Cervicogenic (neck-originating) Headache

[Aaron]

I've been struggling with intermittent cervicogenic headaches ever since I injured my neck at age 8, causing torticollis, which is a unilateral tightening of the neck muscles. A chiropractor was able to straighten my neck out, but it still feels like I always have a crick in my neck and when it flares up the headaches happen, generating from below the mastoid process and shooting into my forehead. I'm not sure to what degree the headaches are caused by nerve compression vs. cerebrovascular impairment. The stubborn tightness is isolated on the right side of my neck, while the left side feels like it lacks muscle tone.

Right now I'm suffering from another bout, usually lasting at least a few days and subsiding if I stay active and avoid strenuous neck movements, and lifting keeps it at bay. It makes it extremely hard to focus due to the sensation, but it also seems like blood flow through my neck is impaired, as it makes me feel flushed and when I stand up I sometimes become dizzy, which only happens when I'm experiencing the headache.

I have a few theories about why it's been so persistent: long-term competitive gaming (which I've quit) and heavy computer usage with a right-handed mouse; chronic tightness in the lower right back/QL/psoas (although equally likely, the neck issues are the cause of this); defensive shoulder posture related to social anxiety; and nerve damage from childhood causing spasms.

I think my neck tightness has played a major role in my ADHD struggles and I would like to get rid of it forever so I don't have to worry about it impairing me during important projects. If anyone has any insights about cervicogenic headache I would love your help. Thanks.

 

[ecstatichamster]

I’ve had a similar problem. Look up mulligan concept. Brian Mulligan. SNAGs.

 

[nerfherder]

Hey @Aaron I suffered from these for a few years, learned of their name on this forum then watched a few youtube vids and tried a few things but in the end figured it out for myself. I will brain dump all I can think of in the hope that some of it may be of use to you. I've gotten a lot of help from here and hopefully I can give something back.

As you know there's a nerve by the first vertebra in the neck (the one right below by the skull) that gets inflamed if you hold my head in a bad position. This causes the migraine pain to start and migrate forward to end behind the eye. My first port of call was the standard "What supplement can I take?" I tried a few things but nothing will help if your posture is off. You're just trying to mask dysfunction. Better to fix it. So I worked on my posture. It took about a year to get completely pain-free but improvement was really quick.

To fix it I fixed my posture in all the places it was wrong - standing, walking, driving, sitting at the computer and (most importantly) sleeping.

In short it is when i tilt my head back relative to my neck but this is disguised if your posture is off (like I had a forward shifted pelvis). It's not like I am walking around looking at the sky all the time, but if you have a slightly off pelvis the vertebrae above it aren't properly stacked and it messes up the head/neck angle. This is hard to describe in words but I could find videos if you are interested - the functional patterns guys from Seattle (and likely Portland) have good videos and if you are motivated enough and have ongoing problems you could find one to work with in real life. [note - not affiliated, just liked their videos]

When standing I had to shift my pelvis back a little which sticks my chest out more then I tuck my chin in a little and this extends the back of the neck. You can find videos where people force this by pulling their head forward to stretch the back of the neck but I prefer to keep it less forceful.

At the pc I sit in the front half of the chair with my chest out and my chin more tucked than usual. My monitor was a little too high so I lowered it a bit. I can feel the slight stretch in the neck. I also do neck mobilty/warming exercises: look up/down, left/right, tilt head left/right. Don't do too many - I do 3 each side. My neck cracks like crazy sometimes and if you ever do these in a quiet room you hear all sorts of grating sounds. I learned these movements in martial arts in my 20s and I've always had those awful sounds.

Driving was funny. I have the back of the seat relatively upright and then work on posture similar to sitting at the pc. I had to remove the head rest from the driver's seat because it was getting in the way of my head position and forcing it forward! That's only in one car though, in the other vehicles the head rest was not in the way. You find your head hits the headrest way more than before as you lose that head-forward posture.

Sleeping was the worst. Most headaches started at 4am with a sore neck from sleeping in a bad position neck-wise. I would sleep in head-forward posture! Sleeping on your back is great, but I don't do that much. Side sleeping works when you get the right pillow height. But every night I warm up stiff neck muscles before going to bed and during the night work on pulling my head back to a good position. For the first few months I was always pulling my head back but after a year or so I seem to be sleeping more reasonably.

I used to get migraines after about 3hrs of driving but that no longer happens. Sleep-induced migraines were the last to go but they have gone. I never used to have a clear head at any point ever but now I am 100% migraine free all the time and only occasionally have a bad night and wake up with a stiff neck. In that case I work on posture and warm-up exercises and take a couple of aspirin and things reduce pretty quickly although sometimes I feel the nerve complaining a bit for a few hours like a migraine without the big pain. On a scale of 0-100 my peak pain has gone from about 90 to 15 and that is really rare, every couple of months.

This is all custom to me and my problem but at the very least it shows you can self-diagnose and fix things.

On a related note I have a friend who has awful arm pain from a nerve by the second vertebra. He had neck surgery to "fix" it but his posture remains really badly head-forward and the pain is coming back. He would be much better off working on his posture but of course he wants more surgery to correct things.

 

[ecstatichamster]

i find your explanation very interesting @nerfherder

Can you find any videos? I'm very interested!

 

[nerfherder]

There's a lot by the Functional Patterns people. I saw a hundred of them, plus more from many other people, but hey the headaches were so awful I understood why people commit suicide for pain and that gave me plenty of motivation to figure things out. Here are a couple of videos but you can just search their channel.

Fix Your (Rounded Back) Posture - Correcting Kyphosis
Functional Strength Training - Addressing a Forward Head, Scapular Winging and Kyphosis

Here is the Functional Patterns video channel.

They got their ideas originally from Tom Myers' Anatomy Trains. I'll buy that one day.

After using their videos as part of the fix for my headaches I hired an FP guy in my country to work with my teenage son on his running/hamstrings and he was great. I figured I owed them something after all the free video time but he was well worth the money and I'll use him again.

 

[ecstatichamster]

thank you very much! I love this. Is there one person you could recommend to consult with? Would you mind PMing me...you are so helpful, you have no idea. This has been affecting me for 20 years or more...

 

[Aaron]

Hey @Aaron I suffered from these for a few years, learned of their name on this forum then watched a few youtube vids and tried a few things but in the end figured it out for myself. I will brain dump all I can think of in the hope that some of it may be of use to you. I've gotten a lot of help from here and hopefully I can give something back.

As you know there's a nerve by the first vertebra in the neck (the one right below by the skull) that gets inflamed if you hold my head in a bad position. This causes the migraine pain to start and migrate forward to end behind the eye. My first port of call was the standard "What supplement can I take?" I tried a few things but nothing will help if your posture is off. You're just trying to mask dysfunction. Better to fix it. So I worked on my posture. It took about a year to get completely pain-free but improvement was really quick.

To fix it I fixed my posture in all the places it was wrong - standing, walking, driving, sitting at the computer and (most importantly) sleeping.

In short it is when i tilt my head back relative to my neck but this is disguised if your posture is off (like I had a forward shifted pelvis). It's not like I am walking around looking at the sky all the time, but if you have a slightly off pelvis the vertebrae above it aren't properly stacked and it messes up the head/neck angle. This is hard to describe in words but I could find videos if you are interested - the functional patterns guys from Seattle (and likely Portland) have good videos and if you are motivated enough and have ongoing problems you could find one to work with in real life. [note - not affiliated, just liked their videos]

When standing I had to shift my pelvis back a little which sticks my chest out more then I tuck my chin in a little and this extends the back of the neck. You can find videos where people force this by pulling their head forward to stretch the back of the neck but I prefer to keep it less forceful.

At the pc I sit in the front half of the chair with my chest out and my chin more tucked than usual. My monitor was a little too high so I lowered it a bit. I can feel the slight stretch in the neck. I also do neck mobilty/warming exercises: look up/down, left/right, tilt head left/right. Don't do too many - I do 3 each side. My neck cracks like crazy sometimes and if you ever do these in a quiet room you hear all sorts of grating sounds. I learned these movements in martial arts in my 20s and I've always had those awful sounds.

Driving was funny. I have the back of the seat relatively upright and then work on posture similar to sitting at the pc. I had to remove the head rest from the driver's seat because it was getting in the way of my head position and forcing it forward! That's only in one car though, in the other vehicles the head rest was not in the way. You find your head hits the headrest way more than before as you lose that head-forward posture.

Sleeping was the worst. Most headaches started at 4am with a sore neck from sleeping in a bad position neck-wise. I would sleep in head-forward posture! Sleeping on your back is great, but I don't do that much. Side sleeping works when you get the right pillow height. But every night I warm up stiff neck muscles before going to bed and during the night work on pulling my head back to a good position. For the first few months I was always pulling my head back but after a year or so I seem to be sleeping more reasonably.

I used to get migraines after about 3hrs of driving but that no longer happens. Sleep-induced migraines were the last to go but they have gone. I never used to have a clear head at any point ever but now I am 100% migraine free all the time and only occasionally have a bad night and wake up with a stiff neck. In that case I work on posture and warm-up exercises and take a couple of aspirin and things reduce pretty quickly although sometimes I feel the nerve complaining a bit for a few hours like a migraine without the big pain. On a scale of 0-100 my peak pain has gone from about 90 to 15 and that is really rare, every couple of months.

This is all custom to me and my problem but at the very least it shows you can self-diagnose and fix things.

On a related note I have a friend who has awful arm pain from a nerve by the second vertebra. He had neck surgery to "fix" it but his posture remains really badly head-forward and the pain is coming back. He would be much better off working on his posture but of course he wants more surgery to correct things.

Thank you for this. A lot of this is stuff I've intuitively understood, but not enough to take action, and I haven't been as persistent as I ought to have been. So reading this is confirmation not only that it can be fixed but that you can do it using methods that make intuitive sense. I use "intuitive" very loosely because obviously it takes a while to sift through the misconceptions and for these kinds of solutions to reveal themselves.

At the same time I feel I've had a slightly different experience. Straightening the back of my neck tends to make it worse, and relaxed shitty computer posture only exacerbates the tightness, not the pain or frequency of the headaches. Unilateral stretching of the entire side of my back and neck seems to make the most difference, probably because I have a greater degree of torticollis than most people suffering from this condition.

However everything else rings true. I will definitely be putting more effort and thought into my alignment and posture, and that YouTube channel is a good find. In the first 30 seconds I chuckled because I realized he was referring to guys like Athlean-X, and the next suggested video was ironically an Athlean-X video with 7 million views. I can relate to your friend in that most of the time, I feel like a patient and don't take proactive measures. Every small change I make has an impact days later.

I’ve had a similar problem. Look up mulligan concept. Brian Mulligan. SNAGs.

Good stuff. I have just started incorporating self-massage, including with a lacrosse ball, and it feels great. So much better than getting a massage from someone else who doesn't know where all the tiny knots and trouble areas/anatomical parts are.

 

[nerfherder]

Yeah we're all different. All I needed was to identify that it was a cervicogenic headache and the rest kinds just happened - if I know what it is then I can try to fix it. You've got enough to get trying things out and start finding out what works. The big idea on this forum is to try stuff out yourself. One thing I should say is that this takes time. I didn't just fix posture and all was good. It took maybe a year of slow progress to get to a point where I was happy. I still get stiff neck muscles and have to massage and stretch a bit.

Also get someone else's point of view if you can. Get a buddy to watch some short videos on posture with you and look at you and give you feedback. Other people see issues that you are blind too.