Cervicogenic Headache: Causes and Treatments
Everyone experiences a headache accompanied by neck pain and stiffness from time to time. A cervicogenic headache presents as one side pain that starts in the back of the head and neck and radiating toward the front. It is a common chronic and recurrent headache that usually starts after neck movement. It usually accompanies a reduced range of motion (ROM) of the neck. It could be confused with a migraine, tension headache, or other primary headache syndromes.
Approximately 47% of the global population suffers from a headache, and 15-20 percent of those headaches are cervicogenic. Females seem more predisposed to cervicogenic headache affecting 4 times as many women as men.
What are the causes of the headache?
Cervicogenic headache does not originate in the head but rather it is thought to be referred pain arising from irritation caused by cervical structures innervated by spinal nerves C1, C2, and C3; therefore, any structure innervated by the C1–C3 spinal nerves could be the source for a cervicogenic headache.
Cervicogenic headache can also be caused by neck and shoulder muscle weakness, poor posture causing muscle imbalance in the neck and shoulder, and harmful habits like excessive texting, which forces the head forward from the center of the shoulder, increasing its relative weight by two to four times, and placing stress on the neck. Forward head posture places strain on the muscles, ligaments, discs and joints of your neck, causing inflammation and irritating the nerves in your neck and head.
People can also develop cervicogenic headaches after an injury to the neck (known as whiplash).
What are the signs and symptoms of Cervicogenic Headache?
- Reduced range of motion in the neck
- Pain on one side of the face or head
- Pain and stiffness of the neck
- Pain around the eyes
- Pain in the neck, shoulder, or arm on one side
- Head ache that is triggered by certain neck movements or positions
- Sensitivity to light and noise
- Nausea
- Blurred vision
How do you treat and heal a cervicogenic headache?
Other than use of medication (NSAIDs, Muscle relaxers etc.), physical therapy is considered the first line of treatment. Manipulative therapy and therapeutic exercise regimen are most effective in treating a cervicogenic headache.
According to a study 72% of patients had achieved a reduction of 50% or more in headache frequency at the 12-month follow-up, and 42% of patients reported 80% or higher relief of some sort.
Most Effective interventions
Modalities (TENS, Low-Level Laser Therapy)
Manual Therapy
Muscle Stretching
Instrument-Assisted Soft Tissue Mobilization
Therapeutic exercises
Dry Needling
If you are untreated properly, a cervicogenic headache can worsen and become debilitating. You can experience chronic, or recurrent headaches that do not respond to medication.
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References
- Al Khalili Y, Ly N, Murphy PB. Cervicogenic Headache. [Updated 2021 Mar 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507862/
- Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011;6(3):254-266.
- Becker WJ. Cervicogenic Headache: Evidence that the neck is a pain generator. Headache. 2010;4 699-705
