Cervicogenic headache

Approximately 47% of the global population suffers from headache, and 15-20% of those headaches are cervicogenic^1,2. This refers to headache caused by disorder of the cervical spine and its components – which includes the cervical facet joints and surrounding muscles. The exact aetiology is still unclear but is thought to be a result of sensory input from these upper cervical structures³.

Patients with cervicogenic headache will usually have accompanying neck pain, altered neck posture and restriction in neck movement. Muscle trigger points are found in the muscles at the base of the skull, and in the neck and shoulder, which can refer as a headache when manually stimulated or stretched.

Imaging such as X-rays, CT scans and MRIs cannot detect cervicogenic headache, but are used to exclude serious pathologies.

Treatment for cervicogenic headache includes:

• Joint manipulation/mobilisation: both are effective in the treatment of cervical pain, although manipulation (chiropractic adjustment) has been shown to be superior to mobilisation in the acute phase⁴. In addition, patients with neck pain with or without headache tend to get greater relief when this is combined with exercise (as compared to exercise alone).
• IASTM (instrument-assisted soft tissue mobilisation): this targets the fascial tissue, which often contributes to pain due to adhesions and restricted movement between layers of fascia. There are several fascial connections in the suboccipital and cervical region. These are treated either with a specially shaped steel device, or with hands-on myofascial techniques.
• Therapeutic exercise: strengthening the neck & upper back musculature is the long-term treatment for cervicogenic headache. Tailored exercise programs to treat chronic postural issues in the neck may reduce the frequency & severity of chronic pain.

If you are a recurrent sufferer of headaches, this could be cervicogenic in origin. Come in for an assessment to see if we can help.

1. Stovner, L., et al., The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia, 2007. 27(3): p. 193-210. 15.
2. Haldeman, S. and S. Dagenais, Cervicogenic headaches: a critical review. Spine J, 2001. 1(1): p. 31-46. 17.
3. Bogduk, N., Cervicogenic headache: anatomic basis and pathophysiologic mechanisms. Curr Pain Headache Rep, 2001. 5(4): p. 382-6
4. Gross, A., et al., Manipulation or mobilisation for neck pain: a Cochrane Review. Man Ther, 2010. 15(4): p. 315-33.