Migraines can be a real pain in the neck
Regular headaches or migraines can be very debilitating. When looking for the causes of ongoing headaches, doctors may look to see if the pain is radiating from the neck up. We take you through some of the more common neck issues that could be causing regular headaches or migraines.
Did you know, most neck-related headaches aren’t all that common?
Known as “Cervicogenic headaches” the general population experiencing these are between 0.4-2.5 percent. The most common cause of these types of headaches comes from musculoskeletal pain, damage to joints, discs, ligaments or fascia in the neck.
According to Epworth Neurosurgeon, Dr Patrick Chan, whiplash from car accidents, falls or sporting accidents is the most common cause of these headaches. In older age groups, degenerative arthritis can also be a significant problem.
“We see headaches related to soft tissue injuries from accidents, those triggered from osteoarthritis or rheumatoid arthritis in the neck, and even those related to bad posture such as sleeping on your stomach with your head turned to one side.” Patrick says.
The other common headache-triggering neck issues are caused by irritation of nerves that radiate up to the head.
“This may involve nerve compression, often called a ‘pinched nerve.’ There have even been instances of migraines triggering neck pain, but that is far less common.”
Patrick says the first port of call is to look for any evidence of symptoms or signs suggestive of musculoskeletal pain in the neck.
“We investigate the neck to see if there is any tenderness in the facet joints, and inspect if we can trigger off the headache from active or passive neck movements,” he says.
“Doctors also like to exclude the more unusual (bit less common) causes such as tumour, infection or similar, using a CT scan of the cervical spine, X-ray of the neck and sometimes the head, and, where appropriate, an MRI.”
Patrick says the most common treatment for musculoskeletal neck injuries is the conservative option of strengthening the neck and increasing flexibility in the neck through exercise and physiotherapy.
“Some medication in the form of anti-inflammatories may also assist with pain management in the case of mechanical neck pain. Sometimes patients may need further pain management. In some instances, we may need to consider a cortisone injection or radiofrequency ablation to the painful area, particularly in cases of chronic arthritis to the joint.”
More extreme neurosurgial options such as spinal fusion, occipital nerve release, or occipital nerve or spinal cord stimulators for neck pain are used as a last resort, and depend on the underlying cause of the pain.
“The best way to avoid neck problems is to maintain good posture, keep your neck flexible and strong through exercise, and avoid any heavy lifting with your neck in an extreme range of motion.
“Avoiding repetitive movements in an awkward neck position will help to avoid neck strain and injury,” he says.
Most headaches caused by neck pain tend to be chronic (ongoing) or sub-acute (not an emergency), so your GP is the best person to consult for advice on the underlying cause of regular headaches. The GP will refer you to a neurologist or neurosurgeon should further investigation be required.
Patrick says if you experience sudden onset of a severe headache or a headache along with high fever or neurological deficits – weakness, numbness, speech difficulties or drowsiness – you should head to the Emergency Department of your nearest hospital immediately for diagnosis, to rule out more sinister health concerns
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