Cervicogenic Headaches

Question 1

What is a cervicogenic headache?

Answer 1

A chronic headache arising from the Atlanta occipital and upper cervical joints felt in more than one area of the head and/or face

Question 2

What are the symptoms of a cervicogenic headache?

Answer 2

• Unilateral or one-sided pain
• Same sided diffused shoulder and arm pain
• Reduced cervical ROM
• Pericranial muscular tenderness on the effected side

Question 3

What age group is impacted most by cervicogenic headaches?

Answer 3

30 - 44

Not usually presented to the healthcare professional until patients late 40’s

Question 4

Which structures are irritated that can cause cervicogenic headaches ?

Answer 4

structures innervated by C1, C2, C3 nerve roots:

• Zygopohyseal joints (most likely)
• Discs
• Ligaments
• Muscles

Question 5

Describe the clinical presentation of a cervicogenic headache

Answer 5

• Unilateral headache - “rams horn”
• Worsened with neck movement or posture
• Tenderness around C1, C2, C3
• Associated with neck pain or dysfunction
• Increase tightness in upper traps, levator scapulae, Scalenes, and sub occipital extensors
• Weakness in deep neck flexors
• Increase activity in the superficial neck flexors

Question 6

What are the different treatments for a cervicogenic headache?

Answer 6

First line = Physiotherapy:

• Cervical spine mobilisations
• Deep neck flexor strengthening
• Thoracic spine mobilisations
• C1-C2 SNAG

Second line

• Nerve blocks
• Triggerpoint injections
• Antidepressants - low dose to reduce pain loop