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Cervicogenic Headaches

Any headache with origin from the cervical spine is defined as a cervicogenic headache.

Symptoms

The primary presenting symptom is usually headache associated with neck pain or stiffness. The pain can be only on one side of the head/neck, or both sides. The typical radiating patterns include pain traveling along the back portion of the skull (the occiput) or along the side of the head and behind the ear (temporal). The pain can also radiate toward the front of the head with perceived pain above or behind the eye. The pain can range from a dull ache to a sharp pain, and associated symptoms include stiffness and decreased range of motion of the neck. Movement tends to be the primary exacerbating factor.

Concerning symptoms that indicate more serious issues include headaches that are getting worse over time; sudden onset of severe headache; headaches associated with high fever, stiff neck or rash; onset of headache after head injury; acute problems with vision or profound dizziness.

Possible Causes

Several structures in the spine can cause neck pain that moves into the head. These structures include the cervical facet joints (the pairs of joints at every level in the back part of the spine called cervical facet joints), the upper cervical nerves at cervical levels C1-2 and C2-3, the intervertebral disc at C2-3, and the cervical paraspinal muscles.

There are several factors that can contribute to making cervicogenic headaches more severe or happen more frequently. These include recurrent physical stress, fatigue, underlying cervical spine problems, prior injuries, poor posture and stress on the muscles. Women are more susceptible to cervicogenic headaches than men.

Treatments

Your doctor at the Center for Pain Medicine will review your history, perform a complete examination, and review or order pertinent imaging before creating an individualized plan of care unique to your symptoms. Your doctor may use medications, recommend physical therapy, or discuss minimally invasive procedure such as trigger point injections, greater or lesser occipital nerve blocks, facet joint injections, medial branch nerve blocks, medial branch nerve radiofrequency denervation, or epidural steroid injections.