By: Michael S. Dooley LMT, MMP
What is a cervicogenic headache?
Over 40 million Americans suffer from headaches every year. One of the most misdiagnosed headaches is the cervicogenic headache, also referred to as a CGH. Cervicogenic means “beginning in the neck”. It is often mistaken as a muscle-tension headache, and it is different from a migraine headache. A cervicogenic headache is more serious because neck disorders often affect the central nervous system, usually the third occipital nerve and cause a vicious cycle of muscle tension causing more nerve pain and more muscle tension.
What are the causes of cervicogenic headaches?
A cervicogenic headache can be caused by a number of factors. These include, but are not limited to, muscle imbalance, disc degeneration, degenerative vertebrae and cervical misalignment caused by trauma, whiplash, poor posture and poor ergonomics of the workstation. Dehydration is a common trigger. Soft tissue that supports the spine moves more fluidly when the body is fully hydrated. The body loses up to 10 percent of its athletic performance when not fully hydrated.
Is your headache a cervicogenic headache?
If you answer “Yes” to two or more of the following questions, your headache is the cervicogenic type of headache.
- Does moving your neck cause your headache?
- Does moving your neck make your headache worse?
- Is the back of your neck tender to the touch?
Types of treatment for the cervicogenic headache
They are pharmacologic management, trigger point injections, nerve blocks, spinal manipulation, manual therapy, correcting the posture by strengthening the weaker muscles, stretching, and ergonomic adjustments to the workstation.
Let’s discuss the easiest, least invasive, and most effective treatments that one should consider first. Manual therapy, correcting one’s posture by strengthening weaker muscles, stretching, and ergonomic adjustments to the workstation top the list.
Manual therapy addresses the dysfunctions of the spine using soft tissue mobilization, joint mobilization, neural mobilization, manual traction, craniosacral therapy, neuromuscular release, and myofascial release. The focus is to restore the structure of the cervical spine (the neck) to its proper order. Because the neck is above of thoracic spine (the chest), lumbar spine (low back), and the sacrum, which is supported by the legs, each of these areas has equal importance in the stability of the neck. An integrative approach to balancing the body and spine, with extra emphasis to the neck, is the first form of treatment with the possibility of lasting results. The multifaceted treatment of manual therapy, focused stretching, and strengthening exercises are proven to relieve or reduce the symptoms of cervicogenic headaches, and the effects are maintained. The initial treatment may last approximately 6 weeks and should be accompanied by ergonomic adjustments to the workstation.
Correct posture is critical for optimal nervous system health. Head-forward posture is a key factor in cervicogenic headaches. I call this “Head-forward Syndrome”. This is when the forward muscles of the neck are shortened from head-forward activities. Adjusting and selecting furniture that gives your spine the support it needs is an important step in posture correction. Taking periodic breaks from activities, such as computer work, reading, writing, cooking, and driving, is advisable. Setting up your desk properly can help eliminate pain caused from muscle imbalances. Important ergonomic adjustments to consider are chair type, height adjustments and how one sits in it, monitor and keyboard height and placement. Those who are on the phone a lot should consider using a wireless headset.
Over-the-counter (NSAIDs) Non-Steroidal Anti-Inflammatory Drugs, such as aspirin, acetaminophen, and ibuprofen can be used as needed to help keep a flare-up from becoming a full-blown headache. Be warned that there is substantial evidence that NSAIDs hamper soft tissue healing. These over-the-counter medications and prescription drugs should not be used on a continual basis, as they can cause residual and rebound effects. Taking medications everyday to get through the pain may cause irreversible damage to vital organs, i.e., stomach, liver and kidneys. If you are already experiencing chronic headaches, you should seek help from a specialist.
My best work is correcting neck dysfunctions with manual therapy and posture coaching to provide relief from cervicogenic headaches. Patients who stretch and strengthen, as directed, experience the quickest results. The results are varied based on the initial condition and participation of the patient.