According to Emedicine.com, “the C2-3 facet joint is the most common source of referred pain in patients with a dominant complaint of headache (60%)”.(1) A quick look at head and neck anatomy reveals a shared neurological connection between the C1-3 nerve roots and the trigeminal cranial nerve. The trigeminal nerve is responsible for sensory input from structures in the face and head, the main input being pain. This results in a pathway for referred pain that is perceived in the head, and thus cervicogenic headache. So how does a pain in the neck result in headaches? Irritation to the facet joints of the upper cervical spine wake up the sensory perception of pain. This awakening drives the feeling of pain via the shared connections with the trigeminal nerve, therefore resulting in headache.

What causes a pain in the neck that is felt in the head? Consider the two main causes being whiplash from motor vehicle accidents and cumulative trauma disorders from poor ergonomics such as prolonged computer use. Now that we have an understanding of the connection between the head and neck, what can we do about it? Manipulative of the cervical spine, including adjustments, mobilization, and exercise have shown great promise in treating cervicogenic headache. As Doctors of Chiropractic, our treatment is the use of the adjustment to restore range of motion, reduce muscle spasm, reduce pain, and ultimately reduce the frequency and severity of headaches.

One study published in the JMPT summarizes its findings, “A large clinical trial on the relationship between pain relief and the number of chiropractic treatments is feasible. Findings give preliminary support for the benefit of larger doses, 9 to 12 treatments, of chiropractic care for the treatment of cervicogenic headache.” (2)

It is imperative that Doctors of Chiropractic and the public at large are aware of the risks and benefits of cervical adjustments. Talk to your chiropractor if you are concerned about any complications of this treatment. These risks, albeit very small, should be posed to you before you begin treatment.

So before losing all hope, consult your chiropractor if your headache pain is not resolved.

(1) Cervical Sprain and Strain. Accessed at: http://www.emedicine.com/pmr/topic28.htm on May 6, 2008.

(2) Dose response for chiropractic care of chronic cervicogenic headache and associated neck pain: a randomized pilot study. Accessed at http:// www.ncbi.nlm.nih.gov/pubmed/15614241 on May 6, 2008.