Cervicogenic Headaches

by Dr. Tan Burns-Tran, D.C.

Cervicogenic headaches are characterized by chronic head pain that is referred from structures in the neck. The common symptoms of cervicogenic headaches include:

Neck pain and stiffness
Occipital pain (back of the skull)
Pain shooting into the temples and behind the eyes
Pain radiating into the top of the shoulder blades (more frequent in women)
Pain radiating between the shoulder blades (more frequent in men)
Made worse with movement of the head and neck

Poorly Understood and Misdiagnosed

If this all sounds familiar, you may be suffering from Cervicogenic Headaches. This is a condition that is often misdiagnosed and poorly understood. It has a high rate of prevalence among females. We often encounter patients who have suffered from headaches for many years without any relief from traditional medicine. Typically, the patient presents to our clinic with a long history of diagnostic tests such as CAT Scans, MRIs, blood tests, etc. Most often, the tests show little evidence of pathological issues that can explain the chronic headaches. W see patients with years of migraine medications, anti-epileptic medications, Ibuprofen and anti-depressants for pain.

A Structural Problem

Cervicogenic headaches may involve compression or irritation of the suboccipital nerve that exits from the first vertebrae in the neck (Atlas). It may also involve spasm and tenderness of the muscles of the neck and shoulders such as trapezius, suboccipital triangle group, sternocleidomastoid, scalenes and levator scapulae.

Typically, there is subluxation (misalignment) of the C1 and/or C2 vertebrae. These two vertebrae are located directly underneath the base of your skull. If you have cerviogenic headaches, this is most likely tender to touch. The vertebrae are typically misaligned in a rotatory malposition. Therefore, you may feel that one side of the upper neck has a more bony prominence than the other side. This subluxation causes the irritation to the suboccipital nerve which causes headaches.

A Structural Problem Requires a Mechanical Solution, not a Chemical One

If the C1/C2 vertebrae are out of alignment, there is not much a chemical agent can do to put those bones in place. Although medication can lessen the pain, manual therapies such as Chiropractic Adjustments, myofascial release and trigger point therapy can address the structural problem that is the root issue.

The Essential Integrative Medicine protocol for cervicogenic headaches include:

* Precise muscle work and manual therapies to remove adhesive and restrictive muscles and connective tissues of the neck and shoulders.
*Precise and gentle adjustment to the C1/C2 to remove pressure of the suboccipital nerves.
*Trigger point injections if necessary
*Dietary analysis to identify triggering nutritional factors
*Lifestyle modifications such as sleep and work habits that may be triggering factors.
*Rehabilitative exercises to increase range of motion and strength
*Yoga and Pilates consultation to achieve wellness and long term stability of the neck.

I hope that this information is helpful in your understanding of a very common ailment. Please let us know if we can help you or help anyone you know that may be suffering from this condition. Please feel free to ask questions and comment below.