Cervicogenic Headache

What is a Cervicogenic Headache?

A cervicogenic headache usually begins as a steady, dull ache in the side 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
• Nausea
• Blurred vision

The condition is the result of a structural problem in the neck and is often caused by vertebrae issues at the top of the spinal cord. Often people who work jobs that require prolonged straining of the neck, such as manual laborers, hairstyles, drivers among others, can lead to muscle tension that can trigger a cervicogenic headache. Other causes of cervicogenic headaches include tumors, fractures, infections, arthritis, and traumatic injury to the neck such as whiplash.

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.

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 bletable, 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.
•  A mixture of a numbing medication and steroid is 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. The goal of botulinum toxin, or Botox, 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 relied 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
• Medications
• 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.