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Cervicogenic Headaches – The “Neck Headache”

Cervicogenic Headaches – The “Neck Headache”

A cervicogenic headache is a headache disorder that affects an estimated 2.2% of the population. What makes a cervicogenic headache different from other headaches is that it is not truly a headache; it is actually a type of referred pain. Referred pain is when the body perceives pain in a location different from where the actual pain is. For example, sometimes when you hit your “funny bone” you may feel a pain in your shoulder. In this case, the headache pain is being referred from bones or soft tissues in the neck. The upper cervical spinal cord has many bundles of nerves that transfer sensation between the neck and the head, which allows for the referral of pain.

How Cervicogenic Headaches Are Diagnosed

Diagnosing a cervicogenic headache can be a difficult process. Though diagnostic criteria are established, often times the presenting patient’s symptoms are hard to tell apart from those of a migraine, tension headache, or other headache disorder. The approach to diagnosing a cervicogenic headache (and also treating it) is multi-disciplined. The diagnostic factors are:

  • Usually, cervicogenic headaches are unilateral, meaning they start on one side at the back of the head, migrate towards the front, and sometimes cause arm pain.
  • Misalignment, muscle spasms, or other cervical dysfunction during a manual exam.
  • Headaches that occur when pressing on a trigger point in the neck or head.
  • Sustained neck positions which aggravate the pain.
  • X-rays and other imaging returns with normal results.
  • Occasionally nausea and/or dizziness.

Some types of cervicogenic headaches cause bilateral pain, and the headache starts out as neck pain or the neck pain exists along with the headache. In this form, the pain is exacerbated by certain movements of the neck. This form of headache is more common in occupations like hair-dressing, truck driving, or carpentry.

Who Gets Cervicogenic Headaches?

Roughly 47% of the world’s population suffers from headaches, and it is estimated that 15-20% of those are cervicogenic. Some research suggests that adults with neck pain are more susceptible to cervicogenic headaches. It has also been noted that four times as many females as males get cervicogenic headaches. During an examination, a doctor will consider any history of trauma, as well as the age of the patient. Usually, younger patients (ages 10-13) have dysfunction in the lower cervical spine, whereas older patients tend to have dysfunction in the upper cervical spine.

How Are Cervicogenic Headaches Treated?

Like diagnosis, treatment should be multi-disciplined. Usually, it is a combination of posture adjustment, massage, physiotherapy, acupuncture, steroid injections, hydrotherapy, and medication. Most patients (70%) are pain-free within a month.


To learn more or to seek treatment, contact KCA Neurology in Franklin and Clarksville, TN at 615.550.1800.


Botox: Migraine

Botox: Migraine

What is Botox?
Botulinum toxin Type A (Botox) and Type B (Myobloc) are toxins produced by bacteria and then purified for medical usage. The toxin blocks the signal from nerves to muscles. It is injected into the skin or deeper into the muscle. As a result, the muscles reduce their contraction resulting in reduction of painful muscle spasms and/or the relaxation of wrinkles.

What should I do to prepare for the procedure?
Wear clothing that allows for easy access to the affected area if possible. No other preparation is needed.

What can I expect to happen during the procedure?
The injection itself is completed while you are seated or lying down. The area will be cleaned with an antiseptic solution. The “Botox” is then injected directly into the skin or muscle. The procedure frequently involves several injections in a small area.

How long will it take?
The actual injections take only a few minutes, but this will vary depending on the number of sites that are injected.

Will it hurt?
You should only feel the typical mild to moderate discomfort associated with an injection.

What should I do after the procedure?
You may be asked to limit your activity for several days after the injection. The pain may actually be worse for a day or two after the injection. Treat this pain with ice or cold packs (15-20 minutes at a time, for a few times each day). Do not use heat for the first 48 hours after the injection.
Make sure to call your doctor if you have severe pain, a fever, or any significant swelling or redness around the area of injection.

How long will it take to work?
While many people experience relief within 10 days, the maximal effect may take up to four weeks.