After I tamed my migraines the only thing that was left was these guys.
Cervicogenic headaches are a type of secondary headache that are caused by pain in the neck extending to pain in the head.
Cervico = neck
Genic = created
Cervico-genic-headache = neck created headache
In this article I’m going to talk about what a cervicogenic headache is and what you absolutely must understand if you want long term relief from it.
After that we will talk about some well known treatments for it.
What is a Cervicogenic Headache?
Cervicogenic headache is a type of secondary headache that comes from pain in the neck (usually C1, C2 or C3 vertebrae are blamed) and extends into the head creating a headache.(Link)
Those who suffer from this pain also have many trigger points in their shoulders and back that can aggravate the neck and cause a pain sensation in the head.
It’s important to remember that our body is tied together so when a pain starts in one area it’s very easy for it to aggravate other sensitive areas.
This is even more true with the neck and head because of the large amount of nerves that can convey the pain from the neck into the face or back.
Supporting proper functioning of the neck and everything that ties into it will yield the best results in treatment.
Who Gets Them?
“Prevalence estimates range from 0.4% to 2.5% of the general population to 15% to 20% of patients with chronic headaches. CGH affects patients with a mean age of 42.9 years, has a 4:1 female disposition, and tends to be chronic.”(Link)
“People with cervicogenic headache often have reduced range of motion of their neck and worsening of their headache with certain movements of their neck or pressure applied to certain spots on their neck.
The headaches are often side-locked (on one side only), and the pain may radiate from the neck/back of the head up to the front of the head or behind the eye.
The headache may or may not be associated with neck pain.”(Link)
The problem with cervicogenic headache is that neck pain is not enough for this diagnosis as tension type headache and migraine can both present with neck pain.
To really be understood as a cervicogenic headache there has to be a cause uncovered that is known to create cervicogenic headache.
The american migraine foundation states “there must be evidence of a disorder or lesion within the cervical spine or soft tissues of the neck, known to be able to cause headache. Such disorders include tumors, fractures, infections and rheumatoid arthritis of the upper cervical spine.”(Link)
Cervicogenic Headache Symptoms
Some of the most common symptoms include:
Pain that only occurs on one side of your head or face
Headaches that are triggered by neck movement
Awkward head positions and a stiff neck
Pressure on certain parts of the neck
Pain lasting hours or days
Pain from Coughing, sneezing or taking a deep breath
Pain from the neck extending to head or down to shoulders and back
Steady pain that doesn’t throb and stays in one spot(Link)
WebMD states that even though CGH and migraine are different, they can have many of the same symptoms such as:
Feeling sick to your stomach with nausea and vomiting
Pain in your arm or shoulder
Worse in bright light
Worse from loud noise
Cervicogenic Vs Migraine
Understanding the difference between cervicogenic headache and migraine is clear on paper but difficult in practise because they present with many of the same symptoms.
Here are the criteria for cervicogenic headache diagnosis as per the international headache society’sguidelines:
Pain localized in the neck and occiput, which can spread to other areas in the head, such as forehead, orbital region, temples, vertex, or ears, usually unilateral.
Pain is precipitated or aggravated by specific neck movements or sustained postures.
At least one of the following:
Resistance to or limitation of passive neck movements
Changes in neck muscle contour, texture, tone, or response to active and passive stretching and contraction
Abnormal tenderness of neck musculature
4. Radiological examination reveals at least one of the following:
Movement abnormalities in flexion/extension
Fractures, congenital abnormalities, bone tumors, rheumatoid arthritis, or other distinct pathology (not spondylosis or osteochondrosis)
Here is a video of what a physical practitioner might use to assess you:
Cervicogenic Headache Causes
These are some common causes and we will talk about how they are connected and stem from the same source:
– Forward head posture
– Poor sleep position
– Nerve compression
– Slipped disk
When we want to understand cervicogenic headaches and any headaches coming from pain in the neck or shoulders we have to look at the rest of the body and how it’s compensating.
The body will always try to protect itself and often does this by changing posture and creating pain.
If we have a muscle imbalance in the neck from let’s say sitting all day(who does that?) then we can develop tight and weak muscles that will continue to put our neck into a posture that will create compression on nerves and aggravate pain.
Forward head posture is one of the most common causes of this and is becoming a huge problem because we are:
– Sitting at desks
– Sitting in cars
– Sitting on couches
– Not exercising
– Looking at phones
But we are doing them with poor ergonomics and not using exercise which usually resets these muscles and fixes imbalances.
Possible Red Flags If You Have Cervicogenic Headache
Sudden onset of a new severe headache;
A worsening pattern of a pre-existing headache in the absence of obvious predisposing factors;
Headache associated with fever, neck stiff ness, skin rash, and with a history of cancer, HIV, or other systemic illness;
Headache associated with focal neurologic signs other than typical aura;
Moderate or severe headache triggered by cough, exertion, or bearing down; and
New onset of a headache during or following pregnancy.
Patients with one or more red flags should be referred for an immediate medical consultation and further investigation from their doctor.(Link)
Cervicogenic Headache Treatments
Cervicogenic Headache ICD 10 code – [M99]G44.841
There are many treatments available for cervicogenic headaches but we want to find the root cause.
Yes you can get a botox injection that will block all nerve pain transmission and you won’t be able to feel the pain, but that doesn’t mean the cause isn’t there and progressively getting worse.
Let’s start with what one physical therapist who’s dealt with many headaches has to say.
This breaks it down and makes it simple to understand.
The functioning and posture of all your limbs depends on your core because your core is what holds everything in place.
But there is a second piece to this that is at play every second of every day, either making your head and neck have to compensate or giving them the correct posture…
And that’s breathing.
So with these three pieces we have a place to start:
1. Correct core abdominal functioning
2. Fix the breathing pattern
3. Stretch and strengthen the neck based on its muscles needs
The process goes:
Reactivate core => correct breathing pattern =>integrate core and breathing into regular daily movement => assess neck and correct anything left over
First and foremost is the core and the weak area that often gives out from a variety of different reasons is the lower abdominals and inner core unit.
Here is a great video on correcting the lower abs:
As you can see this is really simple to do and is just focusing on reactivating the core so it’s functioning properly and can hold the head and neck in the right position.
The problem is that you will not have proper neck mobility without a functioning core and proper breathing pattern.
Breathing is very simple but many of us do it wrong for a variety of reasons like bad posture and fear.
Here is a great video on respiration and how important it is to retrain your breathing pattern for deep abdominal breaths.
Once the breathing and core are corrected you can then continue to progress them into movements so that your brain learns how to breath right, engage the core and move properly all at the same time.
Once this clicks, the neck will unlock its tension and poor posture that is protecting it from injury and you will be able to breathe easier.
It’s super simple but important you see a trained practitioner to teach you how to do it right.
Cervicogenic Headache Exercises
Here are three great exercises for the causes of cervicogenic headaches.
1. First off, if we have a bad breathing pattern and our breath is actually going up into our lungs, chest, shoulders and neck and not down into our abdomen then our neck is getting tons of extra tension. See breathing pattern correction video here.
2. Next off is our lower abdominals. When they don’t engage, our head compensates and brings the neck with it. See abdominal engagement correction here.
3. To stretch tight muscles and strengthen weak muscles of the neck see the video here.
Cervicogenic Headache Home Treatment
Some very common natural home remedies (that may work incredibly well) include:
– Cold or hot therapy(or both)
– Get more of the relaxation mineral magnesium through a spray on, epsom salt and a supplement
– Supplement with sulfur like MSM
– Start adding turmeric and ginger to everything in your diet
– Use essential oils like frankincense
The above tips are just briefly touched upon and you should definitely do more investigation and ask your healthcare provider before making any changes.
As we correct the cause for neck pain like bad posture and breathing and we reduce the triggers for pain like inflammation caused by food and stress, headaches may disappear altogether.
The different causes like osteoarthritis, slipped disk, forward head posture, fractures, poor sleep position and nerve compression all have this; instability in the core, causing compensation in the head, leading to excessive strain on the neck in common.
When we can correct the underlying causes we give our neck and head more support and a break from all the tension.
This, coupled with a proper recovery plan that gives you anti inflammatory nutrients and the building blocks to repair sets you up for long term health and happiness.
To understand everything about headaches that causes inflammation and leads to trigger along with 10 steps you can start taking today to get pain free see our 10 steps program by clicking below.
If you’re finding your headaches more complex and complicated than you or your healthcare provider can handle make sure to check out our article on 7 great tips for complex and complicated migraine here.