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Cervicogenic Headache

Cervicogenic headache was first introduced by Sjaastad et al in 1983. This headache is also known as the controversial headache. It is a new medical term which is described as a headache which originates from structures and tissues in the neck or cervical spine region. This headache was overlooked or ignored by many doctors as the diagnosis of this headache cannot be done. It is also described as a non-muscular and unilateral headache which appears in the cervical spine or neck.

The pain is caused due to the pain fibre structures in the neck which are attached to the cervical spine with the cervical muscles and their attachments, various joints and structures, vertebral arteries and cervical nerve roots. The continuous pain which occurs to the head from the neck is due to the convergence of the sensory fibers of the upper cervical spinal cord and the descending tract of trigeminal nerve. These nerves pass the pain from the neck muscles to the head. In this way, the person feels the cervicogenic headache.

Features of Cervicogenic Headache

Some indication of abnormality in the cervical spine like impaired cervical motion, neck pain, aggravation of the headache by neck movements or a history of neck trauma etc
Pain other than lancinating pain located in the frontal, occipital, orbital or temporal regions of the head

The major criteria for the diagnosis of cervicogenic headache are:-

Symptoms and signs of neck involvement
Reduced range of motion in the cervical spine
Unilateral headpain without sideshift
Ipsilateral neck, arm and shoulder pain

Provocation of attacks :-

Pain which is similar in character and distribution to the continuous occurring pain due to external pressure
Pain triggered by sustained awkward head positioning and neck movements

Risk Factors of Cervicogenic Headache

Nervous tension
Birth Control Pill
Menopause
Smoking and alcohol
Menstrual cycle and hormonal changes
Disorders of the sinuses
Hypertension
Abnormal postures
Diet

Treatment of Cervicogenic Headache

Proper treatment is very essential for the cervicogenic headache. Objective and subjective assessments help the therapist to examine the headache which the person is experiencing that originates from the cervical spine. The following treatments can be taken to reduce the cervicogenic headache and they are:-

Mobilisation
Massage
Exercises
Postural assessment and correction
Relaxation therapy
Electrotherapy modalities such as laser therapy, ultrasound etc

Neurologists and Dieticians are also very helpful in the treatment. Self-help plays an important role in the prevention and treatment of cervicogenic headache. Management of these headaches can be very complex. Besides all these treatments, conventional physiotherapy and oral medical therapy, diagnostic blocks, trigger point injections and multiple procedures can also be helpful in this treatment.

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