Cervicogenic Headache (Whiplash Syndrome)

Whiplash injury to the spine can occur with any abrupt deceleration. Motor vehicle accidents are the most common cause of whiplash injury which can involve any spinal region: cervical (neck), thoracic (mid-back) and lumbar (low back).

Cervical whiplash may also be caused by falls or any trauma to the neck. Cervical whiplash typically causes neck pain associated with “cervicogenic headache”, that is a headache triggered by a painful injury to the neck.

Cervicogenic headaches are secondary headaches, caused by an injury to the cervical spine. This sets them apart from primary headaches, such as migraines and cluster headaches which are triggered by processes inside the skull, involving the brain.

The pain caused by a cervicogenic headache begins in the neck and the back of the head and radiates towards the front of the head. People may confuse cervicogenic headaches with migraines and tension headaches, both of which can cause neck pain. Typically, people who have cervicogenic headaches experience a headache accompanied by neck pain and stiffness. Certain neck movements can provoke cervicogenic headaches.

Treatment Options

At Nura, we treat chronic whiplash pain with medications, physical therapy, nerve blocks and sometimes nerve ablation procedures.

The first interventional procedure may be a simple cervical epidural steroid injection if we believe an injury to an intervertebral disc is contributing to pain.

If epidural steroid is not helpful, we may target cervical facet joints with steroid injections, or we may recommend a diagnostic procedure called “medial branch block”. The medial branch nerves provide sensory innervation to the facet joints and can be easily blocked for diagnostic purpose.

If medial branch blocks relieve pain for the duration of the injected local anesthetic, this identifies the facet joint as a pain generator. The interventional pain specialist can then target the painful facet joint with a nerve ablation procedure called radiofrequency ablation (RFA), which may provide a year of more of pain relief.

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