Cervicogenic Headache

What Is a Cervicogenic Headache?

Headaches happen for lots of reasons. It can be hard to know what kind you have and what’s causing it. But if it’s related to a problem in your neck, there’s a good chance it’s a cervicogenic headache (CH).

Symptoms

One sign of CH is pain that comes from a sudden movement of your neck. Another is that you get head pain when your neck remains in the same position for some time.
Other signs may include:

  • 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

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
  • Feel sick or uncomfortable with loud noise
  • Have blurry vision

Some people get CH and a migraine at the same time. That can make it hard to know what’s really going on.

Causes

Many things can cause a cervicogenic headache, and sometimes there’s no way to figure out exactly what it was.

  • CH can come from problems with the bones in your neck (vertebrae) that happen over time. For example, people in certain jobs, like hair stylists, carpenters, and truck drivers, can get CH from the way they hold their heads when they work.
  • 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). You also can get cervicogenic headaches from a tumor or a fracture (small break) in your upper spine or neck.

Diagnosis

Because there are many types of headaches, it can be hard to be sure you have CH. Your physical therapist will examine you and ask questions about your health. Your PT will want to know what you’re doing when you get the pain and where it hurts.
Be sure to share if:

  • 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.
To learn more about your headaches, you may need one or more of the following:

  • X-ray
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan

He also may suggest a “nerve block.” This is a shot 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.
Your doctor also may have you move your head and neck a certain way to see what’s painful for you. He may press on certain areas of your neck to see if that causes a headache.You also may get a blood test to make sure the problem isn’t a disease that causes pain.

Treatment

If you have cervicogenic headaches, there are several ways to lessen the pain, or get rid of it completely:

  • Medicine: Non-steroidal anti-inflammatories (aspirin or ibuprofen), muscle relaxers, and other pain relievers may ease the pain.
  • Physical therapy: Stretches and exercises can help. Work with your physical therapist to find out what kind of exercise is best and safest for you.
  • Spinal manipulation: This is a mix of physical therapy, massage, and joint movement. It should only be done by a physical therapist.
  • Other options: Non-surgical ways to deal with the pain include relaxation techniques, like deep breathing or yoga, and acupuncture.
  • Surgery: If your pain from CH is severe, you may need an operation to keep your nerves from being squeezed, but this is rare.