Neck Related Headaches

Headaches

Neck Related Headaches

Tension Headaches

Migraine Headaches

Pain Severity

Mild to Moderate – Sometimes Severe

Mild to Moderate

Mild to Severe

Pain Location

Usually One Side

Usually Both Sides

Usually One Side

Family History

No

No

Yes

Nausea

Sometimes

Sometimes

Yes

Vomiting

No

No

Yes

Aura

No

No

Sometimes

Neck Related Headaches

Headaches due to neck problems are called neck related or cervicogenic headaches. The joints, discs, muscles, and ligaments of the neck all contain nerve endings which are sensitive to neck injury or strains that can result in headaches. The pain of neck related headaches is usually worse at the base of the skull, and may spread to the forehead, temples, eyes, face and shoulder. Poor neck posture in moving your neck and/or holding your head and neck in one position for long periods may bring on the pain or make it worse. Neck muscles become stiff or tender and there may be abnormal findings on neck X-rays.

neck related headachesAdditional symptoms of neck related cervicogenic headaches include nausea, vomiting, sensitivity to noise or bright lights, dizziness, blurred vision, or difficulty swallowing. It is sometimes difficult to be sure of the headache type because these same symptoms can also be part of migraine headaches. Sometimes people with tension or migraine headaches may also have neck related headaches and may respond to treatments of the neck.

One study indicated that neck related headaches were diagnosed in at least 18 percent of people with more than four headaches per month and 2.5 percent of the population as a whole. Additional studies found that neck related headaches were diagnosed in 14 percent of people with frequent headaches and 16 percent of people with chronic headaches.

Causes of Neck Related Headaches

There are structures in the neck can cause neck related headaches, most commonly problems with the discs or facet joints of the upper and middle part neck are often involved with injury, arthritis and postural stress, while muscle strain may add to the overall pain.

Disc Problems

Discs in the neck provide much of the stability for the bones above and below them. The outer layer of the disc (anulus) has a very rich nerve supply that can be irritated if the disc develops tears or cracks. The anulus can be injured by a trauma, such as whiplash or by chronic strain due to poor posture. Tears in the outer portion of the disc cause inflammation and even the weight of the head puts more pressure on the weakened disc and causes more pain.

Facet Joints

The facet joints can also be a cause of headaches. When these joints begin to wear, they may pop or crack, however, these noises are not dangerous.

The joints contain cartilage and a rich supply of nerves, and they can wear down, become inflamed, and start hurting similar to other joints of the body. In a medical procedure called radiofrequency neurotomy, the pain can often be helped for 6 to 18 months by applying heat to the nerve.

Atlanto Occipital and Atlanto Axial Joints

Where the skull and neck meet at the top of the neck is a joint called the atlanto occiptial joint (A-O joint). The next joint down is called the atlanto axial joint (A-A joint). These joints do not have discs or facets, but either can become inflamed and cause pain and both joints are vulnerable to whiplash injury. Chronic neck pain and headaches from these joints may respond well posture modifications and retraction neck exercises. Additionally, Chiropractic adjustments may be helpful.

Muscle and Ligament Injury

Nearly two-thirds of recurring headaches are associated with muscle stiffness or spams, however, the muscles are most often not the main cause of pain. Pressure on neck muscles can cause pain, however, this also puts pressure on the facet joints lying under the muscle, so it is not always possible to identify the direct cause of the tenderness.

As a result of injury to a disc or facet joint, neck muscles may go into spasm adding to the overall pain. Discs and facet joints are far more vulnerable to injury and far more likely to cause chronic neck pain than muscles and ligaments.

Occipital Neuralgia

The greater occipital nerve is located at the base of the skull and runs through a muscle called the splenius capitis. In many people with neck related headaches, this muscle is tender and the nerve may be irritated. If a local anesthetic is injected into the muscle and around the nerve, the headaches may improve. On occasion, doctors perform surgery to relieve the pressure on the nerve, however the results are not very predictable.

Treatment of Neck Related Headaches

Changing or avoiding postures or activities that seem to precipitate headaches is an important first step. Once a headache is established, specific postures may relieve pressure on your neck.

Posture

Proper neck posture means alignment of the head and neck to minimize the forces on the discs, facet joints and other structures. Bad posture, especially when sitting for prolonged periods, is one of the most common causes of neck related headaches and improving posture often improves pain. Poor posture places strain on the discs and joints and causes pain.

Good neck posture is also related to good low back posture. It is necessary to sit straight and allow your back to keep its normal curve to balance the rest of the spine. Forward bending should occur mostly at the base of the skull, not the lower back.

Exercises

With the head and neck aligned and balanced, the muscles and ligaments have minimal stress and strain. It is nearly impossible to be in perfect posture all of the time, so the muscles and ligaments must partially support the head and neck. Conditioned muscles are more able to hold the head and neck in proper position and are essential to good posture.

Medications

The most useful over the counter medications for neck related headaches are acetaminophen, ibuprofen, and naproxen. There are much stronger medications that can be helpful, but they require a doctor’s prescription.

Injections

There are several types of injections that can be helpful for neck related headaches. There are two major categories of therapeutic injections; steriod injections and injections that heat or freeze a nerve (neurotomy) to stop it from conducting pain.

Surgery

Surgery should be the last thing to consider for treating neck related headaches, but it can be helpful in patients with severe pain who have not responded to other treatments. Sophisticated testing with X-rays, MRI scans, facet joint injections, and discography is necessary to determine the best surgical options.

Modification of posture and relief of inflammation using non-surgical or injection methods are the most practical and can help in most cases. Choosing a good pillow, using an effective home neck traction device along with specific exercises and supplements can improve the neck in both structure and function to help in the relief of headaches that may be related to the neck. Another natural alternative for headache relief is the Headache pressure point located on the hand.

For more on neck related headaches, see the headache neck pain article.