Cervicogenic Headaches Start in the Neck

A cervicogenic headache starts in the cervical spine—your neck. Sometimes these headaches mimic migraine headache symptoms. Initially, pain may begin intermittently, spread to one side (unilateral) of the patient's head, and become almost continuous. Furthermore, pain can be exacerbated by neck movement or a particular neck position (eg, eyes focused on a computer monitor).

Potential Causes of Cervicogenic Headaches
The cause of a cervicogenic headache is often related to excessive stress to the neck. The headache may result from cervical osteoarthritis, a damaged disc, or whiplash-type movement that irritates or compresses a cervical nerve. The neck's bony structures (eg, facet joints) and its soft tissues (eg, muscles) can contribute to the development of a cervicogenic headache.

Role of Spinal Nerves
Certain spinal nerves structures are involved in many cervicogenic headaches. Spinal nerves are signal transmitters that enable communication between the brain and the body via the spinal cord. At each level of the cervical spine is a set of spinal nerves; one on the left side and one on the right of the spine. C1, C2 and/or C3 may be involved in development of cervicogenic headaches because these nerves enable function (movement) and sensation of the head and neck. Nerve compression can cause inflammation and pain.

Cervicogenic Headache Symptoms
A cervicogenic headache presents as a steady, non-throbbing pain at the back and base of the skull, sometimes extending downward into the neck and between the shoulder blades. Pain may be felt behind the brow and forehead, even though the problem originates from the cervical spine.

Pain usually begins after a sudden neck movement, such as a sneeze. Along with head and/or neck pain, symptoms may include:

  • Stiff neck
  • Nausea and/or vomiting
  • Dizziness
  • Blurred vision
  • Sensitivity to light or sound
  • Pain in one or both arms
  • Mobility difficulties

Risk Factors
Risk factors that may be involved in headache onset or aggravate cervicogenic headaches include:

  • Fatigue
  • Sleep difficulties
  • Cervical disc problems
  • Current or prior neck injuries
  • Poor posture
  • Muscular stress

Diagnosis of Cervicogenic Headache
The diagnosis of a cervicogenic headache begins with a thorough medical history with a physical and neurological examination. Diagnostic testing may include:

  • X-rays
  • Magnetic resonance imaging (MRI)
  • CT Scans (rarely)
  • Nerve block injections to confirm the diagnosis, cause

Treatment for Cervicogenic Headaches
Initially, your doctor may recommend an over-the counter non-steroidal anti-inflammatory drug (eg, aspirin, Aleve). If this is ineffective, then a prescription anti-inflammation and/or pain reliever may be prescribed. Other treatment options, listed in order of from non-invasive to invasive, include:

  • Spinal manipulation or other manual therapies
  • Behavioral approaches (eg, biofeedback)
  • Acupuncture
  • Trigger point injections
  • Prolotherapy
  • Facet joint blocks (a type of spinal joint injection)
  • Nerve blocks (this is usually of the medial branches of the nerves that supply the facet joints)
  • Radiofrequency pulse ganglionotomy of the nerve root (eg, C2, C3)
  • Spine surgery to relieve nerve or vascular compression (this is rarely necessary)
Updated on: 03/08/16
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Exams and Tests for Neck Pain
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Exams and Tests for Neck Pain

Learn about the imaging tests (x-ray, MRI, CT scan) your doctor may order to help diagnose the cause of your neck pain.
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