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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Do you suspect that a pinched nerve in your neck is the culprit behind 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 or irritation of the nerve by bone 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. Muscle spasms are also common. 

Additional symptoms of a pinched nerve in the neck may 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. Your doctor will also check your reflexes, as decreased deep tendon reflexes (especially of the triceps) are commonly seen.

Imaging such as magnetic resonance imaging (MRI) or a computed tomographic myelography (CT myelography) can confirm the diagnosis of a pinched nerve, but is not always necessary. Imaging is mostly used to rule out serious or even life-threatening causes for your neck pain like spinal cord compression or signs of infection, stroke, or cancer, or in the case of trauma (like after a car accident). 

If you believe headache is a symptom of your pinched nerve, please see your doctor, so a proper evaluation can be performed. There are other medical conditions that can mimic that of a pinched nerve, so be sure to get it checked out by a healthcare professional. 

Treatment of a Pinched Nerve in the Neck

Medications such as non-steroidal anti-inflammatories or muscle relaxants, like Flexeril (cyclobenzaprine) are generally prescribed for acute pain relief from a pinched nerve in the neck. 

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 a complementary treatment to medication, as is massage. Cervical nerve root blocks, in which steroids are injected into the affected nerve to relieve inflammation, are also sometimes used if a person continues to have pain despite medication and physical therapy. 

If people with cervical radiculopathy continue to have symptoms despite the therapies above (usually four to six weeks), they are often referred for imaging of the spine (if not done already) and/or to a spine surgeon. 

A Word From Verywell

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 well for you.

Sources:

Childress MA, Becker BA. Nonoperative management of cervical radiculopathy. Am Fam Physician. 2016 May 1;93(9):746-54.

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.

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