Headache | Neck-related Headache Pain
A headache is one type of pain that may be associated with problems with the soft tissues of the neck or cervical spine. A neck-related headache is called a cervical headache or cervicogenic headache. This type of pain is most commonly found in the back of the head and upper neck, where the muscles of the neck are continuous with the muscles of the skull. These muscles may go into spasm if there is problem with the nerves that leave the cervical spine. Neck-related headache pain is less commonly described as sharp and more commonly described as aching, throbbing, or dull.
A less common cause of a headache is an infection such as meningitis. People may suspect a serious problem such as meningitis when fever symptoms begin presenting at the same time as the headache symptoms.
Cervicogenic Headache: Someone with a cervicogenic headache does not have a pain source that originates in their skull and brain. These people do not have a neurologic problem that originates in their brain. Rather, the patients that have a cervicogenic headache have headache pain related to problems in the neck. The structures involved in causing a cervicogenic headache include the neck muscles that attach to the skull and the elements of the cervical spine, including the spinal nerves.
Cervicogenic headaches typically start in the suboccipital area, which is towards the base of the back of the skull. The suboccipital area is the area where the muscles of the back of the neck connect to the base of the skull. The pain originates here, and may be unilateral or bilateral (on one or both sides of the body). The pain begins here and radiates up and around the head. To visualize the area of the head that is affected by pain, take the palm of your hand and cup it around the back of your head, with your thumb and index finger touching the biggest neck muscles. Usually, the pain remains centralized to the back of the head, but it rarely travels towards the front of the head and behind the eyes.
What causes a Cervicogenic Headache? The neck problems that lead to this type of pain condition can be traced back to the problems with the cervical spine, including its sever vertebrae, the spinal nerves that emerge from it, and the other muscles and structures that connect to it. The joints that link vertebrae together at the back of the spine are known as the facet (zygapophyseal) joints. Some of the elements that make up the facet joints include the synovial fluid, synovial capsule, and cartilage. Like the other joints in the body, they may get irritated, inflamed, and painful due to injury, poor posture, and other factors. The nerve that supplies these facet joints is called the medial branch. This medial branch passes into the facet joints, and sometimes emerges from it to become another nerve. The third occipital nerve is the nerve that emerges from it and crosses the C2-C3 facet joints. The facet joints are named according to the two vertebrae that make up each facet structure. The third occipital nerve passes through the C2-C3 facet joints and continues to the back of the scalp.
What causes this occipital nerve to become irritated or to react in a way that the patient experiences pain as a result of it? Whiplash injuries are the most common cause. These injuries occur as a sudden change in velocity whip the head and neck back and forth. The C2-C3 facet joints may be traumatized by this type of violent motion. The injury to the facet joints spreads to the third occipital nerve leading to the headache symptoms that people experience.
Cervicogenic headache treatments include radiofrequency rhizotomy, cervical manipulation, and myofascial release.