Cervicogenic headaches

Cervicogenic headaches

Cervicogenic headaches (used to be called cervical headaches) are unique in that they are caused by a referred source i.e. the headaches do not originate from the head but are from the cervical neck and caused by a neck disorder or lesion (impingement or obstruction of the occipital nerve ascending up to the head is the most prevalent cause).

Symptoms of a cervicogenic headache are quite non-specific and include pain occurring in one or more region of the face and/or head with tender spots of the cervical myofascial tissue also evident. Symptoms and signs can include some of the following (but don’t necessarily prove a diagnosis as are symptomatic of other disorders):

• Mechanical movement causing an increase of pain symptoms.
• History of cervical neck trauma or injury is usually evident.
• A co-existing shoulder pain could be evident.
• A reduction in the range of motion of the neck.
• Nausea
• Vomiting
• Sensitivity to light.
• The sudden onset of nuchal rigidity (severe neck stiffness)

When trying to diagnose a cervicogenic headache, one has to look at the source/origin of the pain. Clinical and imaging methods used to identify a disorder or lesion around the cervical spine and soft tissues can be used to find the source of the headache. Doctors will then usually perform neural blocks to determine which nerve the source of the headache. This trial and error method will successfully confirm the diagnosis if the pain is relieved by a specific neural block.

Causes of a cervicogenic headache

The most common cause of a cervicogenic headache is similar to that of a whiplash-type of injury. The acceleration-deceleration movement causes grinding of the joint and thereby irritation. This irritation is the primary step that starts the process of the headache. Other causes include arthritis in older people (arthritis in the cervical joints will cause irritation of the joint – causing inflammation – causing irritation of the occipital nerve), muscle spasms, grinding of the cervical joints, laxity of the cervical joints as well as other conditions which make one more predisposed to hypermobility of the joints.

Treating a cervicogenic headache

As mentioned earlier, treatment also has to tackle the issue at the source of the problem (in the neck). As such, treatment will vary dependent on the mechanism of the cause and what works best for the patient involved.

Treatment protocols include the following:

• Nerve blocks
• Physiotherapy and an exercise rehabilitative regime
• Botox injections
• Medications

So far, it has been shown that physiotherapy and an exercise regime focused on improving the mobility of the cervical neck and returning the range of movement back to normal, together with a stability focused strength programme, have produced the best long term results in not causing a relapse. Find out more about our headache treatment and how we can help you today.