After a thorough evaluation, and diagnostic tests as indicated, treatments should begin with the least invasive (conservative) and progress to more invasive, depending on the individual.

  • The first line of treatment may be an exercise program focused on muscle strengthening and range of motion. This is generally directed by a physical therapist.  Some people may benefit from cervical traction (device that uses a small halter attached to a weight) under the guidance of a physical therapist.
  • Work and activity modifications may be helpful, especially for those who have jobs that involve heavy labor.  Bedrest is not generally recommended, and may make the pain worse. Adjusting chair/desk height, computer station adjustments, or other ergonomic considerations may also help with the pain for those who work primarily at desk type jobs.
  • Alternating ice and heat to the neck can be helpful if the pain is triggered by certain activities. Caution should be used when using an electric heating pad or microwave heat wraps, as these can result in significant skin burns. A good rule of thumb is to set a timer to 15 minutes, and alternate ice, then heat.
  • Medications such as NSAIDs (ibuprofen, Aleve, naproxen), and muscle relaxers can be very beneficial. Chronic use of narcotics is generally not indicated, as this can lead to dependency. Some people can benefit from other types of medications prescribed by a provider.
  • Injections of steroids (Epidural steroid injection) or local anesthetic blocks can often help with nerve type pain that originates from pressure on the nerves in the neck. Although the injection does not cure the disc degeneration, or slow the arthritis process, injections can help by providing temporary pain relief. In some cases the effects of the injection can last for many months.
  • Occipital nerve blocks: If the pain is from pressure on the occipital nerve, a specific block in the nerve can result in considerable relief. Sometimes, a nerve block is used as both a therapeutic (help the pain), as well as a diagnostic test (if the pain is helped by the block, there may be a better understanding that this is the source of the pain). If the patient has very good relief of the pain from a block, a nerve root ablation (“burning” the nerve) may be a more permanent solution.
  • Surgery- when other less invasive treatments have failed, some people may need cervical surgery. The type of surgery is based on the neurologic examination and the findings on the imaging studies.

If you think you have CERVICOGENIC HEADACHE, one of the providers at the

Neurosurgery Center of Colorado may be able to help- call today for an appointment.