This video is the fifth in a series about headaches.
My previous videos were about migraine, cluster headaches, trigeminal neuralgia, and tension-type
headaches.
Today I’ll talk about cervicogenic headaches.
Cervical refers to the neck.
Cervicogenic means that the headache has originated in the neck.
The sensations from the head and neck are linked, and pain in one area can be felt in
the other area.
This is called referred pain.
When the person has a problem in the neck, the pain can refer to the head, and vice versa.
So, let’s talk about cervicogenic headaches today.
I made this video series in collaboration with Migraine Canada.
If you want to learn more about headaches and migraines, visit their website.
They have a lot of resources, events, and education materials for you to learn more
about migraines.
We learned in previous videos that there are primary and secondary headaches.
Primary headaches are when the headache is the disease itself.
Secondary type headaches are when they are a symptom of another condition.
Migraines, cluster headaches, tension-type headaches are all examples of primary type
headaches.
Trigeminal neuralgia and cervicogenic headache are examples of secondary type headaches.
Cervicogenic headache affects between 1 and 4% of the general population.
Cervicogenic headaches can be isolated, but they can affect people with other headaches,
especially migraines.
A neck problem can trigger a migraine.
A migraine can lead to a bad posture that will lead to a compression of a nerve in the
neck and start a cervicogenic headache.
This is what we call the Migraine Ping Pong Theory.
Many cervicogenic headaches start after a trauma to the neck, like in a car accident
where the neck moves quickly to the front and backwards.
This is known as a whiplash injury.
This type of post-traumatic headache may have all features of a cervicogenic headache.
The diagnosis of cervicogenic headache is basically by doing the treatment in the neck
and observing if the headache improves or not.
If the neck treatment eliminated the headache, it was a cervicogenic headache.
The symptoms of cervicogenic headache include both neck and head pain, and the pain is aggravated
by some movements, posture of the neck, or maneuvers to provoke pressure on the neck
structures.
We have to treat the neck to alleviate the headache.
The types of treatments include a variety of approaches for the muscles, facet joints,
bones, discs, or nerves.
Before I continue, let me remind you that this video is not intended to replace medical
advice.
It is for educational purposes only.
Please talk to your doctor about the diagnosis and treatment plan for you.
In case of emergency please go to the nearest emergency department or call an ambulance.
To treat the neck, remember the toolbox of treatments.
I use the letters 5M IS, which means mind, movement, manual, modalities, medications,
interventional and surgery.
When the origin of the pain is in the muscles, I recommend mind-body relaxation and SSAR
exercises.
These muscles usually have myofascial pain, and the exercises include a mix of stretching,
strengthening, aerobics, and relaxation exercises.
Watch my other video about SSAR exercises for myofascial pain of the neck.
I also recommend modalities like heat, cold, TENS, dry needling.
Self-massage can be very helpful, especially for the sternocleidomastoid and upper trapezius
muscles.
I perform trigger point injections when exercises, self-massage and modalities do not resolve
myofascial pain.
Sometimes I prescribe amitryptiline or muscle relaxants.
When the origin of the pain is in the nerves exiting the neck, I recommend nerve blocks,
like the occipital nerve block on the base of the occipital bone.
In some cases, I send the patient to an interventional pain doctor to do a diagnostic test on the
C2-C3 blocks to see if the headache gets better.
Occasionally I recommend botulinum toxin injections to treat both chronic migraines and the cervicogenic
headache.
I don’t recommend opioids as they risk dependence, addiction, and medication overuse headaches
or MOH.
You may use a Headache diary to track your symptoms, and Migraine Canada has a version
that you can download and an App version.
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Thank you for watching Goodbye!