Cervicogenic Headaches

What are cervicogenic headaches?

Cervicogenic headaches are a type of headache that originates from problems in the neck (cervical spine). These headaches happen when pain is referred from the neck into the head and face. This means that even though you feel pain in your head, the actual source of the pain is actually coming from your neck.

At Tangram Health, our Physiotherapists, Chiropractors, and Exercise Physiologists see many patients with cervicogenic headaches, and understand just how worrying and interfering they can be. So we’ve put together this guide to help people better understand this condition and the many treatments you can choose from to get better.

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What are the symptoms of cervicogenic headaches?

Cervicogenic headaches can have various symptoms, including:

• Pain on one side of the head or face
• Pain that starts in the neck and moves up to the head
• Stiff neck with reduced range of motion
• Pain that worsens with certain neck movements or positions
• Pain behind the eyes
• Pain in the shoulder or arm on the same side as the headache
• Sensitivity to light and noise (less common than in migraines)
• Nausea (less common than in migraines)

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What causes cervicogenic headaches?

Cervicogenic headaches are caused by problems in the neck. Some common causes include:

• Injury to the neck, such as whiplash
• Arthritis in the upper spine
• Pinched nerves in the neck
• Poor posture, especially from long periods of desk work
• Tension in the neck muscles
• Disc problems in the spine
• Irritation of the facet joints in the spine
• Tumours (rare)

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How are cervicogenic headaches different from other headaches?

It's important to differentiate cervicogenic headaches from other types of headaches, as the treatment approaches can be different. Here are some key differences:

• Origin of pain: Cervicogenic headaches start in the neck, while migraines and tension headaches originate in the head.
• Pain location: Cervicogenic headaches typically affect one side of the head, while tension headaches often affect both sides.
• Triggers: Cervicogenic headaches are often triggered by neck movements or positions, while migraines can have various triggers like foods or hormonal changes.
• Associated symptoms: Cervicogenic headaches often come with neck stiffness and reduced range of motion, which is less common in other headache types.
• Response to treatment: Cervicogenic headaches often respond well to treatments targeting the neck, while other headache types may require different approaches.

At Tangram Health, our Physiotherapists and Chiropractors in Sydney are experienced in differentiating between the different types of headaches and can provide appropriate treatment based on the specific type you're experiencing.

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How are cervicogenic headaches diagnosed?

When you visit one of the Tangram Health clinics with symptoms of cervicogenic headaches, our healthcare professionals will use several methods to diagnose your condition:

• Medical history: They'll ask about your symptoms, when they started, and how they affect your daily life.
• Physical examination: Your physiotherapist or chiropractor will check your neck for tenderness, stiffness, and range of motion. They may also assess your posture and the strength of your neck muscles.
• Specific tests: There are several tests that can help diagnose cervicogenic headaches, such as:
  • The cervical flexion-rotation test
  • Manual examination of the upper cervical spine joints and muscles
  • Cervical spine mobility tests
• Diagnostic nerve blocks: In some cases, a medical specialist can inject anaesthetic near certain nerves to see if it relieves the headache.

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Do I need any scans for cervicogenic headaches?

While cervicogenic headaches are often diagnosed through physical examination, imaging tests can be helpful in some cases:

• X-rays: These can show arthritis or other bone problems in the neck.
• MRI (Magnetic Resonance Imaging): This gives a detailed view of the soft tissues and can show problems with discs or nerves in the neck.
• CT (Computed Tomography) scan: This can provide detailed images of the bones in the neck.

At Tangram Health, our Physiotherapists and Chiropractors can refer you for these scans if necessary and explain what the results mean for your condition and treatment.

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How are cervicogenic headaches treated?

Treatment for cervicogenic headaches aims to reduce pain, improve neck function, and prevent future headaches. At Tangram Health, we offer a range of treatments, including:

• Manual therapy: Our Physios and Chiros can use techniques like massage, mobilisation, and manipulation to improve neck mobility and reduce pain.
• Exercise therapy: Specific exercises can help strengthen neck muscles and improve posture.
• Postural correction: We can provide advice on improving your posture at work and home.
• Pain relief: Over-the-counter pain medications or prescription drugs may be recommended.
• Dry needling or acupuncture: These techniques can help relieve muscle tension.
• Injections: In some cases, nerve blocks or joint injections might be used.
• More invasive treatments: For severe cases, treatments like radiofrequency ablation might be considered.

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What exercises can help with cervicogenic headaches?

Exercise is a crucial part of treating and preventing cervicogenic headaches. It helps to:

• Strengthen the muscles that support your neck
• Improve flexibility and range of motion in your neck
• Correct postural problems that may be contributing to your headaches
• Reduce overall tension in your neck and shoulders

Our Physiotherapists, Chiropractors, and Exercise Physiologists at Tangram Health can design an exercise program tailored to your specific needs. This might include:

• Neck strengthening exercises
• Stretching exercises for the neck and upper back
• Posture correction exercises
• Low-impact aerobic exercises to improve overall fitness

Remember, it's important to start gently and gradually increase the intensity of your exercises.

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Can spinal manipulation help cervicogenic headaches?

Manipulation, often performed by chiropractors or physiotherapists, can be an effective treatment for cervicogenic headaches. It involves applying controlled force to joints in the neck to improve mobility and reduce pain.

At Tangram Health, our Chiropractors are the best trained to perform these techniques. Manipulation can:

• Improve range of motion in the neck
• Reduce muscle tension
• Decrease pain signals from the neck to the brain
• Improve overall neck function

However, manipulation isn't suitable for everyone. Our healthcare professionals will assess whether it's appropriate for your condition.

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When are injections used for cervicogenic headaches?

Injections are sometimes used to treat cervicogenic headaches when other conservative treatments haven't provided enough relief. Types of injections include:

• Nerve blocks: These involve injecting anaesthetic near the nerves thought to be causing the pain.
• Joint injections: Corticosteroids may be injected into the joints in the upper neck to reduce inflammation.
• Trigger point injections: These target specific points in muscles that may be contributing to the headaches.

Injections can provide significant pain relief, but they're typically not a long-term solution.

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What are more advanced pain management techniques for cervicogenic headaches?

For severe or persistent cervicogenic headaches that don't respond to other treatments, more invasive techniques might be considered:

• Radiofrequency ablation: This uses heat to destroy nerve fibres carrying pain signals from the neck to the brain.
• Pulsed radiofrequency: Similar to radiofrequency ablation, but uses short bursts of energy to stun the nerve rather than destroying it.
• Spinal cord stimulation: This involves implanting a device that sends electrical signals to the spinal cord to interrupt pain signals.

These treatments are typically only considered after other options have been exhausted and are performed by specialist Pain Physicians or Interventional Radiologists. Our Physios and Chiros can provide information about these treatments and help refer you to these specialists if needed.

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Can cervicogenic headaches be cured?

While there's no guaranteed "cure" for cervicogenic headaches, many people can achieve significant improvement or even complete relief with proper treatment. The key is identifying and addressing the underlying neck issues causing the headaches.

With a combination of treatments like manual therapy, exercise, and lifestyle modifications, many patients at Tangram Health have experienced long-term relief from their cervicogenic headaches. However, ongoing management may be necessary to prevent recurrence.

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How long does it take to recover from cervicogenic headaches?

Recovery time can vary greatly depending on the severity of your condition, the underlying causes, and how quickly you seek treatment:

• For mild cases caught early: You might see improvement in a few weeks with proper treatment
• For more severe or chronic cases: Recovery can take several months of consistent treatment and management

Remember, everyone's recovery is different. Factors like your age, overall health, and how well you follow your treatment plan can all affect your recovery time.

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How can I prevent cervicogenic headaches or stop them from getting worse?

While you can't prevent all cervicogenic headaches, there are steps you can take to reduce your risk or prevent them from worsening:

• Maintain good posture: Especially when sitting at a desk or using electronic devices
• Take regular breaks: If you work at a desk, take short breaks to move and stretch your neck
• Adjust your workstation: Ensure your computer screen is at eye level and your chair supports your lower back
• Use a supportive pillow: Choose a pillow that keeps your neck aligned with your spine while sleeping
• Manage stress: Stress can increase muscle tension in your neck and shoulders
• Stay physically active: Regular exercise can help maintain strength and flexibility in your neck
• Be mindful of your neck position: Avoid prolonged periods with your neck in an awkward position

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When should I see a healthcare professional about headaches?

You should consider seeing a healthcare professional if:

• You have frequent or severe headaches
• Your headaches are interfering with your daily activities or sleep
• You're experiencing neck pain or stiffness along with your headaches
• Your headaches have changed in pattern or intensity
• You've tried over-the-counter treatments without success

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Take home message

Cervicogenic headaches can significantly impact your quality of life, but with proper diagnosis and treatment, most people can find relief and prevent future episodes. Understanding the connection between your neck and your headaches is the first step towards effective management.

At Tangram Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologist can help to manage your cervicogenic headaches effectively. We offer a range of treatments and can provide personalised advice on exercises, posture, and lifestyle modifications to help you achieve long-term relief. Remember, early intervention is key in managing cervicogenic headaches.

If you're experiencing persistent headaches, especially those associated with neck pain or stiffness, don't hesitate to contact us at Tangram Health. We have clinics conveniently located around Sydney in Mt Kuring-Gai, Asquith, Willoughby, Milsons Point, Dural, and Blacktown so you can recover from cervicogenic headaches.