Headache is a symptom of pain located in the head
Headache is a common clinical problem with nearly half of the general population suffering from headaches at some time in any year. 1
According to the International Classification of Headache, there are over 200 types, sub-type, and sub-form of headaches.2
Migraine, tension-type headache, and cervicogenic headache are the common types of headaches.
Neck & Head Pain
Cervicogenic headache was first described in 1983.3 Cervicogenic headache is a secondary type of headache that starts with discomfort or pain in a region of the cervical spine (neck) then extends into the head. Normally the head pain is felt unilaterally (one-sided) or unilateral head pain on both sides (bilateral). The intensity of head pain fluctuates between moderate to severe, with a characteristic of non-throbbing, non-lancinating pain. The duration varies between a few hours to few weeks.
Cervicogenic Diagnostic Criteria
According to the Cervicogenic Headache International Study Group, the sole criterion for diagnosis of cervicogenic headache is a positive finding in either of these two points: 4
- Mechanical precipitation of head pain with pressure over the upper cervical (upper neck) or occipital (base of skull) regions, and/or
- The intensity of the head pain increases with movement of the neck or a sustained awkward neck position
The next three criterions do not diagnose cervicogenic headache alone, however, in combination with the previous criterions it fortifies the diagnosis of cervicogenic headache: 4
- Restrictions of the cervical range of motion
- Ipsilateral neck, shoulder, or arm pain (i.e. neck, shoulder, or arm pain on the same side as the head pain)
- Relief of head pain with administration of diagnostic anesthetic blockades into the upper cervical
Other features that are of a lesser importance, and do overlap the signs and symptoms of migraine (“Migrainous” symptoms) but can occur in cervicogenic headache sufferers include: 4
- Photophobia and photophobia
- Ipsilateral (one-sided) “blurred vision”
- Difficulties in swallowing
- Ipsilateral edema (mainly in the periocular area)
A large percentage of headache symptom stem from extended periods of poor posture, which includes:
- Sustained posture of the head forward relative to the torso
- Sustained posture of shoulders rounded forward
- Sustained posture of increased thoracic kyphosis (hunched back)
- Sustained posture of decreased lumbar lordosis (straightening of the lower back natural curve)
This poor posture is defined as excessive anterior (forward) orientation of the head and shoulders relative to the vertical plumb line of the body.5
Constant poor posture can lead to adaptation to an imbalanced musculoskeletal system, such as myofascial trigger points, decreased joint range of motion and cervical facet joint stiffness. Poor posture is the main contributor to neck dysfunction. Cervicogenic headache has a source of pain in the upper cervical spine (upper neck). Maybe your headache is the result of your poor posture?
1.Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, Steiner, T, Zwart, JA (2007). The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia;27(3),193-210.
2.IHS (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia;33(9), 629-808.
3.Sjaastad O, Saunte C, Hovdahl H, Breivik H, Grønbaek E (1983). Cervicogenic headache: An hypothesis. Cephalalgia;3,249-256.
4.Sjaastad O, Fredriksen TA, Pfaffenrath, V (1998). Cervicogenic headache: diagnostic criteria. The Cervicogenic Headache International Study Group. Headache,38(6), 442-5.
5.Lewis JS, Green A, Wright C (2005). Subacromial impingement syndrome: the role of posture and muscle imbalance. J Shoulder Elbow Surg;14(4):385-92.