2020 Is Giving Me a Headache...

Unfortunately, at one point, everyone has suffered from a headache. Headaches affect almost half of our population (1). There are a wide variety of headache triggers- stress, dehydration, your significant other, family holidays, food, allergies, or literally any of the events that have transpired in 2020. Headaches may also stem from deeper medical issues. Don't worry- we screen you for those too at your appointment!

It is estimated that 15-25% of all headaches are classified as “cervicogenic,” meaning that they are referred from the cervical spine- aka your neck. The average age for someone affected by CHG (cervicogenic headaches) is 40 years old and disproportionately affects women 4x as often as men (2). CHG is most commonly found in patients who have experienced trauma, like a car accident or an earlier concussion (3). This condition is also prevalent in weightlifters (7).

Symptoms of CHG include neck tenderness and stiffness. Moderate to severe pain may begin in the cervical spine and progressively affect the regions of your head. Check out the above image for typical pain patterns. In some instances, pain may even affect the ipsilateral arm- meaning the arm that is on the same side of the body as the headache (4). Often times, we see range of motion loss in your neck. Trigger points are prevalent in the upper trapezius, suboccipital, cervical and shoulder girdle musculature (basically all of the area between the shoulder blades and the neck) (6). CGH patients often demonstrate a loss of strength in the deep neck flexors.These symptomatic episodes can last anywhere from a few hours, to a few days. Pain has been described as deep, aching, and can be triggered or reproduced by sustained or awkward neck postures or pressure through some of your neck musculature. (5).

Does your Google search have you feeling like you have a brain tumor? The American Headache Society endorses the acronym “SNOOP” – not “shoop” unfortunately, where my Salt-N-Pepa fans at?!? “SNOOP” identifies worrisome headache red flags and goes as follows:

Systemic symptoms: fever, weight loss, or the presence of systemic risk factors

Neurologic signs: confusion, impaired alertness, or consciousness

Onset: sudden or abrupt headaches that develop and peak very quickly

Older: new headaches in patients over 50

Previous headache history: any new headaches that deviates significantly from a prior pattern of frequency, severity, and clinical features (8).

Management for cervicogenic headaches includes a multifaceted approach. Since CGH is caused by upper cervical joint dysfunction, spinal manipulation is at the forefront of treatment. Myofascial release and stretching may be needed as well. We will also show you how to do a few exercises at home if needed.

Headaches should NOT be a normal part of life. Give us a call or text to get set up with an appointment. Until next time, Dr. Amy

References 1. Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton RB, Scher AI, Steiner TJ, Zwart JA. The global burden of headache: a documentation of headache prevalence and disability

worldwide. Cephalalgia. 2007 Mar;27(3):193-210.

2. van Suijlekom HA, Lamé I, Stomp-van Den Berg SG, Kessels AG, Weber WE. Quality of life of patients with cervicogenic headache: a comparison with control subjects and patients

with migraine or tension-type headache. Headache. 2003 Nov 1;43(10):1034-41.

3. Treleaven J, Jull G, Atkinson L. Cervical musculoskeletal dysfunction in post-concussional headache. Cephalalgia. 1994 Aug;14(4):273-9.

4. Antonaci F, Sjaastad O. Cervicogenic headache: a real headache. Current neurology and

neuroscience reports. 2011 Apr 1;11(2):149-55.

5. Biondi DM. Cervicogenic headache: a review of diagnostic and treatment strategies. The

Journal of the American Osteopathic Association. 2005 Apr 1;105(4_suppl):16S-22S.

6. Hall T, Robinson K. The flexion–rotation test and active cervical mobility—a comparative

measurement study in cervicogenic headache. Manual therapy. 2004 Nov 1;9(4):197-

202.

7. Rifat SF, Moeller JL. Diagnosis and management of headache in the weight-lifting athlete.

Current sports medicine reports. 2003 Sep 1;2(5):272-5.

8. Silberstein SD, Lipton RB, Dalessio DJ. Overview, diagnosis, and classification. In: Silberstein SD, Lipton RB, Dalessio DJ, eds. Wolff’s Headache And Other Head Pain. 7th ed. Oxford, England: Oxford University Press; 2001:20