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Understanding Headache: Part 4 - The Cervicogenic Headache


Cervicogenic. This refers to a headache stemming from one or many structures in the neck (particularly the upper cervical spine). This experience of pain felt in a location distant to the cause is called referred pain. As information from the pain source is sent back to the spinal cord, the cord is unable to determine the precise location of the pain generator. As a result it relays the pain to a general area where the pain is felt, based on shared neurology.

Within the upper cervical spine, there are many potential pain generators. This includes large muscles which contribute to gross movement of the head and neck, small muscles principally involved in positional perception, ligaments, tendons, joints, fascia and nerves themselves. Many of these structures can refer pain to the back, side or even the front of the head. Sometimes, the pain will be felt as though it is directly behind the eye.

Specific features of a cervicogenic headache include reduced range of motion in the neck, aggravation by neck movements or positions, fluctuating pain intensity and durations and the possibility of nausea, vomiting, dizziness or difficulty swallowing. This type of headache can be experienced on only one side, or both. It can also be present as part of a larger headache picture, presenting in those who suffer tension-type headaches or migraines.

So what causes a cervicogenic headache? Most typically, this form of headache is precipitated by poor work space ergonomics (poor-posture at your desk or work station) and the repetitive strains placed on the neck via physical demands. This can mean the position of the mouse and keyboard related to your desk space, or even where your phone is located. Other contributors can be driving and reading posture, frequent use of hand held devices (iPad’s or e-readers), study positions for students or even how you watch TV. Repetitive stress placed through these structures can eventually lead to overuse, pain and then headaches. Cervicogenic headaches can also be caused by recent or old trauma (such as a motor vehicle accident).

Once diagnosed, what is the next step for this type of headache?

The recent Chiropractic Practice Guideline to headache management has reviewed the most up to date scientific literature and concluded a combination of home-based exercises to restore strength and balance to the neck balances and a course of either joint mobilization or joint manipulation (chiropractic adjustments) are an excellent starting point for patients suffering cervicogenic headaches. Supporting research shows a significant improvement in symptoms within a short to moderate time frame for most patients.

Within this headache type, the key is identifying the functional deficits and limitations of your neck and shoulder region as well as the physical risk factors of your day-to-day which contribute to the headache cycle. Once identified through a thorough history and physical examination, a chiropractor can help you to manage the risk factors and guide you through the process to restore FUNCTION to your biomechanics and MOTION to your anatomy. From here, your quality of LIFE is improved.

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