There are also at least 65 bones, tendons, ligaments, muscles, and other tissues in the neck that can each contribute to cervicogenic headaches. The “classic” cervicogenic headache presentation includes: unilateral pain without side shift; pain beginning in the neck, and then radiating to the occiput (back of head), temporal (side/s of head), frontal (front of head), and orbital (eyes) regions; non-throbbing, non-lancinating pain; variable duration (hours to months); constant or intermittent pain; pain triggered by neck motion or external pressure on the cervico-occipital region of the affected side; normally accompanied by neck range of motion (ROM) restriction and vague pain in the shoulder/upper back area; possibly accompanied by nausea, vomiting, photophobia (light sensitivity), and/or phonophobia (noise sensitivity) but less common than observed in migraine sufferers.
Because each patient may have a unique set of circumstances contributing to their headache and other symptoms, the specifics of treatment will vary from person to person. Conservative care for cervicogenic headaches in a chiropractic setting may include the following: spinal manipulation focusing on the upper cervical (occiput, C1, 2, & 3) regions as well as the whole spine; spinal mobilization in the cervical, cervicothoracic, and thoracic regions; soft tissue techniques including massage, trigger point therapy, vibration, myofascial release, and Graston technique; manual and/or home cervical traction methods; exercise training to stretch muscles, increase spinal range of motion, strengthen the commonly weak deep neck flexor muscles; physical therapy modalities such as electric stim, ultrasound, laser, others; relaxation exercises such as deep breathing; nutritional counseling emphasizing reduction of systemic inflammation; and education to help the patient better understand their condition, as well as encouragement to carry on their daily activities as best as possible and assurance they will experience improvement over time.
Interestingly, several studies have found that dysfunction in the neck may also play a role in other common forms of headache, like migraines. If a headache patient isn’t experiencing improvement from usual care, then it may be a good idea for them to consult with a doctor of chiropractic to find out if any issues in their neck may be a contributing factor in their headaches.
