Most common headache disorders, such as tension-type headaches and migraines are primary headaches, meaning there isn’t an underlying structural cause for your symptoms. However, some headaches, called secondary headaches, are specifically caused by other health conditions.
One type of secondary headache that is often misdiagnosed is a cervicogenic headache. These headaches are commonly caused by an underlying structural problem in the neck – like arthritis or neck trauma or injury. People with these headaches often report a one-sided pain that causes pressure that radiates forward. Unfortunately, these symptoms are commonly reported in patients who experience other common headaches, such as migraines or tension headaches.
However, according to Mary Megally, D.O., a neurologist at Henry Ford Health, there are some important indicators that your provider should look for that would help distinguish cervicogenic headaches from others.
Why Cervicogenic Headaches Occur
Neck injuries, even if minor, can cause muscular and cervical dysfunction. Often, we don’t think about the stress strains or injuries can have on the rest of the body. As a result, sore muscles following an injury can trigger headaches.
“Cervicogenic headaches are often triggered by neck movements, so to many, it may seem like they come out of nowhere – which is why they are often mistaken as tension or migraine headaches,” says Dr. Megally. “And while migraines can cause neck pain, cervicogenic headaches often lack other classic migraine features such as nausea and light sensitivity.”
Evaluating Patients For Cervicogenic Headaches
To help distinguish what type of headache you are experiencing, neurologists use several key points to evaluate your symptoms including:
- Your history of headaches. “Age makes a difference here,” says Dr. Megally. “While migraines are often something that start in the early teens or twenties, cervicogenic headaches typically begin in early 30s or 40s.”
- Your headache triggers. Your provider may ask questions to determine if a recent accident or strain from daily activities could be contributing to your discomfort.
- A physical exam. Your doctor will want to evaluate for any muscle tension in your head, neck and shoulders as well as indicate any trigger points of pain and your current range of motion.
- Imaging. In some cases, your neurologist may want to do imaging of your spine to further understand your symptoms. For example, conditions like arthritis can be seen in imaging and can also cause these headaches.
- Diagnostic nerve block. The International Classification of Headache Disorders (ICHD) has specific criteria for diagnosing cervicogenic headaches. A nerve block is often used to confirm your diagnosis. If it helps provide relief for your headache, then it is likely you are suffering from cervicogenic headaches.
Treating Neck Pain-Related Headaches
“If we do consider your headache to be a cervicogenic headache, physical therapy is the first step,” says Dr. Megally. “These exercises are not only meant to help reduce your pain but also strengthen weak muscles and improving joint mobility in your neck and spine that are causing the dysfunction.”
There are also medications that can help. Not only are nerve block medications used diagnostically, but they can also be used to provide regular pain relief. Additional prescriptions such as neuropathic medications and muscle relaxers can be used to help manage nerve pain. Surgery is only considered if something structural is impeding on your recovery.
Most importantly, if the pain or frequency of your headaches are impacting your quality of life, you don’t need to “live with” discomfort – or rely on tons of medications to find relief. Talk to your primary care provider or neurologist about your symptoms so they can help you find the right diagnosis.
Reviewed by Dr. Mary Megally, a neurologist who sees patients at Henry Ford Medical Centers - Bloomfield Township and Royal Oak.
