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 by a different part of the body than where it is felt. For example, a lower back problem can cause sciatica in a leg, or hip arthritis can cause pain in the knee. Similarly, the neck can cause your head to hurt. Head pain caused by the neck is called cervicogenic headache. 

            Potentially as severe as migraines, cervicogenic headaches can be activated by problems in many different parts of the neck. This pain can come from joints, ligaments, muscles, and other soft tissue in the neck. All of these tissues have one factor in common: they are encased in a surrounding tissue called fascia.  

This fibrous connective tissue covers—or even runs through—almost the entire body. Fascia is like a structural fabric, and in the neck, it is filled with millions of nerve endings. Neck fascia restrictions can irritate these nerves, potentially causing intense headaches.    

Finding Relief 

Cervicogenic headaches are common. In 26 years of practice, I have seen hundreds of patients with this issue. Many of them experienced chronic headaches at least two or more times per week, usually lasting for several hours. One of the patients, whom I will refer to as George, felt a headache come on late every morning which would then linger for the rest of the day. This made it extremely difficult for him to tolerate reading a book or using his computer. It also affected his ability to concentrate on mental tasks.   

            George came into our clinic for lower back pain treatment, as he felt that was a more pressing issue at the time. However, because we achieve our best results when we treat the whole body framework, the initial exam also evaluated his neck for possible concerns. I found significant fascia restrictions in several areas of his body, including in the fascia of several neck muscles and near two of the spinal joints in his neck.  

These restrictions were likely caused by two prior auto accidents and injuries George sustained while playing both high school and college football. We started a series of treatments with gentle fascia release therapy to eliminate those restrictions.  

         The treatment eased George’s lower back pain, but he was also thrilled to find that his headaches were treated even quicker. Within three visits, his headaches were occurring only once or twice per week. They improved as the treatment continued, ultimately disappearing. How was releasing the fascia restriction able to help George’s neck? When fascia is restricted, it can cause muscle imbalance, joint stiffness, and nerve irritation. Releasing those restrictions with gentle manual therapy relieves these underlying issues, which results in pain relief.    

With or Without Neck Pain 

The term cervicogenic headache means that pain is coming from the neck. However, this does not always mean there will be pain in the neck itself. There might be no neck pain at all, but neck fascia restrictions can still cause referred pain felt in the head. On the other hand, it is not unusual for folks to suffer from both neck and head pain. In fact, many patients feel discomfort in their necks before a headache starts.  

A typical 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. Cervicogenic pain could occur on one or both sides, but the location of pain tends to be the same each time. This specific form 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 possible modalities to treat cervicogenic headaches, including prescription medication, spinal or trigger point injections, spinal manipulation, acupuncture, and others. Any of these treatments can be successful. However, in my experience, fascia release therapy offers effective, sustainable relief by treating the root causes of pain (fascia restrictions). It is also safe, gentle, and non-invasive.  

Eric Winder, D.C., uses gentle manual therapy and rehab techniques to help patients with a wide range of pain and injury problems. Dr. Winder has offices in Sarasota and Osprey. For more information, call 941-957-8390 or visit https://gentlebay.com/