Cervicogenic headaches are characterized as head and neck pain originating from the cervical region, a type of secondary headache. This classification is due to the source of the headache being in the neck. Cervicogenic headaches may be from muscle pain and spasms of the neck muscles, cervical facet joints, or the occipital nerve, located at the base of the skull. Multiple studies have indicated that cervicogenic headaches may be under-diagnosed, with estimates of prevalence ranging from 2% up to 22%.
Any injury to the neck or cervical region of the spine can lead to cervicogenic headaches. This injury may be an acute, sudden injury resulting from an automobile accident, a sports-related injury, or a fall, or it may be the result of a long-term sustained injury caused by bad posture or degenerative changes with age.
Cervicogenic headaches rarely present auras or nausea that are commonly associated migraine headaches and the pain is not responsive to traditional migraine medications. However, cervicogenic headaches have been known to precipitate migraine headaches. Appropriate diagnosis of cervicogenic headaches is done by a thorough history and physical exam. Another way in which cervicogenic headaches can be readily diagnosed is if treatment of the neck is able to provide rapid relief from the headache.
The specific treatment for cervicogenic headaches varies by patient and by what is found to be the cause of the headaches. If the problem found in the neck is a result of musculature, then muscle-specific treatment options may provide relief. Such treatments include muscle relaxants, physical therapy including myofascial release, and/or trigger point injections into the muscle. For patients whose cervicogenic headaches are a result of damage to the cervical facet joints, there is often underlying inflammation contributing to pain generation. In this case, an interventional procedure known as a radiofrequency ablation (RFA) can block the pain signal being generated from the joints. To directly address the nerve triggering the cervicogenic headache, the occipital nerve, nerve blocks can be administered to inhibit the problematic signaling.
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