Cervicogenic headache: Causes, symptoms, diagnosis, treatment, and prevention

A cervicogenic headache is a term used to describe a secondary headache, which really means the cause of the head pain is the result of another physical issue or illness. Some healthcare professionals call it “referred pain.”

Cervicogenic headaches are characterized by a disorder that stems from the cervical spine and its discs or soft tissues. There are many structures in the upper neck and the back of the head that can be sensitive to pain. Cervicogenic headache is not a term you automatically apply to a headache with neck pain though. There are different headaches, such as a migraine and tension headaches that can be linked with neck pain and tension; however, people who suffer from cervicogenic headaches have a disorder or lesion in the cervical spine or soft tissues.

Cervicogenic headache pain tends to be located at the base of the skull as opposed to the front and sides of the skull. The trigeminal nerve is a cranial nerve located in the brain and it is responsible for transmitting sensations from the face to the brain. It may be involved in cervicogenic headaches. While migraines often include an aura, those who suffer from cervicogenic headaches do not experience aura.

There are a number of different disorders that have been associated with this type of headache, including tumors and rheumatoid arthritis. Whether or not age-related degeneration of the spinal discs in the neck can cause cervicogenic headache is still being debated.

Causes of cervicogenic headache

We are all susceptible to cervicogenic headache, but normally it is people between the ages of 20 and 60 that experience this type of pain. Cervicogenic headache causes can be acute or chronic and include everything from sudden trauma to lifestyle habits. For example, it is not unusual for people who are hair stylists, carpenters, or truck drivers to get cervicogenic headaches due to the way they hold their heads when working.

Here’s a look at some of the common cervicogenic headache causes:

  • Poor posture
  • Weak neck muscles
  • Disc damage
  • Heavy lifting
  • Whiplash
  • Sports injury or car accidents
  • Forward motion head (act of holding head out in front of you)
  • Tumour
  • Fracture in upper back or spine
  • Working at computer with arms way out in front of body

Symptoms of cervicogenic headache

People who suffer from cervicogenic headaches tend to experience a gradual onset of neck pain and then headache during specific activities. It is also common for sufferers to feel stiffness after an activity and when waking up in the morning.

Some people don’t realize that their neck and head pain are related until the neck discomfort progresses. Some people feel an increase in symptoms when they make certain neck movements, such as while driving a vehicle or working at the computer with poor posture.

The following list covers some of the typical cervicogenic headache symptoms:

  • Pain on one side of the head or face
  • Dull constant pain
  • Head pain when coughing, sneezing, or taking a deep breath
  • Pain that can last for hours or even days
  • Neck stiffness
  • Eye pain
  • Pins and needles in upper back, shoulders, arms, or hands
  • Difficulty turning the neck
  • Lightheaded
  • Nausea

There are many people with cervicogenic headaches who suffer from depression, particularly if the pain is chronic.

Risk factors of cervicogenic headache

In many cases, cervicogenic headaches can be prevented. There are risk factors to watch out for in order to avoid such pain. Some of those risk factors are outlined below.

  • Smoking – this can increase disc degeneration
  • Age – natural wear and tear can cause disc problems
  • Occupation – sitting for long periods of time, working in construction or commercial fishing.
  • Sports – professional sports with high impact
  • Sleep – lack of sleep due to poor posture
  • Lack of exercise – poor physical condition leads to weak muscles
  • Poor nutrition – can lead to fractures

Diagnosis for cervicogenic headache

It isn’t always that easy to diagnose a person with cervicogenic headache (CH). This is due to the fact that there are many different types of headaches. If you are experiencing neck and head pain your doctor will start by asking you what you were doing when the pain first occurred. It is important to tell him/her about any other symptoms you have noticed, if you recall hitting your head, or have had any recent sports injuries. If head pain comes on suddenly and is severe, do not wait to see your GP, seek emergency medical care immediately.

When assessing the cause of a headache, a doctor may use the following diagnostic measures:

  • X-ray – used to see bones in the neck and spine
  • CT scan – special tomography that can look at body parts from different angles
  • MRI – used to attain detailed images of the head, neck, and spine.
  • Nerve block – a shot that numbs nerves in the back of the head and determines if pain is due to nerve problems.
  • Physical exam – testing movement of the head and neck to see how it reacts and how the patient reacts.
  • Blood tests – used to determine if there is a disease causing the pain

Treatment for cervicogenic headache

There are several ways to look at cervicogenic headache treatment. Some people are in so much discomfort that they would just be happy to lessen the pain, while other sufferers are determined to get rid of the condition completely. Both lessening and getting rid of the pain is possible.

It largely depends on the root cause, but this list covers the many different cervicogenic headache treatments available:

  • Medications – anti-inflammatories, muscle relaxers, and other pain relievers to decrease pain.
  • Physical therapy – exercises, including stretches under the supervision of a qualified physical therapist.
  • Spinal manipulation – could be a mix of physical therapy, massage, as well as joint movement, but should be done with a healthcare professional, such as a physical therapist or chiropractor.
  • Nerve block – injection to anesthetize the nerve causing the pain
  • Surgery – could include discectomy, which is an operation to remove material that is pressing on a nerve root or spinal cord.
  • Non-surgical options – yoga, meditation, acupuncture, biofeedback, massage, or chiropractic care.

It is not unusual for people who suffer from cervicogenic headaches to be recommended more than one treatment option at a time.

How to prevent a cervicogenic headache

If you want to prevent cervicogenic headaches, you have to maintain healthy muscles and bones in your neck. This really begins with a healthy diet that includes calcium-rich foods. There are other lifestyle adjustments that have to be taken into consideration, such as stretching. When you spend your day working at a computer, it is important that you take breaks and stretch your neck. Strengthening is equally crucial. Exercising with a focus on the upper back muscles can help build strong neck muscles. Relaxing the trapezius muscles in the upper back can also be helpful. Tension in this area of the body often leads to pain in the neck muscles. Lastly, get a good night’s sleep. This means that you might need to get a new pillow that is non-feather and firm to support your neck properly.

Exercises and other treatment options for a cervicogenic headache

Cervicogenic exercises can be safe when done under the guidance of a physical therapist. There are specific physical movements that can help in the healing process and lessen the chances of recurring pain. Some physical therapy options include joint mobilization, joint manipulation, traction, soft tissue massage, electrotherapy, as well as flexibility, strength, and posture exercises. Some therapists will promote postural taping, which is a taping technique designed to support the upper back and neck. It can help improve spinal alignment and reduce the stress the spine normally experiences during activity. There are also postural braces that can be used and some people find lumbar rolls can be helpful. A lumbar roll is a pillow shaped like a roll that has straps on it so that you can attach it to your chair to support and align your back.

While you should discuss cervicogenic headache exercises with a therapist, here are a couple of exercises that are often recommended for people who are suffering from this kind of headache.

  • Chin tucks – sit or stand with your back and neck straight, while shoulders are back slightly. Tuck your chin in as far as you can without feeling pain. Keep eyes forward and hold for just two seconds. Relax and then repeat this exercise 10 times. Many therapists suggest doing chin tucks three to five times each day.
  • Shoulder blade squeezes – sit or stand tall with your back straight. Squeeze your shoulder blades together as hard as you can without feeling pain. Hold this position for 5 seconds and then repeat 10 times. Do this exercise three to five times per day.

Prognosis for a cervicogenic headache

If you have read this far and think you might have cervicogenic headaches, you might be wondering about the long-term prognosis. Most people with this condition are able to recover quickly with the right physiotherapy treatment. Some people with minor cases of cervicogenic headache heal quickly—in a matter of days. Unfortunately, there are more severe situations where it can take months to recover,

Having cervicogenic headaches can be very disruptive. It isn’t just the pain that sufferers have to deal with; it is the fact that the condition can prevent them from participating in life. Some people find that they can’t concentrate or that the slightest movement of the neck triggers symptoms so they are afraid to participate in activities they would normally enjoy. The sooner sufferers get treatment for cervicogenic headaches, the better the outcome, and that means returning to whatever activities they want.

Related: Vascular headache types: Causes, symptoms, and treatment


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