Suffering from persistent headaches? Explore this overlooked cause…

This content is sponsored by Virginia Spine Institute

We’ve all suffered from that nagging headache, but did you know headaches can sometimes be caused by the spinal nerves within your neck? These headaches are called cervicogenic headaches and are sometimes misdiagnosed as either migraine or cluster headaches (headaches that originate in the head).

“The roots of the upper 3 cervical spinal nerves (located at C1, C2, and C3) share a pain nucleus (which routes pain signals to the brain) with the trigeminal nerve,” explains Dr. Brian Subach, Spine Surgeon at Virginia Spine Institute. “The trigeminal nerve is the main sensory nerve that carries messages from your face to your brain. Because of the shared nerve tracts, pain is misunderstood and thus “felt” by the brain as being located in the head.”

Determining the origin of the headache can be difficult because almost all types of headaches share common symptoms of throbbing pain, nausea, sensitivity to light, and sensitivity to noise. The signs and symptoms that could point towards a cervicogenic headache include tenderness at the base of the skull and possible exacerbation of symptoms with head and neck movement.

A proper diagnosis should include:

  • A medical history and a physical examination
  • A series of basic cervical spine x-rays
  • An open-mouth view of the skull and a lateral skull x-ray may be necessary
  • Diagnostic tools that aim to reduce pain levels to help narrow down the origin of the headache within the cervical spine. It may take several diagnostic tools to arrive at the understanding of the precise source of the cervicogenic headache.
  • Although not mandatory, a CT or MRI may be of interest

The type of treatment a patient receives is dependent on the type of headache they have to ensure the utmost success in relieving the headache without prolonging the pain and extra cost of erroneous treatment. As a general rule, treatment begins once the diagnosis of cervicogenic headache has been made.

Common treatment options involve pain medications, including non-steroidal anti-inflammatory drugs {NSAIDs}, anti-seizure agents such as gabapentin, tricyclic anti-depressants, and/or migraine prescriptions.

Additionally, botulinum toxin injections may be recommended. “Botox has been used since the early 1980s for medical purposes, specifically for headaches,” explains Dr. Niteesh Bharara, Interventional Pain Management Specialist at Virginia Spine Institute. “This is because the botulinum toxins act directly on the muscle by blocking the release of acetylcholine. This helps the muscles to relax, calming the pain signals transmitted to the transgeminal nerve.”

Don’t let headaches rule your life — get to the root of the issue and see a specialist today! Don’t delay! Click here to schedule or call us today at 703.709.1114.


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