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Abe Cherrick, MD
Headache It Could Be a Pain In the Neck
National Spine & Pain Centers
. http://www.treatingpain.com

Headache It Could Be a Pain In the Neck

Many people suffering from headaches might be surprised to learn that their discomfort actually may be caused by a problem in their neck or cervical spine.
Cervicogenic headaches have their origin in the muscles, joints, or discs of the neck. These headaches can mimic the symptoms of other types of headaches so it is important to accurately identify the source of headache pain before beginning a treatment plan.
Getting the facts
A thorough physical examination accompanied by a detailed history will help the doctor determine the cause of pain. During the history, the physician will ask the patient to describe the type of pain experienced, the circumstances surrounding its onset, and any past trauma, like a motor vehicle accident, that might affect the cervical spine. This type of thorough assessment helps the physician get the information necessary to avoid needless, ineffective treatments, and help bring quick, targeted relief.
Exploring treatment options
The most superficial neck injuries may not initially cause headache pain. Simple muscle injuries may only cause localized neck pain, or may cause referred pain in the shoulders, arms, and head.
A prescription for anti-inflammatory and anti-spasmodic medications, coupled with a course of physical therapy, may be all that is needed to treat these complaints, but if these are ineffective; your doctor may recommend trigger point injections. Trigger point injections can deliver anti-inflammatory and anesthetic medicines directly to the muscle to calm both inflammation and spasm.
If a cervicogenic headache results from injury or arthritis in the facet joints of the cervical spine, a different approach is indicated. Your doctor may prescribe a pain relieving procedure in which X-ray guidance is used to place a cortisone injection directly into the affected joint, reducing pain and increasing range of motion. Ideally, the injection will be accompanied by a course of physical therapy to maximize gains. If facet joint injections fail to bring adequate relief, cervical medial branch blocks using cortisone and anesthetic medicine may be prescribed to desensitize the pain-generating nerve and relieve muscle spasms and bring relief from persistent cervicogenic headaches.
If these approaches do not ease a patient's cervicogenic pain, it may be necessary to perform a dorsal root rhizotomy, a procedure that uses x-ray guidance to deliver radiofrequency energy to the pain-generating nerve, deadening it and providing effective relief for months and even years.
If the source of cervicogenic headaches lies deeper still, in the discs of the cervical spine, then your doctor may recommend a course of treatment with epidural steroid injections.
Skilled Diagnostics are the key
The important thing to remember is that most headaches do not have a serious underlying cause, like stroke, aneurysm, or brain tumor. A great number of headaches are caused by tension in the neck muscles, arthritis, or damage to the facet joints in the cervical spine, or faulty discs that pinch the nerves in the cervical spine.
A good diagnostician will be able to deliver an accurate diagnosis of the source of your cervicogenic headache pain.

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