What it is a cervicogenic headache?
A cervicogenic headache is the medical term to describe head pain that is caused by an injury to the neck, shoulders or upper back. Any sustained spasm or strain to the neck muscles or sprain to the spinal joints in the neck can create a cervicogenic headache, in particular in upper three facet joints are thought to be responsible for 70% of all cases. Initially pain from cervicogenic headaches is concentrated around the occiput at the base of the skull then as the headache progresses it radiates up and over to the forehead. The headache is often worse on one side normally the same side as the neck or shoulder injury with pain focusing around the forehead, eye socket, temples and has even been found in some cases to cause severe pain around the back and base of the ear.
What does a cervicogenic headache feel like?
The severity of a cervicogenic headache is very dependent on the severity of original injury or condition. In cases of sudden injury a severe ache will start at the base of the skull and progress with time around to the temple and forehead. In cases related to poor posture the headaches onset will be more gradual with a mild stiffness and tension in the neck developing into the forehead over a couple of days or even weeks. The headache will feel like a general intense pounding ache around the prominent points of the temple, forehead or skull. The pain is constant and made worse by movements of the neck and shoulders or sitting in a prolonged awkward posture with your neck flexed forward or rotated to the side. The headaches can become so intense that the original neck or shoulder injury pain will become secondary to the headache pain. Neck stiffness will be prominent in most cases of cervicogenic headaches leading to a loss in neck mobility. In certain injuries the neck pain either a dull ache or sharp pain will be one sided with the possibility of additional general arm pain.
This type of headache is very common in office workers and many find their headache develops over the course of the day being worse in the evening and easing with rest. In some cases no neck pain or skull pain is reported only forehead pain but on closer inspection the neck and muscles at the base of the skull are normally incredibly tender and painful to the touch but otherwise asymptomatic.
Why & when does a cervicogenic headache happen?
Cervicogenic headaches occur from a wide range of injuries and postural issues. Traumatic injuries to the neck and upper back such as facet joint sprains like whiplash, muscular strains or shoulder injuries that cause muscle tension and stiffness into the neck can generate a cervicogenic headache. Previous neck and shoulder trauma also makes you more susceptible to these types of headaches. In more severe and persistent cases of cervicogenic headaches there is often an underlying neck, shoulder or upper back condition such as osteoarthritis. In other cases any sustained or repetitive poor neck and upper back posture, for instance sitting at a desk looking down at paperwork or up at a computer screen for long periods of time have been known to trigger cervicogenic headaches. Women are a lot more prone to developing cervicogenic headaches than men are.
How long does a cervicogenic headache take to heal?
Cervicogenic headaches can last for anything from a couple of hours to over a week. Normally the headache will last on and off until the original neck, shoulder or upper back injury has healed. Unfortunately for office workers or drivers whose headache is brought on by their poor work posture will find their headache returns each time they sit for any length in the poor or awkward posture. This will persist until they resolve the underlying posture by adjusting their workstation ergonomics, having any underlying neck or back problems treated and by strengthening their upper back and neck to hold a better posture.
How will a cervicogenic headache be diagnosed?
Your GP or therapist will be able to diagnose you by taking a full history of your headache symptoms including when they start, how long they last for, where exactly do you feel the headache and what activities normally pre-empt the headache. Most importantly the GP will ask you whether you experience any additional symptoms like flashing lights, nausea or vomiting, dizziness and many more this is to rule out migraines or headaches caused by other conditions in the body. This is extremely important as it determines whether any extra tests or investigations are needed. The GP or therapist will examine your neck, shoulders and upper back to determine where the source of the injury or dysfunction is located. This will dictate what type of treatment is prescribed. No X-rays or further investigation should be needed to confirm the diagnosis.
How are cervicogenic headaches treated?
Your GP may prescribe a short course of anti-inflammatory painkillers to reduce and control the painful inflammation that would occur at the point of injury in the neck, shoulder or upper back, however medication isn’t considered effective treatment for the headache itself just a way to reduce the pain levels emitted from the original injury. Applying a covered ice pack to the area of the injury or to the base of the skull/ top of the neck may also significantly hasten the healing process by reducing the pain and swelling. Please make sure the ice pack is covered to prevent any ice burn and for best results use the icepack use regularly for 10-15 minutes with intervals of 30 minutes. Avoiding all aggravating movements and postures is advisable, however complete rest is not. Try to move gently and often this will prevent stiffness levels from building in your neck. When you have to sit for a long time don’t try to over force a good or correct posture. Instead go with what is comfortable for you even if that is slouching a little, the key element is not to stay in that posture for too long. The golden rule is to be a fidget!
The only way to treat a cervicogenic headache is to eliminate the root source of the pain. Many people find manipulative therapies such as Chiropractic, Osteopathy or Physiotherapy to be helpful in returning the neck, shoulder and upper back joints back to their healthy state. Massage therapies and therapies like the Bowen technique are very good at reducing the muscular tension and alleviating the pressure around the neck and shoulders. It is very important to follow your treatment up with some strengthening exercises for the neck and upper back to prevent any weakness left after the injury from progressing and to avoid future reoccurrences of the injury and headache. Starting with simple stretches and progressing to strengthening exercises will counteract any stiffness and weakness that has developed. Your therapist or GP will be able to advise you on when it is appropriate to start and what exercises you should concentrate on. For office worker or drivers alike it is extremely important to take a good look at your work station ergonomics. That means for drivers, ensuring that they are sitting at the right height and distance from the wheel and for office workers, making sure that your computer screen is at the right height and distance from your eye line and adjusting your chair to the right height. Unless these problems are corrected then you will redevelop cervicogenic headaches again and again. Postural therapies like the Alexander Technique is effective for teaching your body how to hold a good posture as is pilates and yoga for strengthening your postural muscles.