What is neck pain and cervicogenic headache?

Neck pain is a common condition with localized pain in the neck region which may spread to the upper back or the arm. It is often the result of strain to the muscles, ligaments, intervertebral discs and other tissues surrounding the cervical spine . Pain can also be referred from the upper back or shoulder region.
Neck pain can also be associated with headache originating from the head and upper neck region (i.e. cervicogenic headache)

What causes neck pain and cervicogenic headache?

  • Direct trauma e.g. falls, whiplash
  • Sudden unguarded movement
  • Overuse or repetitive microtrauma
  • Postural factors e.g. prolonged head down posture, sleeping posture
  • Muscle imbalance
  • Poor sleep & stress

What symptoms might you experience?

  • Neck pain usually localized to the neck & upper shoulder region, but may also spread to the upper back/ arm area
  • Headache typically localized to the back of the head & neck, but may also spread to the forehead, temples, eyes or ears
  • Immediate pain/ pain shortly after injury/ gradual onset of pain
  • Pain worsens with neck a/o arm movement associated with decreased mobility, stiffness & muscle spasm

How is it treated?

As with most musculoskeletal conditions, management must involve a combination of medical and physiotherapeutic treatments.

Medical management involves prescription drugs to relieve pain, inflammation and ease muscle spasm e.g. NSAIDs and muscle relaxants; topical pain relief e.g. analgesic patch; joint injection if recommended.

Physiotherapy management

  • Activity modification & ergonomics
  • Pillow selection & sleeping posture advice
  • Cold/ heat pack
  • Therapeutic modalities such as cervical traction therapy, SIS therapy, electrical stimulation and ultrasound treatment
  • Manual therapy as tolerated (therapist applies hands-on treatment to alleviate stiff joints and sore muscles where applicable)
  • Therapeutic exercises to help restore pain-free movement and improve posture
  • Neck collar may be recommended in early stages of acute and irritable neck pain (depending on therapist’s assessment)

Lifestyle management

  • Stress management
  • Sleep hygiene

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