When these structures are damaged, the nerve endings send pain signals up the pathway from the upper nerves of the neck to the brain. During this process they intermingle with the nerve fibers of the trigeminal nerve. Since the trigeminal nerve is responsible for the perception of head pain, the patient therefore experiences the symptoms of headache.
While many patients who are diagnosed with cervicogenic headache have the traditional symptoms of tension headache, some of the patients who have the traditional symptoms of migraine (and cluster migraine) headache also respond to cervicogenic headache diagnosis and treatment.
Causes of Cervicogenic Headache
Cervicogenic headache is usually due to a trauma to the neck. A definite percentage of patients who have cervicogenic headaches experience these headaches after they have been in motor vehicle accidents or have had a sports injury or repeated minor sports injuries, e.g. being thrown off a horse, being tackled in football, etc.
In elderly people arthritic changes of the neck may cause headaches during the later years. Other patients have experienced headaches as a result of neck traumas related to more innocuous accidents such as childhood falls off swings, fall down stairs.
Diagnostic Tests for Cervicogenic Headache
InjectionOn first observation, preliminary physical examinations can determine areas of tenderness, spasm or pain. Once discovered, a diagnostic block involving the use of very small amounts of local anesthetics to the suspected structure in the neck are used to diagnose cervicogenic headache.
Diagnostic blocks used in the diagnosis of cervicogenic headache include the following:
Facet/Paravertebral Nerve Blocks are injected into the side of the neck to assess and treat inflamed facets in the neck which cause pain and stiffness.
Injection of dye into a cervical disc (provacative discography) which reproduces the headache, and immediately afterwards, injection of local anesthetic which alleviates the headache (alleviating discography), is another example of a diagnostic block.
Cervicogenic Headache Treatments
Headache TreatmentThere are many treatments for cervicogenic headaches depending upon the specific nature and pathology in the area of the neck.
In mild cases, manipulation, massage and physical therapy can deal effectively with the condition. In serious conditions, damaged structures in the neck are more serious, so nerve block injections are required, and surgery may also be recommended.
Nerve block injections involve the use of a local anesthetic and corticoid steroid applied to the nerves of damaged structures which can include joints, ligaments, muscles, and cervical discs. When these structures are damaged, their nerve endings send pain signals to the brain. The nerve block injection prevents these pain signals from being sent therefore alleviating the headache.
Nerve block injections used to treat cervicogenic headache can include:
- Occipital Nerve Blocks are injected into the back of the neck to treat pain going up the back of the head.
- Facet/Paravertebral Nerve Blocks are injected into the side of the neck to treat inflamed facet joints in the neck which cause pain and stiffness.
- Supraorbital Nerve Blocks are injected above the eyebrows to treat that region of the head.
- Cervical facet rhizolysis (using heat to burn selected nerves of the small joints which connect each vertebrae).
- Other rhizotomy procedures (burning nerves with heat) about the face and neck for certain headache syndromes.
- And cervical discotomy and fusion (removing a disc responsible for sending pain signals).