shoulders and your knees aligned below your hips. Keep your toes tucked under. Inhale, relaxing your belly so it moves toward the floor. Gently arch your back, tilting your tailbone and chin toward the ceiling. Exhale, gently rounding your spine while drawing your chin to your chest and untucking your toes. Repeat movement for 6-10 repetitions.
- BirdDog exercise: From the same all-fours position, tuck your right toes under and extend your right leg behind you. Slowly lift your leg off the floor no higher than hip height. Bracing your core, slowly reach your left arm forward no higher than shoulder height and turn your palm inward so your thumb points at the ceiling. Keeping your hips and shoulders level, hold for no more than 7-8 seconds. Return to the starting position and repeat on the opposite side. Do 6-10 repetitions.
If left untreated, cervicogenic headaches can become terribly debilitating. The pain from dysfunctions in the neck or upper spine will cause the headaches to continue to return and become chronic. And while acute pain is temporary and alerts us to current or potential issues, chronic pain is unnecessary and emotionally challenging. If you suffer from any of the symptoms above and your pain won’t go away with conventional medications, consult a qualified physician, chiropractor and/or physical therapist to get properly diagnosed and treated.
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