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 a person’s 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 make your head hurt. Head pain caused by the neck is called cervicogenic headache. 

            Potentially as severe as migraines, cervicogenic headaches can be caused 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 surrounded by a tissue called fascia. This fibrous connective tissue covers or even runs through almost every part of the body. Fascia is like the structural fabric of the body—and in the neck, it is filled with millions of nerve endings. However, restrictions in neck fascia can irritate these nerves and potentially trigger intense headaches.    

Finding Relief 

Cervicogenic headaches are common. In my 26 years of practice, I have seen hundreds of patients with this problem. Many of them experienced headaches at least two or more times per week, often lasting for several hours. One of these patients, whom I will refer to as George, suffered from a headache late each morning which would linger for the rest of the day. This made it extremely 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, as he felt that was a more pressing issue at the time. But since we achieve our best results by treating the whole framework of the body, I evaluated his neck for possible issues as well. I found significant fascia restrictions in several areas of his body, including in the fascia of several neck muscles and near two of his spinal joints in his neck. These restrictions were likely caused by two prior auto accidents and injuries he experienced from high school and college football.  

We began a series of treatments with gentle fascia release therapy to eliminate the restrictions. While George experienced relief from his lower back pain, he was even more thrilled to feel his headaches alleviate as well. Within three visits, the headaches were occurring only once or twice a week until they disappeared altogether. 

How was releasing fascia restriction able to help his neck? When fascia is restricted, it can cause muscle imbalance, joint stiffness and nerve irritation. Therefore, releasing those restrictions with gentle manual therapy relieves these problems and offers 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 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 those with neck pain to suffer from head pain as well. In fact, many patients feel discomfort in their necks before a headache even 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 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 several possible ways to treat cervicogenic headaches, including prescription medication, spinal or trigger point injections, spinal manipulation, acupuncture and more. Any of these treatments can be successful. However, in my experience, fascia release therapy tends to offer effective, sustainable relief by addressing the root causes of pain (fascia restrictions) in a safe, gentle and non-invasive approach.  

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 Gentlebay.com.