Cervicogenic headaches, sometimes called secondary headaches, are the result of referred pain from the bone and/or soft tissues of the neck.
Although this condition differs from primary headache disorders such as migraines or tension headaches — which result from vascular or muscle disorders — the presenting symptoms may be indistinguishable.
Causes of Cervicogenic Headache
Head and neck injury are the most common causes of cervicogenic headaches; however, this condition may manifest without underlying trauma. Inflammation of the cervical facet joint and/or muscle imbalance may also be associated with this condition.
Weight lifters and patients who have suffered a whiplash injury or concussion are especially prone to cervicogenic head pain, as are hairstylists, commercial vehicle drivers and carpenters.
This condition commonly affect patients who maintain specific postures for extended periods, including those who use a computer or smartphone for much of their day. Some medical professionals have referred to this condition as “text neck.”
Symptoms and Diagnosis of Cervicogenic Headache
The most common symptoms associated with this condition are pain in the head and face, radiating from the cervical spine. In some cases, the pain may extend to areas of the shoulder and arm. The pain is typically bilateral, affecting both sides of the body equally, but it may affect only one side.
Neck stiffness is a common indicator of cervicogenic conditions. Some patients may also experience associated nausea, vomiting, dizziness or photophobia.
This condition can present a diagnostic challenge, as it frequently manifests in ways that may be initially indistinguishable from primary headache disorders.
The doctor will begin by taking a full medical history. Manual manipulation of the neck, including palpation of the cervical spine, may help the doctor differentiate between primary and secondary conditions.
The doctor may also recommend X-rays, CT scans, MRI and/or EMG imaging to help identify the specific origin of the pain. For some patients, postural and breathing pattern evaluation, and soft tissue and range-of-motion assessments can be beneficial in the diagnostic process.
Cervicogenic Headache Treatment
The appropriate course of treatment for cervicogenic headache will depend on the cause. However, a conservative approach is commonly recommended for initial treatment. Medication may be prescribed to reduce inflammation and facilitate healing.
The doctor may also recommend a variety of noninvasive treatment protocols. These may include gentle spinal manipulation, muscle stretching, relaxation techniques, postrual braces and therapeutic exercise to address neuromuscular imbalances. Instrument-assisted soft tissue mobilization and structural reintegration therapy offers another potential intervention for cervicogenic headaches.
Ongoing physical therapy and exercise regimen may provide long-term relief of secondary headaches. If non-invasive treatment protocols do not provide relief, a trial of diagnostic nerve (medial nerve branch) blocks may be recommended. These nerves supply the underlying facet joints and may be a source of pain. If the medial branch diagnostic blocks provide relief, then the physician may recommend a procedure called Radiofrequency Ablation for more sustained relief. In extreme cases, surgical intervention may be necessary.
Ultimately, the most effective cervicogenic headache treatment requires a multifaceted treatment approach tailored to the patient’s individual needs.