CERVICOGENIC HEADACHE

By Jay Herrera, DPT
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Feeling exhausted, back and spine disease. Woman having bad ache. Female placing hands on her neck suffering from pain

Cervicogenic Headache

Headaches can come in many forms with an array of causes but often individuals do not consider such symptoms to stem from the neck. Due to this “pain in the head” possibly, originating from the neck or cervical region, it can be classified as “cervicogenic headache.” Neck structures like muscles, specific cervical or neck joints, ligaments and other soft tissues can elicit these headaches. Therefore, the source of inflammation or dysfunction in cervical tissues can refer the pain to the head.  In addition to the neck feeling stiff, these symptoms usually present with a dull ache (not throbbing) of moderate intensity, arising from the neck region (usually at the base of the skull called the suboccipital region). However, instead of a dull ache, a person can complain of a variety of symptoms such as tightness around the forehead like a tight band, discomfort behind one of the eyes, the side of the head (temple region) or even on top of the scalp. The cervicogenic headache typically only occurs on one side of the head, but is not constant or continuous. These episodes can be of varying duration as well. The symptoms typically worsen with poor postures or sustained faulty positions like prolonged sitting at a desk, specific neck motions and even stress.

Conservative options for Cervicogenic HA:

  1. Awareness of prolonged sitting posture like in front of computer screen or tv. Consider assessing posture every 15-20 minutes during prolonged sitting (see exercise below)
  2. Improve posture with combining proper neck musculature flexibility exercises with neck/cervical and scapular strengthening-endurance training
  3. Use of modalities like heat or ice on neck
  4. Consider formal rehabilitation from a licensed professional with experience in treating patients with cervicogenic headaches which could range from physical therapy, chiropractic care, acupuncture, osteopathy. However, these therapies should include a combination of manual therapy (various techniques for improving neck mobility and muscle length) and exercise (stretching, strengthening, endurance training).

Home Exercises

  1. Retraction / Chin Tuck – Slowly draw your head back so that your ears line up with your shoulders
  2. Upper Trap Stretch – Begin by retracting your head back into a chin tuck position. Next, place one hand behind your back and gently draw your head towards the opposite side with the help of your other arm.
  3. Levator Scapulae Stretch – Grasping Wrist – Grasp your arm of the affected side and pull it gently towards the opposite side in front of your body. Next, tilt your head downward and to the side looking away from the affected side until a stretch is felt.
  4. Shrugs & Pinches – Seated or standing, shrug both shoulders then pinch the shoulder blades back together. This can also be done to check posture.
  5. Wall Angels – Stand with your back against a wall with arms raise to 90 degrees. While making contact with your head, wrists, elbows and shoulders, slide your arms up and down the wall as shown.
  6. ADL – Desk Ergonomic set up – Sit at your desk on a comfortable and adjustable chair with back rest to maintain lumbar curvature and use an ergonomic keyboard. Do not slouch.  Your desk should be set up so that the monitor is at or just below eye level. The elbows, hips and knees bent 90-110 degrees. Adjustments can be made for monitor height, keyboard height, seat height, desk height and/or foot rest height in order to achieve proper alignment. Electronic desk is preferred if available to be able to adjust the height of the desk with buttons.

Further medical intervention: If symptoms persist, please consult your physician.

 

 

Bibliography:

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Blanpied et al. Neck Pain: Revision 2017: Clinical Clinical Practice Guidelines Linked to the international Classification of Functioning, Disability and Health From the Academy of Hand and Upper Extremity Physical Therapy and the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys. Ther. 2017 ; 47(7): A1-A83-CPG85.

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https://www.medbridgeeducation.com/patient-education-library/condition/148-Cervicogenic-Headache

Nicolson GG and Gaston J. Cervical headache. JOSPT 2001; 31 (4): 184-193.

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