Diagnosis and Treatment of a Headache from a Pinched Nerve

Understanding and Managing a Headache from a Pinched Nerve in the Neck

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A pinched nerve in your neck may be the source of your headache. Let's learn more about how a pinched nerve in the neck is diagnosed, how it may cause head pain, and how it's treated.

A pinched nerve in the neck – known medically as cervical radiculopathy – is caused by one of the following health conditions:

herniated disc: rupture of the disc located between the vertebrae in your spine

cervical spinal stenosis: narrowing of the spinal canal

degenerative disc disease: impingement of the nerve by bony spurs when arthritis develops in the spine

Symptoms of a Pinched Nerve in the Neck

While often not the first symptom described, many individuals with a pinched nerve in the neck suffer from headaches. When the upper nerve roots are involved, the headache is described as a cervicogenic headache.

Headaches caused by lower nerves in the neck are more common. Usually the pain is located on the same side as the affected nerve root. The pain is commonly described as aching and radiating from the back of the head to the forehead. Often there is tenderness when pressure is applied to the muscles in the neck on the same side as the pinched nerve.

Additional symptoms of a pinched nerve in the neck include:

  • same-sided shoulder and arm pain
  • numbness and tingling
  • weakness

Diagnosis of a Pinched Nerve in the Neck

A thorough physical exam by your primary care physician may be all you need to diagnose a pinched nerve in your neck. One diagnostic test is called the Spurling maneuver, in which your healthcare provider will press down on the top of your head when it is turned to the affected side.

If this downward pressure reproduces your symptoms – like pain, numbness, or tingling – than this is suggestive of a pinched nerve.

Imaging such as magnetic resonance imaging (MRI), computed tomographic myelography (CT myelography), or electromyography (EMG) can confirm the diagnosis of a pinched nerve.

When diagnosing a pinched nerve, your doctor will want to rule out serious or even life-threatening causes for your neck pain like spinal cord compression or signs of infection, stroke, or cancer.

If you believe headache is a symptom of your pinched nerve, please see your doctor so the diagnosis can be confirmed.

Treatment of a Pinched Nerve in the Neck

Medications such as non-steroidal anti-inflammatories, opioids, anti-depressants, like venlafaxine (Effexor),  or muscle relaxants, like cyclobenzaprine (Flexeril) may be helpful – especially for acute pain management.

Oral steroids are sometimes used, but long-term use should be avoided due to potential side effects. As always, please consult your doctor before taking any medication, as they all have potential side effects.

Physical therapy is another complementary treatment to medication, as are cervical nerve root blocks – in which steroids are injected into the affected nerve to relieve inflammation.

If people with cervical radiculopathy continue to have symptoms, despite physical therapy and medication, then they are often referred to a spine specialist.

What Should I Do?

If you suspect a pinched nerve as the source of your headache, speak with your healthcare provider. Do not let this headache disrupt your life and restrict activities you enjoy doing.

While this may not be a condition that can be cured, with the help of your primary care physician, spine specialist, and physical therapist, you can find a therapy regimen or solution that works for you.

Sources:

Eubanks JD. "Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms." Am Fam Physician. 2010 Jan;81(1)33-40.

Headache Classification Committee of the International Headache Society. "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia 2013;33(9):629-808.

Persson L, Carlsson J, & Anderberg L. "Headache in patients with cervical radiculopathy: a prospective study with selective nerve root blocks in 275 patients." Eur Spine J. 2007 July;16(7):953-9.

Radhakrishnan K, Litchy WJ, O'Fallon WM, & Kurland LT. "Epidemiology of cervical radiculopathy. A population-based study from Rochester,Minnesota, 1976 through 1990." Brain. 1994;117(Pt 2):325-35.

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