Cervicogenic headache is a painful discomfort with chronic evolution manifested in the area between the atlanto-occipital joint and the upper cervical segments C1, C2, C3, commonly known as the neck region. In most situations, this type of headache is accentuated by sudden movements of the neck and shows a tendency to radiate to the occipital region and the face. The pain is of a secondary type, being caused by a trauma to the cervical area, an infectious process or the persistence of elevated blood pressure values.
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Cervicogenic headache causes
The main pathological mechanism that generates the appearance of this type of pain is represented by irritation of emerging nerve fibers at the level of the C1-C3 cervical joints, responsible for the transmission of nerve impulses to the nociceptive nucleus of the head and neck (trigeminocervical nucleus).
The main factors that contribute to the occurrence of headaches in the neck area are:
- Cervical trauma
- Sudden acceleration-deceleration injuries (car accidents)
- Muscle tension caused by adopting bad positions during work (especially office work)
- Involuntary contraction of the neck and scalp muscles due to intense stress.
Diseases associated with headache in the neck area
Pathologies with a high risk of unfavorable evolution in the long and short term that can associate cervicogenic headache includ:
- Intracranial tumors
- Bacterial meningitis/viral meningitis
- Giant cell arteritis (inflammation of the endothelium of the arteries located in the head and temples)
- Subarachnoid hemorrhage (bleeding manifested in the space between the brain and the membrane that covers it – the arachnoid)
- Carotid artery or vertebral artery dissection.
Fortunately, these conditions represent a less frequent cause of head and neck pain, but they should not be excluded by the clinician due to their increased potential for adverse evolution in the absence of prompt institution of specific treatment.
Other symptoms that accompany cervicogenic headache
The main manifestations that can be present in the evolution of this type of headache include:
- The feeling of stiffness with the limitation of neck mobility
- Extension of the pain to the shoulder or upper limb
- Painful periocular discomfort (at eye level)
- Sensitivity to intense light
- Blurred vision
- Dizziness
- Sometimes feeling nauseous.
When should we contact a doctor?
Cervicogenic headache must be an alarm signal in situations where it is accompanied by certain manifestations represented by:
- Fever, increased stiffness of the neck (the patient cannot put his chin on his chest)
- Skin eruptions
- Jet vomiting
- Neurological manifestations with specific aura, which may suggest the evolution of a severe pathology with a high potential for the occurrence of harmful complications.
The sudden installation of a pain at the posterior cervical level or that gradually worsens in the absence of the obvious action of some predisposing factors or that manifests itself in the context of an HIV infection or against the background of some personal antecedents of tumoral pathologies of the central nervous system, constitute other alarm signals that should direct the patient to the neurologist or infection specialist.
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Relief of headaches
The medicinal treatment of cervicogenic headache that does not manifest itself against the background of underlying conditions with unfavorable development potential can be carried out with the help of:
- Nonsteroidal anti-inflammatory drugs
- Muscle relaxants
- Neuroleptics of the type of tricyclic antidepressants administered according to the recommendations of the attending physician
- Epidural administration of injectable solutions with steroids.
TENS transcutaneous electrical nerve stimulation is a physiotherapy procedure which uses low-frequency electrical impulses for the temporary relief of cervicogenic headache, without eliminating the causes that favor its occurrence.
Learn more about physiotherapy for pain relief and regaining mobility
Nerve block interrupts the transmission of nerve impulses along the paths of the nerve roots located at the C1-C3 level and may involve the local administration of an injectable anesthetic substance or thermal ablation by radiofrequency.
The administration of nonsteroidal anti-inflammatory drugs for the treatment of cervicogenic headache
Nonsteroidal anti-inflammatory drugs represents a class of drugs used to relieve pain, reduce inflammation and combat acute fever in the evolution of an extensive number of pathologies. The administration of this type of medicine in large doses or for long periods of time can generate unwanted side effects among which are found:
- Adverse reactions in the gastrointestinal tract – gastric discomfort, nausea, vomiting, diarrheal stools, digestive microhemorrhages or gastric ulcer.
- Affecting the excretory system by decreasing the blood flow at the renal level and the glomerular filtration rate with the appearance of hydrosaline retention.
- Increased risk of morbidity cardiovascular – NSAIDs can cause the occurrence or exacerbation of arterial hypertension with an increased risk of congestive heart failure.
- Increasing the risk of hemorrhagic accidents and affecting the functioning capacity of the hematogenous marrow which can be manifested by thrombocytopenia, leukopenia, hemolytic and aplastic anemia.
- Liver damage and increased serum transaminases.
The etiological treatment of cervicogenic headache addresses the causes that induce its occurrence this manifestation and may include:
- Physiotherapy – represents a method of treating cervicogenic headache due to structural causes and aims to reduce the tension in the head and neck muscles, frequently caused by long-term adoption of vicious working positions.
- Therapeutic massage – the application of massage techniques specific to the occipital area, cervical distension techniques, stretching and elongation maneuvers, manipulations or mobilizations of the cervical spine to relieve muscle contractions that cause pain.
- Appropriate treatment of infectious pathologies that associate pain in the head and neck.
- Maintaining the tensional values within physiological limits.
- Prompt therapeutic management in the case of patients with head trauma, acute vascular events (carotid artery dissections) or brain tumors that can cause headaches in the neck area.
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2024-03-10 23:08:43
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