Cervicogenic headaches can mimic migraines, so it may be difficult to distinguish a cervicogenic headache from a migraine headache. The primary difference is that a migraine headache is rooted in the brain, and a cervicogenic headache is rooted in the cervical spine (neck) or base of the skull region.
Some headaches are caused by eyestrain, stress, tiredness, or trauma. If you feel a headache coming on, you may be able to isolate the cause. Cervicogenic headaches are different because they are caused by problems with the nerves, bones, or muscles in your neck. Although you may feel pain in your head, it doesn’t start there. Instead, the pain you feel is referred pain from another location in your body.
In addition to a throbbing head pain, symptoms of a cervicogenic headache may include:
- pain on one side of your head or face
- a stiff neck
- pain around the eyes
- pain while coughing or sneezing
- a headache with certain neck postures or movement
Cervicogenic headaches can also cause symptoms similar to migraine headaches, such as light sensitivity, noise sensitivity, blurry vision, and an upset stomach.
Because cervicogenic headaches arise from problems in the neck, different conditions can trigger this type of pain. These include degenerative conditions like osteoarthritis, a prolapsed disc in the neck, or a whiplash injury. Falling down or playing sports can also cause injury to the neck and trigger these headaches.
Cervicogenic headaches may also occur due to your posture while sitting or standing at work. If you’re a driver, carpenter, hairstylist, or someone who sits at a desk, you may unknowingly push your chin forward which moves your head out in front of your body. This is called cervical protraction. Sitting or standing in this position for long periods of time can put pressure or stress on the neck and base of the skull, triggering a cervicogenic headache.
Falling asleep in an awkward position (such as with your head too far to the front or back, or off to one side) can also cause these types of headaches. This can happen if you sleep in a chair or while sitting up in bed. A compressed or pinched nerve in or near the neck is another cause of cervicogenic headaches.
A cervicogenic headache can be debilitating and recurrent, but several techniques can help you manage pain and prevent further occurrences.
Your doctor will first confirm that you have a cervicogenic headache. Your doctor may apply pressure to different parts of your neck or base of your head to determine where your pain originates, and to see if a particular spot is triggering a headache. Your doctor may also see if different neck positioning provokes a headache to occur. If either of these things cause a headache, this means the headache is cervicogenic.
Since inflammation and other problems with the nerves, muscles, tendons, or joints can cause these headaches, your doctor may recommend oral over-the-counter medications or prescribe an oral medication to relieve pain. These include:
- aspirin or ibuprofen (Motrin)
- acetaminophen (Tylenol)
- a muscle relaxant to ease muscle tightness and reduce spasms
- a corticosteroid
Your doctor may also recommend physical therapy to strengthen weak neck muscles and improve mobility of your joints. Your doctor may also recommend alternative therapies to lessen nerve, joint, or muscle pain in the neck. These include massage therapy, spinal manipulation through chiropractic care, cognitive behavioral therapy, acupuncture, and relaxation techniques. Other options for managing pain include:
- avoiding activities that worsen pain
- applying ice or heat for 10 to 15 minutes, several times a day
- using a neck brace when sleeping upright to prevent bending your neck forward
- practicing good posture when sitting, standing, or driving (stand or sit tall with your shoulders back, and don’t lean your head too far forward)
Surgery or injection
In rare cases, spine surgery is needed to relieve cervicogenic headache due to nerve compression.
Your doctor can also diagnose (and treat) a cervicogenic headache with a nerve block. This involves injecting a numbing agent and/or a corticosteroid into or near the nerves in the back of your head. If your headache stops after this procedure, this confirms a problem with the nerves in or near your neck. Sometimes, doctors use imaging tests to take pictures of the inside of the neck to check for problems with the joints or soft tissue. These tests can include an X-ray, a CT scan, or an MRI.
Some occurrences of cervicogenic headaches are not preventable. This is the case with headaches stemming from a condition like osteoarthritis, which tends to set in with age. Some of the same strategies for managing pain may also prevent these headaches. For example, practice good posture when sitting or driving. Don’t sleep with your head propped too high on a pillow. Instead, keep your neck and spine in alignment, and use a neck brace if you’re sleeping in a chair or sitting upright. Also, avoid head and neck collisions when playing sports to prevent injury to the cervical spine.
If left untreated, cervicogenic headaches can become severe and debilitating. If you have a recurrent headache that doesn’t respond to medication, see a doctor. The outlook for cervicogenic headaches varies and depends on the underlying neck condition. However, it is possible to alleviate pain and resume an active lifestyle with medication, home remedies, alternative therapies, and possibly surgery.