Headache occurs at all ages. Primary headaches which occur on themselves and secondary headache is because of some reason. Therefore, it is essential for what kind of patient is suffering from.
One sided, origin from neck, reduced neck ROM, dizziness, shoulder blade hurts.
This headache arising with neck pain is also called a cervicogenic headache.
As the name suggest the cause of this headache is coming from cervical spine and this headache is usually associated with the neck pain.
Sustained posture ( forward neck), side posture with back of the neck pressed, tightened neck muscles injuries like RTA , whiplash, excessive strain/stretches on the neck, looking up on the celling like painter, hunch posture trigger points.
Top 3 nerves which enter the brain, hypersensitive brainstem.
When you come to pain physician, to diagnose it, there are certain criteria for it.
If the headache started along with the neck pain. Headache worsens with the neck movement.
There is restricted range of motion around neck.
Improvement in headache after resolution of neck pain. For this we do blockade of upper cervical nerves ( C2,C3 nerve block and if after blockade the pain goes away then this is another confirmatory
We use most modern techniques to diagnose.
- Structural imaging like magnetic resonance imaging (MRI) can diagnose:
disc degeneration, compensatory posterior ligamentous complex thickening, Dural or nerve root compression, spinal canal stenosis and facet arthropathy
Management
Usual treatment includes
- Physical therapy and exercises
- Medications include NSAIDs, TCAs – amitriptyline, Muscle relaxants such as baclofen, Anticonvulsants such as gabapentin or carbamazepine
- Percutaneous interventional procedures including local anaesthetic blocks and pulsed radiofrequency therapy
- Surgery
To see video demonstration of the percutaneous interventional procedure, follow the link https://youtu.be/rbSk9_c7WRM
