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Christopher Frandrup, M.D., DABPM, FIPP

What Are Cervicogenic Headaches?

What Are Cervicogenic Headaches?

What Are Cervicogenic Headaches?

Cervicogenic headaches are a frequently underdiagnosed headache that can cause pain not only in the head but also in the sides of the face. While many people are familiar with tension headaches, cluster headaches, and migraines, cervicogenic headaches are in a category of their own that is less well-known.

What are cervicogenic headaches?

There are two categories of headaches – primary and secondary. In a primary headache, the head pain originates in the head itself. Secondary headaches arise due to conditions in other areas of the body. Cervicogenic headaches are headaches caused by pain originating in the cervical area of the spine. This means that cervicogenic headaches primarily involve the occipital nerve, located at the base of the skull. The trigeminal nerve that enervates the facial muscles may also be involved in this type of headache.

Most cervicogenic headaches are very different from other types of headache in pain quality and location. While other headaches may have pain in the front and sides of the skull, cervicogenic headaches have pain that is felt in the base of the skull and radiates up from the occiput. This pain does not increase when bending forward and does not present with an aura (as with some migraines).

Migraine medicine is generally not helpful for this type of headache. Cervicogenic headache sufferers also rarely experience nausea as a side effect. Diagnosis of these headaches is usually by process of elimination, but if treatment of neck pain helps relieve the headache, it may be a cervicogenic headache.

The incidence of cervicogenic headaches is estimated at anywhere from two to 22%. These types of headaches may be misdiagnosed as tension headaches. When this occurs, symptoms may be successfully treated, but the underlying causes remain, which means the headaches will reoccur.

Causes of cervicogenic headaches

The causes of cervicogenic headaches are various. Acute causes can include accident or injury (with automobile accidents being a common cause). Other more chronic causes can include:

  • Poor posture: Chronic compression of or pressure on the cervical spine can cause pain in the occipital nerve.
  • Weak neck muscles: Muscles that cannot properly support the head or maintain the stability of the neck during movement may lead to cervicogenic headaches.
  • Disc damage: Arthritis, age, or injury can damage the cervical vertebrae. Improper healing or bone growth can put pressure on the nerves in the neck and cause pain.

Cervicogenic headaches – who’s at risk?

There are many risk factors for cervicogenic headaches, some of which are preventable.

  • Smoking: Smoking increases the pace of disc degeneration and can cause pain in the entire musculoskeletal system, including the cervical spine.
  • Age: Older people are at risk due to natural wear and tear.
  • Occupation: Those who work at jobs where long periods of sitting occur are at risk, as are those with high-impact occupations where injury is common (e.g. professional sports, some types of construction, commercial fishing, etc.).
  • Poor sleep: Poor quality of sleep due to poor sleep posture is a risk factor for this type of headache.
  • Lack of exercise: Weak neck muscles and poor physical condition in general contribute to the development of neck pain of all types, including pain that leads to cervicogenic headache.

Other risk factors may include gender, as women are more likely to suffer from fracture of the vertebrae due to brittle bones, and poor nutrition.

Treatments for cervicogenic headaches

Treatment of cervicogenic headache is dependent on the cause of the headache. To treat pain initially, your doctor may recommend over-the-counter, non-steroidal anti-inflammatory drugs (NSAIDs). Prescription anti-inflammatories may be utilized to relieve pressure on the affected nerves.

If the pain is caused by damage to the vertebrae, your doctor may recommend a nerve block or a facet joint injection to anesthetize the nerve causing the pain. For bulging or herniated discs, the doctor may recommend removing the excess tissue that is applying pressure to the nerve.

For pain related to muscles in the neck putting pressure on the nerve, muscle relaxants are an option. This is a short-term option that should be followed by other muscle strengthening and alignment exercises to help support the head and keep the spine healthy.

Complementary therapies for cervicogenic headaches include biofeedback, massage therapy, acupressure, acupuncture, and chiropractic care. Your pain management specialist may recommend one or more of these techniques to relieve pain and pressure on the nerves.

Cervicogenic headaches – prevention

The best way to prevent cervicogenic headaches is to keep the muscles and bones of the neck healthy. Bone health begins with a healthy diet filled with calcium-rich foods. Muscular support for the neck and head is imperative. To that end, there are a number of lifestyle adjustments you can make.

  • Stretch: If you spend your day working at a computer, take some time off to stretch your neck, rolling it around slowly and bending forward and back.
  • Strengthen: Full body exercise daily, with a focus on the muscles of the upper back, can help build strong neck muscles.
  • Relax: We hold tension in the trapezius muscles of our upper back, which can lead to strain and pain in the muscles of our neck. Getting a massage to this area can help those large muscles release tension.
  • Sleep well: Choose a non-feather pillow that is relatively firm to keep your neck properly aligned and supported as you sleep.

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