10/19/2022
And not only headaches...this type of tension can also cause symptoms that mimic sinus pressure, eye watering and redness, upper tooth pain, itching deep in the ear canal, ear ache, and/or ringing in the ears, and more. If you've been relying on nasal sprays, antibiotics, antihistamines and have no improvement, consider that the cause may be elsewhere
🔈CERVICOGENIC HEADACHE (CGH) Syndrome
• Chronic hemicranial pain that is referred to the head from either bony structures or myofascial soft tissues of the upper CSP, - OA, C1-3 segments.
• The C1-C3 nerves relay pain signals to the nociceptive nucleus of the head and neck, the trigeminocervical nucleus. This connection
is thought to be the cause for referred pain to the occiput and/or eyes.
• The trigeminocervical nucleus is a region of the upper cervical spinal cord where sensory nerve fibres in the descending tract of the trigeminal nerve (trigeminal nucleus caudalis) are believed to
interact with sensory fibres from the upper cervical roots. This functional convergence of upper cervical and trigeminal sensory pathways allows the bidirectional referral of painful sensations
between the neck and trigeminal sensory receptive fields of the face and head.
• A functional convergence of sensorimotor fibres in the spinal accessory nerve (CN XI) and upper cervical nerve roots ultimately converge with the descending tract of the trigeminal nerve and
might also be responsible for the referral of cervical pain to the head.
Important to differentiate between: Migraine without aura, Tension-type, and Cervicogenic
headache.
• In Cervicogenic Headache, patient may present with combination of:
- movement dysfunction in whole of Csp
- muscle function impairment
- upper cervical individual joint dysfunction
• Pain and tenderness in sensitive structures in the upper neck, fascia in the head, TMJ,
mandible.
• History is important, look for activities involving some repetitive movement
static posture, maybe previous injury.
• Usually Ipsilateral pain but it can be bi-lateral!
• Patient can report unsteadiness and light-headedness, but fainting is a red flag!
