Cervicogenic headaches are a very common issue that affects a large percentage of the population. These headaches are often confused with migraine headaches but have different signs and symptoms and therefore much different causes and treatments. Cervicogenic headaches are defined as headaches that originate from the cervical spine (neck) especially involving the upper cervical spine and occiput. This style of headache typically presents as severe pain at the base of the skull and in the back of the head that may sometimes radiate to the forehead, temples, ears, or near the eyes in more severe cases. As usual, sorry ladies, females are affected much more often than males. The pain is often aggravated or exacerbated by specific neck and head movements or holding certain postures for a long period of time such as looking up or down. The pain is usually one sided and localized to the back of the head and neck. The neck is often limited in its range of motion and has a stiff or tensile feeling associated with normal head and neck movements.
Patients often experience pain and stiffness into the same side shoulder, neck, and arm which raises concern for a pathologic headache which is much more serious. Upon examination, the pain can usually be reproduced by applying pressure over the affected cervical spine region. There will be noted changes in the cervical musculature including muscle spasms, shortening, and asymmetrical muscle tone. X-rays are usually not very helpful except to rule out pathology or post traumatic fraction of injury. There are many different theories about the etiology of Cervicogenic headaches. The most commonly accepted theories points to pain referral patterns from the cervical musculature. Pain referral patterns coming from issues with the muscles, ligaments, joints, joint capsules, and vertebral discs cause pain to travel into the back of the head and neck. Recent studies have also found that injuries to the connective tissues that connect the rectus capitis posterior muscles and the spinal dura could also be a common source of the headaches.
Treatments vary but chiropractic has been proven to be efficient and safe form of alternative and non-invasive treatment. Soft tissue and muscle therapy on the muscles of the posterior neck, head, and shoulder can relieve tension and stress and reduce the frequency, duration, and severity of cervicogenic headaches. Gentle chiropractic manipulation can reduce adjustments and restore proper biomechanics of the cervical spine as well as improve range of motion. Trigger point therapy, deep tissue massage, and myofascial release have been shown to be beneficial as well and core stabilization exercises to target the deep neck flexor muscles of the cervical spine. Chiropractors can provide specific stretches and strengthening exercises to balance the muscles of the posterior neck and restore range of motion to the area. Stress management can be very beneficial to those suffering from Cervicogenic headaches to help reduce stress and muscle tension in the back of the neck and proper posture and ergonomics at home and work is necessary. Certain headaches require immediate medical attention. The signs to follow are red flags that point to more serious issues and should be evaluated by a medical professional. A very severe and abrupt afternoon that is something new or that has never been experienced before before the patient is the most common red flag. Patients should also look for cognitive or behavioral changes as well as seizures, vomiting without nausea, and neurological symptoms. All persistent headaches practiced by a child should raise concern as well as patients on anticoagulant medications, known history of cancer, and measured diastolic pressures greater than 115 mmHg.