What is a Cervicogenic Headache?
A cervicogenic headache is triggered by an issue in the neck. It usually begins as a steady, dull ache in the side or back of the neck. The pain will then radiate upward to the back of your head, usually on one side. It can spread to the forehead, temple, and areas surrounding the eyes and/or ears.
At times, the pain associated with cervicogenic headaches can be difficult to distinguish from a migraine or tension headache. However, there are common symptoms that make these headaches easier to diagnose, such as:
- Reduced range of motion in the neck
- Pain in the neck, shoulder, eyes, or arm, usually on one side of the body
- Pain on one side of the face or head
- Head pain triggered by certain movements or positions of the neck
- Sensitivity to light and noise
- Blurred vision
The condition can the result of tight muscles in the back of your neck, irritation of nerves in the back of the neck, or a structural problem in the neck vertebrae. Often, people who work jobs that require prolonged straining of the neck, such as manual laborers, hairstyles, and drivers among others, can lead to muscle tension that can trigger a cervicogenic headache. Other causes of cervicogenic headaches include traumatic injuries such a whiplash, arthritis, infection, tumors, or certain fractures.
Treatment depends on what is causing the cervicogenic headache, and likely will include a combination of the following:
- Conservative treatment: medications, physical therapy, massage therapy
- Injections: occipital nerve blocks, botulinum toxin injections, facet joint injections
- Surgery is rarely needed
Occipital Nerve Block Procedure to Relieve Cervicogenic Headaches
Cervicogenic headaches originate most often in the back of the head or neck area. Many patients will say that the pain starts at the base of their skull and travels up to the top and/or sides of their head and even spread to the forehead. This can occur due to tight, or dystonic, muscles in the back of the neck and also due to irritation to the occipital nerve. Many times, an occipital nerve block is extremely effective at reducing cervicogenic headaches caused by irritation of the occipital nerve.
At Janerich Pain Specialists, we use an ultrasound machine to locate the occipital nerve so the precise area that needs to be injected is directly visualized at all times. This has been shown to improve outcomes and accuracy of the injection. It can take as little as 15 minutes for the patient to notice improvements, with full pain relief within several days, depending on the patient.
Occipital nerve block procedure steps:
- While the patient is lying face down on the procedure table, the skin will be cleansed with Chloraprep, Betadine, or an alcohol solution.
- An ultrasound machine that has been sterilized is then used to locate the occipital nerve.
- Using direct ultrasound visualization a fine needle is advanced until the tip is just next to the occipital nerve, ensuring that any nearby blood vessels are avoided.
- A mixture of a numbing medication and steroid is then injected.
- Some patients notice relief within minutes although many notice relief in several days.
- Patients are advised to rest following the procedure but can return to normal activity the following day as tolerated.
- Pain relief varies from individual to individual, but on average, many will remain pain-free for months afterward.
- The procedure can be repeated if needed.
The effects of the procedure vary from individual to individual, but on average, many will remain pain-free for months afterward. Typically, patients will need three to four injections per year.
Botulinum Toxin, Botox or Dysport, injections to relieve Cervicogenic Headaches
If the origin of the headache is stemming from tight, or dystonic, muscles in the neck or base of the skull, an injection with botulinum toxin may be recommended. There are several types of botulinum toxin such as Botox or Dysport. The goal of botulinum toxin is to relax the muscles that are tight and/or in constant spasm. The doctors at Janerich Pain Specialists use EMG guidance when injecting botulinum toxins to ensure the precise location of the medication into the tight muscle. Patients typically experience relief in 10-14 days from injection and it can last up to 90 days. The procedure is repeated every 3 months to maintain pain relief.
Other Treatments Available for Cervicogenic Headaches
Although botulinum toxin injections and occipital nerve blocks are both safe and effective in treating cervicogenic headaches, there are other treatments available, such as:
- Home remedies such as routine breathing techniques, exercise, and stretching
- Physical Therapy
- Electrical stimulation to the nerves
- Rarely surgery is needed
- However, it’s always important to speak with an experienced medical professional to know what your best medical options are going forward.
How Janerich Pain Specialists Can Help
The physicians at Janerich Pain Specialists have decades of experience treating neck pain. Dr. David Janerich completed specialized fellowship training using ultrasound and neurotoxins to help patients experience many more headache-free days. Dr. Janerich and his team are prepared to help relieve the symptoms of cervicogenic headaches so you can continue with your daily life.
If you suffer from cervicogenic headaches and are interested in learning more about the occipital nerve block procedure, schedule an appointment with our experienced medical team today.
Don't Let Pain Hold
You Back Any Longer
Real Clients...Real Stories
I was recently referred to Dr. Janerich by my podiatrist regarding chronic pain in my knees that I have suffered from for years due to osteoarthritis. I have had pain in my knees since I was 38 years old; I am now 65.
I have tried a multitude of treatments. Among them: Laser treatments, physical therapy, Synvisc injections by an Orthopedic doctor, acupuncture and serious pain pills, along with hundreds of dollars of supplements that promised to turn me into Wonder Woman. [That never happened] No former treatments ever gave me any long-lasting relief. When I saw Dr. Janerich, he gave me something I hadn't experienced in years, "HOPE".
He offered me a nerve block procedure to ease my pain and other options for longer term relief. He was patient and thorough. I never knew there was a bridge treatment between the Synvisc injections and total knee replacements.
So far, the nerve block has been working like a miracle. I may never run a marathon, but I feel so much better. My outlook is positive and I am sure glad I went for this treatment.
Dr. Janerich's staff is friendly and personable. I would recommend anyone to come to this office for pain relief.
Approximately 20 years ago, I had a work related injury that resulted in serious injury to both my upper and lower back also affecting my legs. There have been many times that the pain in my legs was so severe that I didn't even think they would hold me up.
After endless visits to chiropractors, acupuncturists and physical therapists I still ended up with limited or no relief. In some cases it actually made my pain worse.
I went to see two surgeons from The University of Philadelphia who told me that I would need several surgery's and even if everything went perfectly I would still only have about 50% relief. They told me that we all have our crosses in life to bear and that I should consider this mine. They felt the risk and recovery from multiple surgery's would not be worth any minimal reward. I was so discouraged and resolved to the fact that there was no choice but to live with this debilitating pain. I didn't want to take pain killers as they would only mask the pain for a short time and I would just have to keep taking them. This was not an option for me. I took Tylenol and tried to aggravate my back as little as possible.
Anyone who has a back injury or chronic pain knows exactly what I'm talking about. You still have to live your daily life in spite of it. I became very depressed believing that this was just how it was going to be.
About three months ago, I began treatment with Dr. David Janerich. He introduced me to new options and procedures which aren't regularly practiced or even recognized in our area that might help with my chronic pain. I figured, what do I have to lose.
After several injection treatments, for the first time in 20+ years I finally have received considerable relief. I am able to perform my normal daily functions with little to no pain. Things that people normally take for granted were now possible. My leg pain is totally gone
now and any back pain I have is minimal. I never thought that this would have been possible for me.
His entire staff have been great. They handled all necessary paperwork and pre-authorizations from the insurance company. They are all compassionate and truly care about their patients.
Dr. Janerich's dedication in helping his patients obtain a life without severe chronic pain is second to none. I would highly recommend that anyone who was in my condition give him the opportunity to use these same procedures and change their lives as well.