Migraine is the third most common disease in the world, and it affects more people than diabetes, asthma, and epilepsy combined, according to facts and figures from the Migraine Trust. While medical science is still working to understand all the causes and triggers of migraines, some sufferers report that sustaining neck and back injuries can increase the frequency of their attacks.
What is a Spinal Cord Injury?
A spinal cord injury is when something happens that causes damage to the cylindrical bundle of nerves encased in the spinal column, which links almost all parts of your body to your brain and comprises your central nervous system. When this cord is damaged, it can result in temporary or permanent alterations in the way it works. This might affect the use of muscles, the degree of feeling in your arms and legs, or the system that controls unconscious movements such as your heart rate, breathing, urination, and digestion.
Types of Spinal Cord Damage
The spinal cord has five specific sections, any of which could sustain damage as a result of an injury. The types of injuries that typically affect this cord include complete injuries, when the cord is totally severed, and incomplete injuries, which make up 60% of the types of spinal cord damage. These are usually caused by facet joint damage resulting from falls, motor vehicle accidents, and repetitive strain injuries in younger patients.
Older patients usually develop degeneration of the joints from wear-and-tear arthritis, muscle spasms, and tightness, however. When the joints become painful, the patient feels it in the upper section of their neck and the head. This can trigger a cervicogenic headache, which means it’s caused by injury or inflammation of the neck or cervical spine. While cervicogenic headaches may feel very similar to migraine pain, the latter is believed to be a vascular or blood-flow-based issue that occurs in the brain.
Spinal cord problems can also result from poor posture, such as sitting or standing badly at work. People in occupations like drivers, carpenters, hair stylists, and desk workers often unintentionally push their heads further in front of their bodies than is natural. The position is called cervical protraction and holding such a posture for long periods of time creates stress on the neck and the base of the skull. Falling asleep in an awkward position can also cause compression or pinching of a nerve in the neck. These are all perfect recipes for cervicogenic headaches!
Symptoms of Cervicogenic Headaches
You can tell the difference between a cervicogenic headache caused by a spinal cord injury and a migraine by evaluating the symptoms. Besides a throbbing head, you might find one side of the head or face is more painful than the other. You could also experience:
- Stiffness in your neck
- Pain and tenderness around your eyes
- Stabs of head pain when you cough or sneeze
It’s also possible that headaches develop when you hold your neck in a certain position or move in a particular way. Cervicogenic headaches might also bring on symptoms like light or noise sensitivity, blurry vision and gastric problems, which all seem similar to a migraine attack.
Cause vs. Trigger
It’s important to understand the difference between a cause and a trigger. Spinal cord injuries don’t cause migraine headaches, but any form of injury can trigger an episode in someone who experiences migraines. The spinal cord injury can cause muscle tightness, degeneration of the facet joints and arthritis, all of which can trigger a migraine. In addition, living with a spinal cord injury can reduce a patient’s overall health and well-being, putting them at a higher risk for migraine episodes. A study of 61,000 patients in Canada showed 28.9% of those with a spinal cord injury experienced migraines, compared with 9.9% without an injury.
Getting a Diagnosis
Diagnosing a cervicogenic headache versus a migraine is no simple process, and you may have to see a number of medical practitioners before you finally get an answer. It’s also entirely possible that you may experience both migraine episodes and cervicogenic headaches separately and individually, or that your migraines could be triggered by characteristics of a cervicogenic headache. Remember, every patient is an individual, and the way you respond to both stimuli and treatment is likely to be different from others.
To determine whether you have a spinal cord injury, ask your primary care physician to refer you for x-rays. If you’ve recently been involved in a vehicle collision or a fall, this could be a contributing factor to your pain, and an x-ray will uncover any existing evidence of this type of injury. The doctor may press on various parts of your neck and head to identify the origin of the pain, and ask you to move your head into different positions to see whether this precipitates a headache.
Patients who suffer from migraines regularly and who start to have episodes more often should discuss this with their migraine doctor, especially if you suspect you might have an injury. Once a diagnosis is reached, your medical team will know whether to treat you for migraines, cervicogenic headaches or a neck or back injury.
Treatment for Cervicogenic Headaches
Treating patients with these headaches begins with caring for the spinal cord injury that’s causing the problem. Apply heat or ice for 10 to 15 minutes several times a day to reduce the pain. Your doctor might recommend over-the-counter pain medication or NSAIDs to reduce the effect of the injury. This could help prevent your muscles from tightening up in response to the pain, which can trigger a migraine. The medication can also provide relief from the pain of your cervicogenic headache.
Depending on the results of the x-rays, your doctor will determine whether you need a referral to a surgeon for damage to the spinal cord, or to go for physical therapy to strengthen your neck muscles and improve your joint mobility. He or she might also suggest alternative therapies like massage, chiropractic manipulation, acupuncture or other pain management options like wearing a neck brace, sleeping upright for a period of time and developing better posture to prevent further inflammation.
Identifying the Problem
Having a spinal cord injury can definitely increase your risk for migraines, but when patients with such an injury experience headaches these have a higher chance of being a cervicogenic headache than migraines. It’s important to determine precisely which type of headache you have in order to treat the problem effectively. Keeping a detailed migraine diary is the best way to gather data that your doctor can use to form a diagnosis, because this will soon show if a relationship exists between common migraine triggers and your episodes.