Cervicogenic headache

Definition  

A cervicogenic headache is, by its definition, any headache which is caused by the neck. The term 'cervicogenic' simply refers the cervical area, which is a part of your spine located right near the base of the skull. The pain of cervicogenic headache is usually unilateral; it originates in the neck and then spreads to the oculofrontal-temporal areas of the head. The headache initially presents as intermittent episodes and then progresses to an almost continuous pain. Pain may be triggered or exacerbated by neck movement or a particular neck position; it can also be triggered by applying pressure over the ipsilateral upper part of the back of the neck or the ipsilateral occipital region.

Causes  

One of the most prominent causes of a cervicogenic headache is simply undergoing an excessive amount of stress to your neck and spine.

Risk Factors  

There are several factors that can contribute to making cervicogenic headaches more severe or happen more frequently. These include fatigue, problems sleeping, disc problems, current or prior injuries, poor posture and stress on the muscles.

Symptoms  

Common symptoms of a cervicogenic headache include a steady, non-throbbing pain at the back and base of the skull, sometimes extending down to the neck and between the shoulder blades. The pain can also be located behind the brows and forehead. Because of the location, most of the pain is felt in the head, even though the problem is originating from the spine. Pain usually starts after a sudden neck movement, such as a sneeze. Along with head and/or neck pain, symptoms may include nausea, vomiting, dizziness, blurred vision, becoming very sensitive to light or sounds and feeling pain down one or both arms. The neck also becomes very stiff and the patient may have trouble moving.

Diagnosis  

The workup of cervicogenic headache begins with a careful history taking and physical examination and order of appropriate diagnostic studies that includes standard radiographs, 3-dimensional CT, MRI, and possibly electromyography; nerve blocks may also be used to confirm the diagnosis.

Treatment  

Pharmacologic management of cervicogenic headache usually starts with simple analgesics, such as NSAIDs, aspirin, and acetaminophen; the response varies from patient to patient. Combination products (eg, hydrocodone/acetaminophen and butalbital/acetaminophen/caffeine) often are prescribed but cannot be recommended, given the potential for residual and rebound effects. If all other treatment fails, judicious use of an opioid can be tried, using a sustained-release medication on an around-the-clock basis for persistent headaches to avoid a rebound effect. Invasive procedures include trigger point injections, greater or lesser occipital nerve blocks, facet joint blocks, segmental nerve root blocks, and diskography; spinal manipulation; and behavioral approaches.

Prevention  

There is no direct and identified prevention measures that could certainly help a person avoid episodes of cervicogenic headaches. However, as always, you are advised to take healthy diets, get proper sleep and reduce overall tension.



Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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