A cervicogenic headache is a headache that actually involves the neck. Through different treatment options, chiropractors are one of the better choices when it comes to treating this issue.
Who is most affected?
The mean age for cervicogenic headaches is in the 40’s, and the condition affects women more often than men at a rate of 4:1 (1,3). Cervicogenic headaches can be as debilitating as tension or migraine headaches, and a loss of cervical spine function compounds the problem. It is common in patients who have experienced trauma, especially a motor vehicle accident or an earlier concussion (4). The condition is particularly prevalent in weightlifters (10).
Symptoms:
Cervicogenic headache patients typically have neck tenderness and stiffness. By definition, pain is typically on one side shift, but in some cases, the condition may present on both sides. Moderate to severe pain may begin in the neck and progressively affect areas in the head. Symptomatic episodes may last hours to days. The characteristic continuous, fluctuating pain is described as deep but generally not throbbing. Symptoms may be triggered or reproduced by sustained or awkward cervical spine postures (6).
Trigger points are prevalent in the upper trapezius, suboccipital, cervical and shoulder girdle musculature (7,59).
Cervicogenic headache patients often demonstrate a loss of strength in the deep neck flexors and over-activation of the SCM and upper trapezius muscles (8,9).
The most common cause of cervicogenic headaches are upper cervical spine restriction (12). Restrictions in motion in the upper cervical area is present in 63% of CGH patients and has good reliability (13). Lower cervical spine restrictions may also be a culprit, especially following trauma (14). Adjacent spinal regions should be assessed as limited upper thoracic mobility leads to substitution with excessive extension in the upper cervical spine (41).
Co-existent myofascial problems are consistently present (15). Palpation of trigger points in the suboccipital, SCM, upper trapezius, levator, scalenes, pectoral and temporalis muscles often reproduces or intensifies symptoms (4,17). There is a strong association of trapezius muscle tenderness to intensity and number of symptomatic headache days. (57) Upper crossed syndrome is also often present.
Do I need imaging?
Although radiography, advanced imaging, and lab tests may be needed to identify alternate diagnoses, these tests are non-confirmatory and of limited value for cervicogenic headache patients (18). MRI has shown no demonstrable anatomic difference between CGH patients and asymptomatic subjects (12).
Outcomes with Chiropractic:
A survey of 381 chiropractors found that over 80% of plans for recent onset headache (less than 3 months duration) required less than 10 visits scheduled at 1-2 visits per week for less than 8 total weeks (58)
One randomized controlled trial demonstrated that 6-8 of SMT sessions produced good outcomes (45)
A Spine Journal study found that spinal manipulation cuts the number of CGH symptomatic days in half, and the number of treatments has a linear dose response to improvement (55).
At Creekside, we typically combine SMT with myofascial release to provide the best outcomes for our patients. The combination of neural mobilization and soft tissue techniques induces significant improvement of pain and function (51).
Other treatments:
Myofascial release and stretching may be needed in the suboccipital, SCM, upper trapezius, levator, scalenes, pectoral and temporalis muscles. Fascial adhesions in the connection between the suboccipital region and cervical dura may restrict normal upper cervical motion and may be released with IASTM.
Although some patients report palliative relief of CGH symptoms with NSAIDs, medical management of CGH is generally ineffective (34).
At Creekside Chiropractic & Performance Center, we are highly trained to treat this condition. We are the only inter-disciplinary clinic in Sheboygan county that provides chiropractic, myofascial release, ART (Active Release Technique), massage therapy, acupuncture, physiotherapy, rehabilitative exercise, nutritional counseling, personal training, and golf performance training under one roof. Utilizing these different services, we can help patients and clients reach the best outcomes and the best versions of themselves. Voted Best Chiropractor in Sheboygan by the Sheboygan Press.
Evidence Based-Patient Centered-Outcome Focused
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