by Eric Winder, DC  

The neurosurgeon Karl Lewit is well known in my profession for saying, “He who treats the site of pain is lost.” What he meant by this statement is that pain is often caused in a different part of the body than where it is felt. For example, a lower back problem can cause sciatica in the leg, or hip arthritis can cause pain in the knee. Similarly, the neck can cause the pain in the head, known as a cervicogenic headache. 

            Potentially as severe as migraines, cervicogenic headaches can be triggered by problems in many different parts of the neck. While a Google search will quickly reveal this kind of pain can come from joints, ligaments, muscles and other soft tissue in the neck, all these tissues have one factor in common—fascia.  

This fibrous connective tissue surrounds, or even runs through, almost every part of the body. Fascia is like the structural fabric of the body. In the neck, it is filled with millions of nerve endings which means that fascia restriction in different parts of the neck can potentially trigger intense, painful headaches.    

Finding Relief 

This kind of pain is common. In 24years of practice, I have seen dozens of people with this problem. Many of them experienced headaches at least two or more times per week, typically lasting for several hours.  

One of the patients, whom I will refer to as George, developed a headache each morning which lasted for the rest of the day. This made it difficult for him to tolerate reading a book or using his computer, and it affected his ability to concentrate on mental tasks.  

George came into our clinic for lower back pain treatment since he felt this was a more pressing issue for him at the time. However, because we achieve our best results when we treat the whole framework of the body, assessing his neck for possible problems was part of the complete exam. He had significant restriction in the fascia of some specific neck muscles and two of the spinal joints in his neck.  

When his treatment began, therapy to release the fascial restriction in his neck was part of the process. While George’s lower back pain was responding to treatment, he was also thrilled to find that his headaches were reduced even more quickly. Within three visits, his headaches were occurring only one or two times a week. They continued to improve, and eventually disappeared completely. So how did releasing fascia restriction help his neck?  

When fascia is restricted, it can trigger joint stress and muscle imbalances which cause pain. Releasing the restrictions can offer relief to the painful areas. There can be other causes of cervicogenic headaches than restricted fascia such as whiplash, tumors or repetitive stress (think: holding a phone to your head with your shoulder).   

However, I find that stiffness or distortion in the fascia of muscle, bone or tissue in the neck to be the most common cause. Fascia restriction responds to safe and gentle treatment, and most of my patients with this type of headache respond quickly to treatment.    

With or Without Neck Pain 

The term cervicogenic headache means the pain is coming from the neck. However, this doesn’t always mean there is pain in the neck itself. There might be no neck pain at all, but restrictions in the neck can still cause referred pain that is felt in the head.  

On the other hand, it is not unusual for people to have neck pain combined with head pain. In fact, many patients feel discomfort in their necks before a headache starts. Another feature of cervicogenic headache is a consistent pattern of pain.  

Migraines tend to cause pain on just one side of the head, but which side feels pain can vary from time to time. Cervicogenic pain can be on one or both sides, but the location of pain tends to be the same each time. This type of headache also most commonly starts at the back of the skull, although it can affect almost any part of the head. 

There are many approaches to treat a cervicogenic headache such as prescription medication, spinal or trigger point injections, spinal manipulation, acupuncture and more. Any of these treatments can be successful. In my experience, fascia release therapy provides relief by addressing root causes (fascia restrictions) in safe, gentle and non-invasive way.  

Dr. Eric Winder has 24 years in practice with a focus on pain relief and restoration of alignment and motion. He uses fascia release therapies, without forceful manipulation. For more information, visit GentleBay.com.