Headaches Originating from the Neck-Cervicogenic headache

 

• Contrary to popular belief, headaches don't always originate from the brain or other structures in the head. It's been long thought and debated that headaches could originate from the neck, and in 1983, the term "cervicogenic (neck-originating) headache" entered medicine.
• Structures located in the neck or back of the head, such as nerve roots, bones, muscles, joints, and discs, can manifest their various disorders as a headache.
• Cervicogenic headaches occur when problems in the cervical spine (neck) cause referred pain in the head. These headaches are often described as dull, aching, and typically one-sided. They can be triggered or exacerbated by neck movements or poor posture.
•  The pain is usually on one side. However, depending on the location and degree of disorders in the neck, pain can occur on both sides. There might be movement restrictions in different directions during neck movements, and the headache might be triggered by various neck movements.
• Patients complaining of cervicogenic headaches often have a history of rigorous sports, head and neck trauma (e.g., car accidents).
• Even a minor collision in a car accident can later cause damage leading to cervicogenic headaches. In such cases, the rapid back-and-forth movement of the head in a whip-like manner can cause the injury.
• The intensity and duration of pain vary from patient to patient. The pain usually starts from the neck and is neither throbbing nor piercing.
• Symptoms such as nausea, sensitivity to light and sound, which are distinctly observed in migraines, may also be observed in cervicogenic headaches, but they are less frequent and less prominent.
• Unfortunately, like in many types of headaches, patients with cervicogenic headaches have often been mistakenly treated as if they have migraines.

How are cervicogenic headaches treated?

Here are some effective treatments to consider:

1. Physical Therapy

Physical therapy is often one of the first-line treatments for cervicogenic headaches. A skilled physical therapist can help you improve posture, strengthen neck muscles, and reduce tension in the neck and shoulders. They may employ techniques like:

• Neck stretches and exercises: Your therapist will design a personalized exercise program to strengthen and improve the flexibility of your neck muscles.
• Manual therapy: Hands-on techniques like joint mobilization and soft tissue massage can help alleviate pain and improve neck mobility.
• Postural education: Learning proper posture and ergonomics can prevent future headaches.

2. Medications

Medications can help manage cervicogenic headache symptoms. Your doctor may recommend:

• Pain relievers: Over-the-counter pain relievers like ibuprofen or prescription medications may be used to reduce pain and inflammation.
• Muscle relaxants: These can help relax tense neck muscles that may be contributing to your headaches.

3. Lifestyle Modifications

Making certain lifestyle changes can help reduce the frequency and severity of cervicogenic headaches:

• Ergonomic adjustments: Ensure your work or home setup promotes good posture to prevent strain on your neck.
• Stress management: Practicing relaxation techniques like yoga, meditation, or deep breathing can help reduce muscle tension and stress-related headaches.

4. Injections and Procedures

If conservative treatments don't provide sufficient relief, your doctor may suggest more invasive options like:

• Nerve blocks: In some cases, nerve blocks may be recommended to provide temporary relief by blocking pain signals from the neck.
• Radiofrequency ablation: This procedure involves using radiofrequency energy to disrupt nerve signals in the neck that may be causing headaches.
• Botox injections: Botulinum toxin injections can help relax overactive muscles in the neck and provide relief from chronic headaches.

5. Surgery

Surgery is typically considered a last resort when all other treatments have failed, and a specific structural problem in the neck is identified as the cause of the headaches. Surgical options are rare and come with potential risks, so they are only recommended when absolutely necessary.

Conclusion

Cervicogenic headaches can be debilitating, but with the right treatment plan, relief is possible. It's essential to work closely with a healthcare professional to identify the underlying causes and tailor a treatment plan to your specific needs. Whether it's physical therapy, medications, lifestyle changes, or more advanced procedures, there are effective ways to manage and alleviate cervicogenic headaches, allowing you to regain control of your life and enjoy headache-free days.

Always consult with a healthcare provider for a proper diagnosis and guidance on the most suitable treatment for your condition.

• ​​​​​Limited benefits are obtained from painkillers in treatment. Physical therapy is known to provide benefits by relaxing neck movements and relieving muscle tension in the neck.
• In cases where physical therapy and rehabilitation are ineffective, interventional methods are utilized.Pain sources in the neck are deactivated using radiofrequency or other methods.