What is cervicogenic headache and how is it treated?
What Is Cervicogenic Headache? Doctors may prescribe medications used for migraines, tension-type headaches, or neuralgias (nerve pain) to relieve CGH pain. Some of the commonly used medications for CGH are:
What kind of doctor should I See for cervicogenic headache?
Other providers that may need to be involved in management of cervicogenic headache include physical therapists, pain specialists (who can do the injections/blocks) and sometimes neurosurgeons or orthopedic surgeons.
How is a cervicogenic headache with a nerve block diagnosed?
Your doctor can also diagnose (and treat) a cervicogenic headache with a nerve block. This involves injecting a numbing agent and/or a corticosteroid into or near the nerves in the back of your head.
What is the difference between cervicogenic and migraine headaches?
Cervicogenic headaches can mimic migraines, so it may be difficult to distinguish a cervicogenic headache from a migraine headache. The primary difference is that a migraine headache is rooted in the brain, and a cervicogenic headache is rooted in the cervical spine (neck) or base of the skull region.
What doctor treats Cervicogenic headaches?
Treatment for Cervicogenic Headaches Other providers that may need to be involved in management of cervicogenic headache include physical therapists, pain specialists (who can do the injections/blocks) and sometimes neurosurgeons or orthopedic surgeons.
Can a neurologist diagnose a cervicogenic headache?
Some neurologists maintain that this headache can be diagnosed on clinical features; others are not convinced of the validity of such diagnosis. Manual therapists use manual examination of vertebral motion segments, whereas interventional pain specialists use fluoroscopically guided diagnostic blocks.
How do you relieve a cervicogenic headache?
TreatmentMedicine: Non-steroidal anti-inflammatories (aspirin or ibuprofen), muscle relaxers, and other pain relievers may ease the pain.Nerve block: This may temporarily relieve pain and help you better work with physical therapy.Physical therapy: Stretches and exercises can help.More items...•
Is cervicogenic headache serious?
Although rare, it can be a sign of a tear in one of the neck arteries. This is a common cause of stroke, especially in people under age 45. If you notice any of these signs with a headache, seek emergency care right away: Sudden, severe neck pain.
Do cervicogenic headaches show up on MRI?
Diagnostic imagery such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) may only be used to support a diagnosis, but do not generally confirm the diagnosis in CGH.
Can MRI detect cervicogenic headache?
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)
What is the first treatment of cervicogenic headache?
Physical therapy is considered the first line of treatment. Manipulative therapy and therapeutic exercise regimen are effective in treating a cervicogenic headache.
Will cervicogenic headaches go away?
Cervicogenic headaches are treatable, but it all depends on the cause. It's essential to have a medical diagnosis when you have recurrent headaches. If not treated, the pain can get worse, or the neck condition deteriorates.
Does cervicogenic headache affect eyes?
Cervicogenic headaches CGH symptoms usually occur on just one side of the neck, head, and/or face and commonly affect the area around the eye. This headache is usually a moderate, dull ache but can be more intense. In some cases, it can also result in eye swelling and blurred vision.
How long can cervicogenic headaches last?
A “cervicogenic episode” can last one hour to one week. Pain typically is on one side of the head, often correlating with the side of the neck where there is increased tightness. Almost certainly, range of motion will be compromised. Common causes of CGH can be chronic: poor posture, as noted above, or arthritis.
How common is cervicogenic headache?
A cervicogenic headache is a rare chronic headache in people who are 30 to 44 years old. Its prevalence among patients with headaches is 1% to 4%, depending on how many criteria fulfilled and based on many different studies.
Can physical therapy help cervicogenic headaches?
Physical therapy can be an effective treatment for the source of your cervicogenic headaches. People with headaches that are triggered by cervical disc pain can particularly benefit from two therapeutic exercises. Treatment exercises for cervicogenic headache pain will often focus on the suboccipital muscles.
Who can help with cervicogenic headache?
Other providers that may need to be involved in management of cervicogenic headache include physical therapists, pain specialists (who can do the injections/blocks) and sometimes neurosurgeons or orthopedic surgeons.
What is a cervical headache?
Cervicogenic headache is referred pain (pain perceived as occurring in a part of the body other than its true source) perceived in the head from a source in the neck. Cervicogenic headache is a secondary headache, which means that it is caused by another illness or physical issue.
What causes a headache in the neck?
Such disorders include tumors, fractures, infections and rheumatoid arthritis of the upper cervical spine. There is debate as to whether cervical spondylosis (age-related wear and tear affecting the spinal disks in your neck) can cause cervicogenic headache.
Which vertebrae are pain generating?
The junction of the skull and cervical vertebrae have regions that are pain generating, including the lining of the cervical spine, the joints, ligaments, cervical nerve roots and vertebral arteries passing through the cervical vertebral bodies.
Can a headache cause neck pain?
The term cervicogenic headache is commonly misused and does not simply apply to a headache associated with neck pain; many headache disorders, including migraine and tension-type headache, can have associated neck pain/tension. Rather, there must be evidence of a disorder or lesion within the cervical spine or soft tissues of the neck, ...
Can nerve blocks help with headaches?
Nerve blocks are used both for diagnostic and treatment purposes. If numbing the cervical structures abolishes the headache, that can confirm the diagnosis of cervicogenic headache and also provide relief from the pain.
Can cervicogenic headaches be sidelocked?
People with cervicogenic headaches often have a reduced range of motion of their neck and worsening of their headache with certain movements of their neck or pressure applied to certain spots on their neck. The headaches are often side-locked (on one side only), and the pain may radiate from the neck/back of the head up to the front ...
What is the best way to treat neck pain?
Neck pain resulting from muscle imbalance, forward head postures, and rounded shoulders may be treated with therapeutic exercises. These exercises focus on strengthening and stretching the neck and its supporting muscles. A physical therapist or other health professional may design a neck exercise program specifically for the patient.
How to treat CGH?
Self-care methods can help some people manage their CGH symptoms from starting or getting worse. The following options can help control CGH symptoms: 1 Avoiding postures or movements that provoke the pain to start 2 Maintaining a good posture while sitting or driving—by sitting tall with shoulders back and without protruding the head forward 3 Using a neck brace can be helpful while sitting upright or sleeping in a chair 4 Using a supporting travel pillow (similar to a neck brace) on the plane or bus to avoid excessive side-bending or flexion 5 Avoiding tummy-sleeping posture if waking up with pain is a problem 6 Finding the right pillow to prevent the head from being too high or too low when sleeping
What is the difference between biofeedback and cognitive behavioral therapy?
Cognitive behavioral therapy teaches strategies for positive thinking and problem solving. Biofeedback aims to train the mind and body to become more aware of physiological responses that may be causing pain , and how to manage them. See Mind-Body Therapy for Neck Pain.
How to stop neck pain while sitting?
Avoiding postures or movements that provoke the pain to start. Maintaining a good posture while sitting or driving—by sitting tall with shoulders back and without protruding the head forward. Using a neck brace can be helpful while sitting upright or sleeping in a chair.
Can CGH pain be treated?
Treatment strategies without a confirmed source of the CGH pain are mostly speculative in terms of their effectiveness. CGH pain which cannot be relieved by a combination of noninvasive treatments may require more invasive treatment options, such as injections or surgery. See Surgery for Neck Pain.
Affiliations
1. Department of Neurology, University of California, Irvine, CA 92697, USA. [email protected]
ORCIDs linked to this article
This is a comment on " Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. " Spine J. 2010 Feb;10 (2):117-28.
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What is the difference between a migraine and a cervicogenic headache?
The primary difference is that a migraine headache is rooted in the brain, and a cervicogenic headache is rooted in the cervical spine (neck) or base of the skull region. Some headaches are caused by eyestrain, stress, tiredness, or trauma. If you feel a headache coming on, you may be able to isolate the cause.
What are the symptoms of a cervicogenic headache?
What are symptoms of a cervicogenic headache? In addition to a throbbing head pain, symptoms of a cervicogenic headache may include: pain on one side of your head or face. a stiff neck. pain around the eyes. pain while coughing or sneezing. a headache with certain neck postures or movement.
What does it mean when you have a headache and you cough?
pain while coughing or sneezing. a headache with certain neck postures or movement. Cervicogenic headaches can also cause symptoms similar to migraine headaches, such as light sensitivity, noise sensitivity, blurry vision, and an upset stomach.
How to prevent neck bending?
applying ice or heat for 10 to 15 minutes, several times a day. using a neck brace when sleeping upright to prevent bending your neck forward. practicing good posture when sitting, standing, or driving (stand or sit tall with your shoulders back, and don’t lean your head too far forward)
How to help a weak neck?
Physical therapy. Your doctor may also recommend physical therapy to strengthen weak neck muscles and improve mobility of your joints. Your doctor may also recommend alternative therapies to lessen nerve, joint, or muscle pain in the neck. These include massage therapy, spinal manipulation through chiropractic care, cognitive behavioral therapy, ...
What is the best medication for headaches?
These include: aspirin or ibuprofen (Motrin) acetaminophen (Tylenol)
Is cervicogenic headache preventable?
Prevention. Some occurrences of cervicogenic headaches are not preventable. This is the case with headaches stemming from a condition like osteoarthritis, which tends to set in with age. Some of the same strategies for managing pain may also prevent these headaches.
How to tell if you have a migraine or a CH?
Pain that stays in one spot, like the back, front, or side of your head or your eye. Even though CH and a migraine are different, some of the symptoms can be similar. For example, you may: Feel sick to your stomach. Throw up. Have pain in your arm or shoulder. Feel sick or uncomfortable in bright light.
What does it mean when your headache goes away?
They also may suggest a "nerve block.". This is a shot done by a specialist that puts numbing medicine into certain nerves in the back of your head. If the pain goes away with the nerve block, it means your headache is probably caused by a problem with nerves in your neck. Nerve block is also one way to treat CH.
Why does my headache get worse?
The headache gets worse over time. You also have fever or a rash. You hit or hurt your head. These might be signs of another health problem that needs attention. Get emergency medical care if the headache comes on all of a sudden and is very painful or if you start to feel dizzy.
What is spinal manipulation?
Spinal manipulation: This is a mix of physical therapy, massage, and joint movement. It should only be done by a physical therapist, a chiropractor, or an osteopath (a doctor who has special training in the way your nerves, bones, and muscles work together).
What is the best way to see bones in your neck?
X-ray: Small dos es of radiation are used to make pictures of the bones in your neck and spine. Computerized tomography (CT) scan: Several X-rays are taken from different angles and put together to show more information than is on a single X-ray.
How to relieve pain from a nerve block?
Nerve block: This may temporarily relieve pain and help you better work with physical therapy . Physical therapy: Stretches and exercises can help. Work with your doctor or a physical therapist to find out what kind of exercise is best and safest for you.
What is it called when you hold your head out?
Sometimes CH happens in people who hold their heads out in front of their bodies. That's called "forward head motion," and it puts extra weight on your neck and upper back. It also can come from a fall, sports injury, whiplash, or arthritis. Or the nerves in your neck might be compressed (squeezed).
What is a cervicalogenic headache?
Cervicogenic headache constitutes 15 to 20% of all chronic and/or recurrent headaches and is categorized as a secondary headache, meaning the condition results from an underlying disease. CGH specifically stems from a neuromusculoskeletal dysfunction of the cervical spine, particularly the upper three cervical segments. 1,2,3
How does cervical mobilization help with CGH?
Consistent with current understanding of CGH, “osteopathic physicians theorize that cervical mobilization and manipulation procedures decrease the afferent stimulus into the spinal cord from cervical joint receptors by relaxing the paraspinal muscles and releasing strain on the connective tissues and joints, thus relieving the pain of CGH.” 8 An osteopathic approach to CGH may be beneficial therapeutically, but also diagnostically. As noted, imaging studies and other diagnostic modalities are often of limited value beyond evaluating the differential diagnosis of CGH. In addition, the reproduction of CGH symptoms with nerve stimulation has demonstrated consistency in diagnosis across medical and therapeutic paradigms.
What causes CGH in cervical spine?
While any area of the body may result in cervical spine dysfunction, one of the most important causes of CGH may be myofascial trigger point activity , specifically from the sternocleidomastoid muscles. 20,21. Once identified, appropriate OMT may be used to treat the somatic dysfunction, which may, in turn, resolve CGH symptoms.
How does chronic headache affect the healthcare system?
Chronic headaches affect a sizeable portion of the population and present a significant cost to the healthcare system. Evaluations suggest that many clinicians order unnecessary testing, such as imaging; delay treatment of pain by referring to sub-specialists; or utilize non-specific pharmacotherapy in managing pain. 22
What area of the skull is affected by headaches?
9 Pain often involves the posterior occipital area of the skull and extends to the ipsilateral orbit.
Is a cervicogenic headache a secondary headache?
The authors share how an osteopathic approach to this secondary headache disorder may save time and cost. Cervicogenic headache constitutes 15 to 20% of all chronic and/or recurrent headaches and is categorized as a secondary headache, meaning the condition results from an underlying disease. CGH specifically stems from a neuromusculoskeletal ...
Can TGC cause hypertonic muscle pain?
Depending on the duration and severity of the original sensory input, the TGC may be susceptible to hyperexcitability, which may lead to hypertonic muscles and pain in structures that share this innervation.
What is the best treatment for neck pain?
Sometimes, neck pain that stems from muscle imbalance, bad postures, etc. may be treated with special therapeutic exercises that focus on stretching and strengthening the neck muscle and surrounding muscles. Dr. Rodriguez may design a program specifically for your case.
What is manual therapy for CGH?
Manual therapy involves manipulation and joint mobilization for CGH. In this method. procedures are focused around massage, physical therapy or other types of manipulation. When combined with exercise, manual therapy has shown to provide great outcomes. Spinal manipulative therapy may relieve pain by relieving some of the pressure from the joints and thus, improving nerve function.
Can spinal surgery cause headaches?
If your cervicogenic headaches originate with nerve compression or a pinched nerve, there are some rare cases where spinal surgery may be needed. This is, however, incredibly uncommon, and Dr. Rodrigues only uses this as a last resort when all other remedies have failed.
Can cervicogenic headaches stop you from living?
Don’t let cervicogenic headaches and neck pain stop you from living your life. Dr. Rodriguez and his team at the Pain Relief Center are dedicated to the eradication of pain. Contact The Pain Relief Center today for more information about cervicogenic headaches and neck pain.
Cause
Overview
Signs and symptoms
- People with cervicogenic headache often have reduced range of motion of their neck and worsening of their headache with certain movements of their neck or pressure applied to certain spots on their neck. The headaches are often side-locked (on one side only), and the pain may radiate from the neck/back of the head up to the front of the head or behind the eye. The headac…
Contraindications
- People suspected of having cervicogenic headache should be carefully assessed by their doctor to exclude other primary (migraine, tension-type) or secondary (vessel dissection, posterior fossa lesions) causes of headaches.
Medical uses
- Nerve blocks are used both for diagnostic and treatment purposes. If numbing the cervical structures abolishes the headache, that can confirm the diagnosis of cervicogenic headache and also provide relief from the pain.
Treatment
- Treatment for cervicogenic headache should target the cause of the pain in the neck and varies depending on what works best for the individual patient. Treatments include nerve blocks, medications and physical therapy and exercise. Physical therapy and an ongoing exercise regimen often produce the best outcomes. Other providers that may need to be ...
Literature
- Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol 2009; 8:959.