Numerous conditions, such as migraines or problems with your neck, spine, or posture, can produce pain in the back of the head and neck (cervicogenic headache). This frequent, persistent headache typically begins following neck movement. Medications, alternative therapies, and lifestyle modifications can all help prevent or minimize discomfort. Recognizing more symptoms could aid in the diagnosis.
Potential Causes of Pain in the Back of the Head and Neck:
Any structure innervated by the spinal nerves C1–C3 may be the source of a cervicogenic headache, which is believed to be pain resulting from irritation induced by cervical tissues innervated by spinal nerves C1, C2, and C3. Causes may include:
- Tension headache
- Improper posture: By placing stress on your shoulders and neck, improper posture occurs during sitting, working, driving, and sleeping.
- Headache caused by low blood pressure
- Neuralgia occipital
- Migraine
- Headaches that occur right after or even during physical exercise are known as exertion headaches.
Clinical Presentation
Patients typically report unilateral pain that doesn’t shift to one side. It is more common in women. The topography of pain typically originates in the neck and extends to the oculofrontotemporal region, where head movement exacerbates carrying-length bouts or fluctuating chronic pain. Pain is moderate to severe, varies in length, and is neither throbbing nor terrible.
Although the patient is less likely to complain of light and noise sensitivity than in migraine headaches, pain may resemble main headache symptoms like tension or migraine headaches. It could be linked to ipsilateral neck, shoulder, or arm pain as well as a decreased neck range of motion.
Warning Signs: When Neck and Head Pain Requires Medical Attention
- Headache, stiff neck, and fever. These three symptoms could be signs of bacterial meningitis, an infection of the brain covering and spinal cord that needs to be treated with medication right away.
- Pain radiating down one arm, particularly if the hand or arm is tingly, weak, or numb. This could mean that a nerve is being compressed by a herniated cervical disc.
- Loss of control over the bladder or bowels. This could be a sign of spinal cord pressure that requires urgent care.
- Severe instability. A fracture or damaged ligaments may be the cause if you can abruptly tilt your head forward or back considerably more than normal. This often only happens after a major collision or accident, and your doctor or an X-ray is more likely to notice it than you are.
- Persistently enlarged neck glands. Neck pain and enlarged glands can be caused by an infection or a tumor.
- Pressure or soreness in the chest. In addition to more typical heart symptoms, neck pain may be a sign of a heart attack or an irritated heart muscle.
Treatment of Head and Neck Pain:
Head and Neck Pain can be treated with physical therapy, manipulative therapy, and interventional therapy.
Manipulative therapy and exercise regimens can reduce headache frequency and provide relief. However, treatment should be gradually advanced, including gentle muscle stretching and manual cervical traction.
Interventional therapy, such as intra-articular injections, third occipital nerve block, and radiofrequency ablation, can be used for specific causes.
Cervical epidural steroid injections can also help treat pain in this setting. However, pharmacological therapy, including pregabalin, duloxetine, and gabapentin, has variable responses, and further studies are needed for validation.
Read Also: What Causes Joint Pain All Over the Body
Summary
Head and neck pain requires interprofessional management, including physical therapy, manipulation, exercise, interventional treatment, and steroid injection. Cognitive behavior therapy may be beneficial for recurrent headaches.
References
Al Khalili, Y., Ly, N., & Murphy, P. B. (2022). Cervicogenic headache. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK507862/.
Kane, A. W., Diaz, D. S., & Moore, C. (2019). Physical Therapy Management of Adults with Mild Traumatic Brain Injury. Seminars in speech and language, 40(1), 36–47. https://doi.org/10.1055/s-0038-1676652
