Cervicogenic Headache

Cervicogenic headache is a fancy medical term for a pain in the neck that causes headache. Neck pain and headaches quite often go together. Many people experience this when they have a minor car accident and this results in neck strain. Many times the pain in this area can actually cause a migraine, but more often it causes tension type headache.

Sometimes it occurs when you might have lifted something heavy. You strain the muscles in your neck and if they don't heal quickly, the continuing spasms can cause headaches. Sometimes it happens if you just sleep wrong and twist your neck.

If you look at the picture below, the red areas are where muscles attach to the scalp from the neck. When these muscles spasm they pull on the scalp and create pain.

The black dots in the picture along the neck are "trigger points" which when pressed can be pressure points of pain and spasm.

Cervicogenic headache spasmotic pain is a pulling throbbing sensation, and if truly severe, can have a burning quality to it.

Cervicogenic headache, recurring headache

There are over 20 muscles in the neck that can refer pain up to the head. No wonder it hurts!

As mentioned above, in patients who already have migraine, this can provoke more migraines. This is because the muscle contractions at the C2/C3 level of the spine, feedback into the area of the brainstem where migraines are generated. This is called the trigeminal nuclealus caudalis.

OK you say, now how do I get rid of this?

Several methods have shown to be effective for this type of headache and some are medication, some are lifestyle.

Physical therapy

This is best attempted after an anti-spasmotic medication is on board, but once done properly can really help with neck pain. A good physical therapist can teach you how to strengthen the muscles of the neck to prevent re-injury and thereby reduce your headaches.

PT sessions also usually include moist heat to the area before stretching and some massage. I have been to PT for neck problems and found it to be very helpful.

Medication

In this case there are a great variety of anti-spasmotics that can help cervicogenic headache. Some like Elavil for cervicogenic headache is discussed on another page of this website. Another great option is a drug called Zanaflex(tizanadine). Both Elavil and Zanaflex cause mild sedation, so they are best taken at night. A nice option for daytime use is Skelaxin as 92% of people who take it have no sedation.

We find these to be better options for headache patients than Flexeril or Soma which are very sedating and only affect the muscles with no benefit on a headache profile. Ask your health care provider if this might be best for your needs.

Pillows

Surprise!! This really has an effect on neck pain and many people just don't consider it that important. I recommend only one headache pillow at night time and use one that supports the neck. One of the best is one I use personally called the Chiroflow Pillow which was developed by a chiropractor.

In fact, this pillow is so great that I wore one out and am on the second one. I recommend it to all my patients with neck pain. I have a full review of the Chiroflow pillow here.

Purchase the pillow and start having a great nights sleep.

Chiropractic care

This may really help you once severe spasms are under control. Like physical therapy, do not attempt this until some anti-spasmotics are on board as you may get worse. Beware of ANY chiropractor who says "I can cure your headaches." There is no cure only management and this treatment is only part of the whole picture for your headaches.

Exercise

Unfortunately, one of the most common causes of cervical spasming is deconditioning, which means lack of exercise. Regular exercise helps to tone the muscles, especially the paraspinus muscles. When these are in good shape, there is less tendancy for spasm and therefore less pain.

Trigger point injections

Trigger points are seen on the diagram along the muscles.They are also known as headache pressure points.

When pressed, if the muscle is in spasm, they hurt! Injections of small amounts of steroid mixed with a numbing agent (like lidocaine) will help calm the pain down. 90% of people respond after only one set of injections and they usually take only a few minutes. Our patients benefit from this treatment greatly when the neck is a big part of their headache profile and these injections greatly reduce cervicogenic headache.

If your headaches do not sound like this, or your pain is of a different quality, you might have a different type of headache that should be investigated further.

If you have never had headaches before, please call your doctor as there are many other rare conditions that could cause this including emergency headaches.