The Overlap of Headaches and Migraines

“Cervicogenic headache may mimic those commonly associated with primary headache disorders such as tension-type headache or migraine and as a result, distinguishing among these headache types can be difficult.”

– David M. Biondi, DO

In this review of cervicogenic headaches (Headaches from the neck), Dr. Biondi gives an in depth research based approach to explaining the relationship between the neck and headache pain. I would attempt to do this myself, but why not have a Harvard professor do it for me.

Why do I share this? Because this is an established professor of medicine who is giving validity to the relationship between the neck and headaches/migraines. Not only does he establish a relationship, but he advocates for a conservative approach to care, meaning physical therapy and hands on techniques to restore proper mobility in the neck. This is something that you won’t find on WebMD, but should be common practice.

The quote above gives a snapshot of the type of information that Dr. Biondi uncovers in his search of a cause of headache pain. The argument is not that all headache and migraine pain comes from a neck issue, but rather there is a significant amount of overlap in the symptoms that a migraine, tension type or cervicogenic headache will present with. This makes it difficult to make an accurate diagnosis.

I will go off on my own tangent now… If it is difficult to make a diagnosis, why not rule out the really bad conditions (more on this in another post) and then refer to or go straight to a physical therapist to receive care that addressed the cervical spine. If it doesn’t work, we should have that information within a couple weeks. If this conservative step is missed, it could be that the neck needed to be treated all along and now you are sent home with medications that are limited in their effectiveness and little to no hope of significant long term relief.

Whats the down side?

The side-effect to physical therapy would possibly be some muscle soreness, but compared to the side effects of just one migraine medication:

  • Dizziness.
  • Fatigue.
  • Headache other than migraine.
  • Tingling of the skin.
  • Dry mouth.
  • Flushing (hot flashes)
  • Feeling hot or cold.
  • Chest pain

This seems like a reasonable decision.

Here is the resource for the full article if interested:

Biondi, D. M. (2001). Cervicogenic headache: Diagnostic evaluation and treatment strategies. Current Pain and Headache Reports, 5(4)

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