Headache: Cervicogenic headaches

What is a cervicogenic headache?

The word cervicogenic is defined as something originating from the cervical spine or other anatomical structures in the neck, such as nerves or muscles.

Therefore, a cervicogenic headache (CGH) is a headache originating from the cervical spine or the structures in the neck. 

A cervicogenic headache is considered  a secondary headache because it is the result of an underlying condition, for example, a neck injury. Primary headaches are headaches that are not the result of an underlying condition.  Migraines, tension and cluster headaches are considered primary

Who gets cervicogenic headaches?  

Females and males experience CGH at equal rates. CGHs most frequently begin between 30 and 44 years of age.  They are often experienced by office workers, hair dressers, carpenters and truck/tractor drivers. In weight lifting athletics CGH is one of the top types of headaches experienced by these athletes.

These headaches can be the result of whiplash, neck sprains and strains, and concussions. If headaches begin more than 3 months after a concussion these headaches are likely a result of problems in the neck.

How frequent do cervicogenic headaches occur?

0.4% to 4.6% of the population with experience a CGH at some point in their life. That means in Winnipeg, with a population of approximately 700,000, 2800 to 31,000 will experience a CGH sometime in their life. Clinically, about 20% of patients dealing with headaches are suffering with CGH but I would say this is even more frequent in my chiropractic practice.

Signs and symptoms strongly indicating cervicogenic headache

The clinical features most strongly indicative of CGH are:

  • Varying duration or fluctuating continuous pain
  • Moderate, none throbbing pain
  • History of neck trauma
  • Pain that radiates to the shoulder and arm

Features that may indicate a cervicogenic headache

  • Most often occurs on one side
  • Headache starts in the back of the head and neck and migrating to the front
  • Aggravated by specific neck movements or sustained postures
  • Feeling locked up in the upper neck
  • Examination reveals altered joint motion.
  • Reproduced headache with the touching of tender points in the neck 
  • Reduced range of motion in the neck
  • Various attack-related events:
    • Nausea
    • Vomiting
    • Same sided swelling and flushing around the eye
    • Dizziness
    • Photophobia – sensitivity to light
    • Phonophobia – sensitivity to sound
    • blurred vision in the ipsilateral eye 

Other possibilities

When listening to your history I need to consider other possibilities such as:

Migraines can be similar to CGH because they can both present with:

  • Nausea
  • Pain in the arm or shoulder
  • Feeling sick or uncomfortable in bright light
  • Feeling sick or uncomfortable with loud noise
  • Blurred vision
  • Neck pain 

Treatment

Joint manipulation (chiropractic adjustments) and therapeutic exercises are the current first line of treatment for cervicogenic headaches.   Manipulation has resulted in than 70% of people achieving 50% or more reduction in headache frequency and 40% of patients reported 80% or more relief of some sort.

There are other more invasive forms of treatment 

  • Intraarticular injections
  • Epidural steroid injections
  • Botox
  • Rhyzotomy
  • Nerve release

I hope you found this informative.  If you feel like you are experiencing this type of headache please contact me and set up an initial appointment.

References