Cervicogenic Headaches

Your Headache: A Real Pain in the Neck
Headache
Photo Credit: openDemocracy via Flickr

Your head hurts — the consistent ache, the vice-like pressure around your forehead, the boring pain behind your eyes, or the spreading pain from the back of your skull across the temple — what gives?

These are just a few examples of how headaches present for some people, and as you might expect, there are a number of subtle differences which account for the difference in how you feel. No matter what you’re feeling, you’re certainly not alone in these experiences. The World Health Organization (WHO) references the 2010 Global Burden of Disease Study (published in the reputable Lancet journal) in estimating that 47% of adults have experienced at least one headache within the last year. “That’s nice,” I imagine you’re saying, “but it doesn’t help my headache.”

That’s very true, but to address the symptoms your headache is creating, the type of headache you are experiencing must first be determined. The International Classification of Headache Disorders (3rd Edition) sets out 14 (fourteen!) distinct classes of headaches, as well as sub-classes within those groups — fortunately, there are three general groups that present most frequently in my clinic: Migraines, Tension-Type Headaches, and Cervicogenic Headaches. The topic for today? Cervicogenic Headaches. We will address the others in a future post.Cervicogenic Headache Summary

Cervicogenic Headache: An overview

Cervicogenic headache is a long, unfamiliar term to most — let’s break it down. The “cervical spine” references the first seven vertebrae extending down from your head — these are the bones that make up your neck — so the cervico- component of the word references your neck. The term -genic is a suffix meaning “causing, forming, or producing”. Altogether then, a cervicogenic headache is a ‘headache coming from the neck’.

This type of headache is less common than its better-known siblings — migraines and tension-type headaches. In the general population, cervicogenic headaches are estimated to impact 0.4-2.5% of people annually, but that figure jumps significantly in people with chronic headaches to 15-20%.

Why is that important? For people who only get occasional headaches, cervicogenic headaches are unlikely to be a source of their discomfort. But for those who experience chronic headaches, it is much more likely cervicogenic headaches are either the primary source, or contributing factor to your symptoms. For a significant section of those experiencing chronic headaches then, identification and treatment of this headache variety is very important.

What kind of treatment is recommended?

Fortunately, chiropractic care frequently manages painful conditions related to muscles and joints of the neck with success. Conservative treatment options, all of which are easily provided in the modern practitioners office, such as manual therapy (massage, mobilization, manipulation), modalities (laser, electrical stimulation), and postural exercises are suggested as treatment solutions when managing this type of headache. Acupuncture has also demonstrated clinical improvements in chronic headaches, potentially making this a treatment option as well.

How might I know if this is part of my headaches?

The onset of muscular tightness and soreness, impaired joint mobility, and/or limited range of motion in your neck (less movement) coupled with the onset of your headache may indicate these structures are generating your symptoms.

Summary

Cervicogenic headaches are “headaches coming from your neck”. They are relatively uncommon (~2%) compared to other varieties in the general population, but if you are someone who experiences chronic headaches, it is much more likely cervicogenic headaches play a part in your symptoms (15-20%). Early research suggests manual therapies are effective for the treatment and management of cervicogenic headaches.


*A follow-up: The significant increase in presence of cervicogenic headache for people with chronic headaches compared to those without chronic headaches may suggest we’re missing cervicogenic headaches early in diagnosis. Perhaps earlier identification of a problematic areas in the neck can limit the number of chronic headaches that are influenced by this sub-category of headaches. Seek assessment for your headache(s) if they are stopping you from being you.*


Questions or comments? Want me to review the other varieties of headaches as well? Please feel free to contact me anytime at drjimgilliard@gmail.com, by phone at (905) 634-6000, or book an appointment at Endorphins Health and Wellness Centre in Burlington.

Quick References
  1. Chaibi A, Russell MB. Manual therapies for cervicogenic headache: A systematic review. J Headache Pain. 2012;13(5):351–9.
  2. Global Burden of Disease Study: 2010. The Lancet, Vol. 380, No. 9859
  3. Haldeman S, Dagenais S. Cervicogenic headaches: A critical review. Spine J. 2001;1:31–46.
  4. The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2013;33(9):629–808.
  5. Vickers AJ, Rees RW, Zollman CE, McCarney R, Smith C, Ellis N, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ. 2004;328(7442):744–9.

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