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Chronic Cervicogenic Headaches

Chronic Cervicogenic Headaches

Treating Chronic Cervicogenic Headaches

Chronicheadaches are defined as the occurrence of headache symptoms 15 or more times in a given month. Depending on the origin and root cause of the pain Newbridge can offer several solutions which are outlined below.

Diagnosing Cervicogenic Headaches

Excessive amounts of stress to the neck and spine are the most common causes of cervicogenic headaches, symptoms include a steady, non-throbbing pain to the back and base of the skull. The pain can also sometimes extend down to the neck and between the shoulder blades, occasionally pain is experienced behind the brows and the forehead.

Criteria for diagnosis has been established but its presenting characteristics may be difficult to distinguish from primary headache disorders such as migraine, tension-type headache, or hemicrania continua. Diagnostic workup begins with a careful history overview and physical examination. This is followed by ordering appropriate diagnostic studies including standard radiographs, 3-dimensional CT, MRI, and possibly electromyography; nerve blocks may also be used to confirm the diagnosis.

Treatment Options

Patients experiencing headaches as a result of a cervicogenic component  can be treated by performing one of the following: cervical epidural steroid injections, greater and lesser occipital nerve blockade, radiofrequency thermal neurolysis or trigger point injections. These treatments can all be performed at Newbridge Spine’s on-site ASC facilities in Frederick, Waldorf and Prince Frederick. It’s important to note that cervicogenic headaches are not always able to be cured but once properly diagnosed, they are able to be managed effectively.

  1. Cervical epidural steroid injections relieves pain in the neck, shoulders and arms caused by a pinched nerve or nerves in the cervical spine. Conditions such as herniated discs, spinal stenosis, or radiculopathy can compress nerves causing inflammation and pain. Medication injected here helps decrease the swelling of these nerves.
  2. Greater and lesser occipital nerve blockade is an injection of a steroid or other medication around the greater and lesser occipital nerves that are located on the back of the head just above the neck area. The steroid injected reduces the inflammation and swelling of tissue around the occipital nerves. This may in turn reduce pain and other symptoms caused by inflammation or irritation of the nerves and surrounding structures. Typically, headaches over the back of the head, including certain types of tension headaches may respond to occipital nerve block
  3. Radiofrequency thermal neurolysis uses high frequency radio waves to produce a heat lesion. The lesion created can then inactivate a nerve that is responsible for transmitting pain. This technique is most commonly applied to treat spinal pain caused by facet joint disease. This type of treatment works in the lumbar area for facet joint arthritis, as well as in the cervical neck region where facet pain is caused by arthritis or from whiplash injuries.
  4. Trigger Point Injections are procedures used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.

In a study of 520 Chronic Migraine Patients, 80% were not properly diagnosed. A percentage of those cases were the result of a cervicogenic component

[Source: *http://www.mychronicmigraine.com]

Migraines
Patients presenting with migraines would not be appropriate for care at our center but will be referred to the care of a trusted neurologist for proper treatment.

Newbridge Spine and Pain Center is able to evaluate and treat any patient suffering from chronic headaches. If you believe you may be a candidate for treatment of chronic headaches contact us to schedule a consultation.