Cervicogenic Headache Causes and Risk Factors
- Common Sources of Pain in CGH. Facet joints. There are 2 small facet joints at the back of each spinal level, allowing restricted movements between adjacent vertebrae, such as between ...
- Causes of Pain in CGH. Depending on the structures involved, several causes of CGH can arise in the cervical region. ...
- Risk Factors for CGH. Occupational hazards. ...
What is the best treatment for cervical headaches?
- Medicine: 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. ...
What causes cervical headaches?
Those include:
- Cold or flu symptoms
- Stress
- Alcohol
- Hormonal changes
- Teeth grinding at night
- Changes in diet
- Lack of sleep/Change in sleep patterns
What causes headaches in the base of the skull?
- Shifting and unbalanced posture
- Muscle tension around the head, neck, and shoulders
- Disruption of nerve flow, spinal fluid flow, and blood flow at the base of the skull
What is causing my neck pain and headache?
What causes headache, dizziness, fatigue, and neck pain?
- Causes. There can be several reasons for a headache with neck pain, dizziness, and fatigue. ...
- Other causes. Other possible causes of headaches, dizziness, neck pain, and fatigue include dehydration and anxiety.
- Techniques to relieve cervical headaches and neck pain. ...
- When to see a doctor. ...
- Prevention. ...
- Summary. ...
How do you get rid of 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...•
How do I know if I have a cervicogenic headache?
A cervicogenic headache (CGH) presents as unilateral pain that starts in the neck. 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.
How long do 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.
What does a cervicogenic headache feel like?
A cervicogenic headache presents as a steady, non-throbbing pain at the back and base of the skull, sometimes extending downward into the neck and between the shoulder blades. Pain may be felt behind the brow and forehead, even though the problem originates from the cervical spine.
What kind of doctor treats cervicogenic headache?
Physical therapy and an ongoing exercise regimen often produce the best outcomes. 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 mimics cervicogenic headache?
Occipital neuralgia and cervicogenic headache are secondary headache disorders that share similar clinical features of posterior headache, neck pain, and referred fronto-orbital pain.
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.
Can a chiropractor help with cervicogenic headaches?
Chiropractic treatment of cervicogenic headaches is safe and effective. A recent study published in the journal “BMC Musculoskeletal Disorders” compares the effects of chiropractic adjustments with standard therapeutic care and found that chiropractic adjustments were by far more effective.
Is a 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 get worse when lying down?
Cervicogenic Headache. Frequently worse at night, cervicogenic headache wakes the individual with neck pain radiating to the occiput and anteriorly to the forehead and is caused by mechanical neck position during sleep.
Is cervicogenic headache a disability?
The level of disability is associated with the severity of pain only in primary headaches, but not in pain syndromes of vertebral origin (cervicogenic headache and low back pain). Disability is associated with the severity of depressive symptoms in all headache types but not in low back pain.
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.
Is a 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.
What does a spinal headache feel like?
Spinal headache symptoms include: Dull, throbbing pain that varies in intensity from mild to very severe. Pain that typically gets worse when you sit up or stand and decreases or goes away when you lie down.
What kind of headache is at the base of your skull?
Occipital neuralgia is a condition in which the nerves that run from the top of the spinal cord up through the scalp, called the occipital nerves, are inflamed or injured. You might feel pain in the back of your head or the base of your skull.
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.
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.
What to do if you have a headache and it's so bad?
Get emergency medical care if the headache comes on all of a sudden and is very painful or if you start to feel dizzy.
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 does it mean when you have a pain in your head?
Pain on one side of your head or face. Steady pain that doesn't throb. Head pain when you cough, sneeze, or take a deep breath. An attack of pain that can last for hours or days. Stiff neck -- you can't move your neck normally. Pain that stays in one spot, like the back, front, or side of your head or your eye.
What is a cervicogenic headache?
Summary. A cervicogenic headache is a pain that develops in the neck, though a person feels the pain in their head. Cervicogenic headaches are secondary headaches. Secondary headaches are those caused by an underlying condition, such as neck injuries, infections, or severe high blood pressure. This sets them apart from primary headaches, such as ...
What is the best treatment for cervicogenic headaches?
Physical therapy is an effective treatment for cervicogenic headaches since a structural problem in the neck usually causes them.
What is the pain on one side of the head?
In most cases, cervicogenic headaches develop on one side of the head, starting from the back of the head and neck and radiating toward the front. Some other symptoms of a cervicogenic headache include: pain in the neck, shoulder, or arm on one side. head pain that is triggered by certain neck movements or positions.
How to treat headaches with radiofrequency ablation?
Also called radiofrequency neurolysis, this procedure involves using radio waves to heat the tip of a needle. A doctor will then apply the needle to the nerve that is causing the pain. The heat from the needle effectively deadens the nerve, interrupting the nerve’s ability to send pain signals to the brain.
What is the pain in the neck?
pain in the neck, shoulder, or arm on one side. head pain that is triggered by certain neck movements or positions. sensitivity to light and noise. nausea.
What to do if you have a headache and confusion?
If a person experiences confusion and vision loss alongside a headache, they should contact a medical professional. People should contact their healthcare providers if they experience a headache along with: severe pain. fever.
What can a doctor do for a numbing headache?
A doctor can inject pain-numbing medicine into nerves and joints in the head and neck. These often provide pain relief and can help determine the source of the pain.
What is a cervicogenic headache?
Cervicogenic Headache Causes and Risk Factors. The causes for cervicogenic headache (CGH) are based on the involvement of several anatomical structures in the upper cervical region that are sensitive to pain. The nerves that supply these structures are capable of referring pain from the neck to different parts of the head including the forehead, ...
What causes pain in the cervical spine?
Cancer or benign tumors in the cervical region may compress or pinch the cervical spinal nerves causing pain
What is the most common cause of CGH pain?
The upper cervical facet joints relating to vertebrae C1-C3 are most commonly involved in CGH pain, 1 although the facet joints of lower vertebrae may also be involved. At least 70% of CGH cases are reported to occur due to traumatic injuries to the cervical facet joints between vertebrae C2 and C3 2. The atlanto-occipital joint.
How many facet joints are there in the cervical spine?
There are 2 small facet joints at the back of each spinal level, allowing restricted movements between adjacent vertebrae, such as between C2 and C3. The facet joints in the cervical spine are prone to injury due to the weight-bearing function they perform while supporting the head. The upper cervical facet joints relating to vertebrae C1-C3 are ...
What is the role of cervical discs in the neck?
The cervical intervertebral discs act as shock absorbers between vertebral bones, help facilitate neck movements, and maintain spacing for nerves and joints to function.
What are the main sources of pain in CGH?
One or more of the following anatomical structures in the cervical spine can be primary sources of pain in CGH: are most commonly involved in CGH pain. Facet joints. There are 2 small facet joints at the back of each spinal level, allowing restricted movements between adjacent vertebrae, such as between C2 and C3.
What is the most common headache in weightlifters?
CGH is reported to be the most common type of headache among weight-lifting sportsmen. 3. Forward head posture. Holding the head out in a forward position while doing activities such as working on a computer on a continual basis may eventually lead to CGH. See Forward Head Posture’s Effect on the Cervical Spine.
How to treat cervicogenic headache?
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 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 Does Cervicogenic Mean?
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, known to be able to cause a headache. 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.
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 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 ...
When Is Cervicogenic Headache Serious?
In some cases, CGH may be caused by dangerous underlying conditions such as tumor, hemorrhage, fracture, or arteriovenous malformation ( abnormal connection between arteries and veins) in the head or neck region. In such cases, one or more of the following symptoms may also be present:
What causes CGH headaches?
CGH may be caused by trauma, such as fracture, dislocation, or whiplash injury, or an underlying medical condition such as rheumatoid arthritis, cancer, or infection. While the pain source is located in the cervical spine, ...
What causes CGH pain?
Injury to neck muscles. Tumors in the cervical region. See All About Neck Pain. A common cause for CGH is whiplash injury resulting in pain shortly after the injury. CGH originating from whiplash may resolve in a few days, or may last for years. See Whiplash Symptoms and Associated Disorders. advertisement.
What nerve causes cervical pain?
In the upper cervical spine region, the trigeminocervical nucleus is an area of convergence of sensory nerve fibers originating from both the trigeminal nerve and the upper spinal nerv es. The trigeminal nerve is responsible for pain sensation in the face including the top of the head, forehead, ...
What is a CGH headache?
Cervicogenic headache (CGH) occurs when pain is referred from a specific source in the neck up to the head. This pain is commonly a steady ache or dull feeling, but sometimes the pain intensity can worsen. CGH symptoms are usually side-locked, which means they occur on one side of the neck, head, and/or face.
What does it mean when you have a CGH?
CGH symptoms are usually side-locked, which means they occur on one side of the neck, head, and/or face. Cervicogenic headache usually begins as a dull ache in the neck and radiates upward along the back of the head, almost always one-sided. Pain may also spread to the forehead, temple, and area around the eyes and/or ears.
Why is CGH so hard to diagnose?
While the pain source is located in the cervical spine, CGH can be difficult to diagnose because pain is not always felt in the neck. CGH symptoms can also mimic primary headaches, such as migraine and tension-type headache.
How to treat cervicogenic headache?
Physical therapy in the form of delicate and graded muscle stretching and manual cervical traction is the initial treatment for cervicogenic headache. If this does not do the trick, a doctor may recommend a steroid or anesthetic injection into the neck. 1
Where does the pain come from when you have a cerviogenic headache?
That being said, the pain of a cervicogenic headache is felt to be referred from the first three spinal nerves —known as C1-C3 of the upper or cervical spine where your neck lies.
What is the condition where you get a headache from your neck?
Diana Apetauerova, MD. Updated on January 23, 2020. If you experience headaches that seem to come from your neck, you may be suffering from a cervicogenic headache, which is a condition that still leaves many headache specialists scratching their heads.
What does it feel like to have a migraine on the same side?
Shoulder, neck, or arm pain on the same side of the headache. Occasional migraine symptoms like nausea, vomiting, blurry vision of one eye (on the same side of the headache), dizziness, and a sensitivity to light and sound 2 .
What does it mean when your head hurts?
Constant, non-throbbing pain that radiates from the back of the head to the front. Duration of pain is variable. Intensity of pain fluctuates but is generally moderate to severe. In addition to head pain, a person may also experience the following associated symptoms: Neck stiffness. Shoulder, neck, or arm pain on the same side of the headache.
Is there consensus on the diagnosis of headaches?
The diagnosis of this condition is challenging, as its symptoms overlap with other types of headaches. In addition, there is no consensus on exactly how this disorder is diagnosed. In fact, there are two sets of criteria described by different groups, the International Headache Society (IHS) and the Cervicogenic Headache International Study Group (CHISG).
Can cervical manipulation be used for headaches?
Surgery is the last option for a patient when other treatment modalities fail. High-velocity cervical manipulation techniques are not recommended for the treatment of cervicogenic headache, due to the risk of dissection of an artery in the neck and vertebrobasilar stroke. 6 .
What nerves cause cervicogenic headaches?
A cervicogenic headache 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. This may include the joints, disc, ligaments, and musculature.
How old do you have to be to get a cervicogenic headache?
A cervicogenic headache is a rare chronic headache in people who are 30 to 44 years old.
What is the inverse relationship between headache severity and ROM?
The inverse relationship between headache severity of CGH and ROM towards the most restricted side for the Cervical Flexion-Rotation Test (FRT) was statistically significant for all patients with cervicogenic headaches (Sn = 0.91, Sp = 0.90). The patient should feel no pain at the time of the test. During this test, the neck of the patient is passively held in end range flexion. The therapist rotates the neck to each side until they feel resistance or until the patient says they are in pain. At this end point, the therapist makes a visual estimate of the rotation range and says on which side the FRT was positive or negative. The test was positive when the estimated range was reduced by more than 10° from the anticipated normal range (44°).
What is a CGH?
Cervicogenic headache (CGH) is a chronic headache that arises from the atlanto-occipital and upper cervical joints and perceived in one or more regions of the head and/or face. A cervicogenic headache is a common cause of a chronic headache that is often misdiagnosed.
What causes headaches in the C-fibers?
Aseptic inflammation and neurotransmission within the C-fibers that is caused by cervical disc pathology is thought to produce and worsen the pain in a cervicogenic headache. The trigeminocervical nucleus receives afferents from the trigeminal nerve as well as the upper three cervical spinal nerves.
What is a headache associated with?
Headache associated with fever, neck stiff ness, skin rash, and with a history of cancer, HIV, or other systemic illness; Headache associated with focal neurologic signs other than typical aura; Moderate or severe headache triggered by cough, exertion, or bearing down; and.
How many vertebrae are in the cervical spine?
Clinical Relevant Anatomy. Upper Cervical Spine. The cervical spine consists of 7 vertebrae, C1 to C7, the cervical nerves from C1 to C8, muscles and ligaments (see cervical Anatomy) The first two vertebrae have a unique shape and function. They form the upper cervical spine.
What nerves cause cervicogenic headaches?
A cervicogenic headache 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. [5][6]
How to treat a cervicogenic headache?
There are several types of treatments and healthcare workers including nurse practitioners need to be aware of them. Physical therapy is considered the first line of treatment. Manipulative therapy and therapeutic exercise regimen are effective in treating a cervicogenic headache. Another option for treatment of a cervicogenic headache is interventional treatment, which will differ depending on the cause of a headache. There is some evidence that cervical epidural steroid injection has some benefits in treating pain in a cervicogenic headache. Steroids can work in this setting due to the theory that the pain continues sensitizing the cervical nerve roots and initiates a pain-producing loop involving nerve root and microvascular inflammation as well as mechanically-induced micro-injury. Unfortunately, cervicogenic headaches tend to recur and can significantly affect the quality of life. (Level V) Thus, some patients may also benefit from simultaneous cognitive behavior therapy. [10]
What is occipital neuralgia?
It is very important to be able to distinguish occipital neuralgia from the occipital referral of pain from the atlantoaxial or upper zygapophyseal joints or tender trigger points in neck muscles or their insertions. Occipital neuralgia can produce symptoms indistinguishable from a cervicogenic headache. It typically presents as sharp pain in the occipital region. The greater occipital nerve is the terminal branch of the dorsal ramus of C2, with contribution from C3, while the lesser occipital nerve is a branch of the dorsal ramus of C3. Treatment of occipital neuralgia includes segmental nerve blocks at C2 and C3, cryoneurolysis, radiofrequency ablation, and neuroablation such as dorsal rhizotomy at C1, C2, and C3 and posterior rhizotomy at C1, C2, and C3.
What is a CGH headache?
A cervicogenic Headache (CGH) presents as unilateral pain that starts in the neck. 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. Diagnostic criteria must include all the following points: 1. Source of the pain must be in the neck and perceived in head or face. 2. Evidence that the pain can be attributed to the neck. It must have one of the following: demonstration of clinical signs that implicate a source of pain in the neck or abolition of a headache following diagnostic blockade of a cervical structure or its nerve supply using a placebo or other adequate controls. 3. Pain resolves within three months after successful treatment of the causative disorder or lesion.[1][2][3][4]
Does cervical epidural work?
There is some evidence that cervical epidural steroid injection has some benefits in treating pain in a cervicogenic headache. Steroids can work in this setting due to the theory that the pain continues sensitizing the cervical nerve roots and initiates a pain-producing loop involving nerve root and microvascular inflammation as well as mechanically-induced micro-injury.
Is it safe to inject steroids in cervical epidural space?
Cervical epidural steroids injections with an interlaminar needle approach at C7-T1 or C6-7 epidural space is relatively safe compared to other interventional cervical procedures. According to He et al.’s study, steroids injection reduced the daily NSAID usage at both 3 and 6 months.
Can cervical spine imaging show headache?
Imaging of the cervical spine is not sensitive enough for diagnosing a cervicogenic headache. No specific radiologic abnormalities were found by recent studies such as Pfaffenrath et al. and Fredriksen et al. The most frequent findings in the literature were a rectilinearization of the cervical spine and/or disc protrusions. Although not widely used in the clinical world, functional imaging shows a hypomobility or hypermobility at a certain level of the cervical spine. An MRI is commonly ordered to help rule out Chiari malformations, nerve root pathology assessment, or even in the spinal cord pathology. [7][8][9]
