Cervicogenic headaches are a syndrome of chronic, hemicranial pain that is referred to the head from bony structures or soft tissue of the neck.
Adequate treatment of these headaches is often difficult to achieve, particularly from the emergency department, as a multi-faceted approach including pharmacologic, physical, anesthetic nerve block, psychological and sometimes surgical therapy, is often required.
The emergency physician may prescribe simple agents such as acetaminophen and ibuprofen, with or without muscle relaxants to treat cervicogenic headaches.
When close follow up is ensured, low doses of tricyclic anti-depressants or anti-epileptics such as gabapentin, divalproex sodium, carbamazepine, and topiramate may be utilized; while these are not FDA approved for the treatment of cervicogenic headaches, they have been shown to be effective for some headache types and neurogenic pain syndromes.
References
Biondi, DM. Cervicogenic Headaches: A Review of Diagnostic and Treatment Strategies. JAOA. Volume 105. No. 4. Suppl; 16-22. April 2005.
