Headaches are a common medical complaint, and there are many different causes of headaches. One potential cause that is often overlooked is issues with the spine. The spine is made up of small bones called vertebrae that are stacked on top of each other, along with discs between each vertebra that provide cushioning. Issues with the vertebrae or discs can put pressure on nearby nerves, muscles, and blood vessels, which can trigger headaches or make existing headaches worse. Here’s an overview of some of the most common spine problems that can contribute to headaches.
Cervical Spine Issues
The cervical spine refers to the vertebrae in the neck region. There are several cervical spine problems that may provoke or worsen headache pain:
Cervical Spondylosis
Cervical spondylosis involves age-related wear and tear of the cervical vertebrae and discs. As the spine degenerates, it causes narrowing of the space around the spinal cord and nerves. This can lead to pinched nerves that radiate pain into the head.
Cervical Spinal Stenosis
Closely related to spondylosis, spinal stenosis refers to abnormal narrowing of the spinal canal. This narrowing puts pressure on the spinal cord and nerves, which can manifest as headache.
Herniated Cervical Discs
Cervical disc herniations happen when the discs between vertebrae rupture or bulge out. This can compress surrounding nerves and result in inflammation that translates into headaches.
Cervical Radiculopathy
Also known as a pinched nerve, radiculopathy occurs when a nerve root becomes compressed, inflamed, or damaged. Common symptoms are radiating neck and head pain.
Cervical Facet Joint Dysfunction
The facet joints connect the vertebrae and allow the neck to move. If these small joints lose normal motion or become irritated, it can cause referred pain into the head.
Cervical Sprain or Strain
Ligament or muscle injuries in the neck may lead to cervical sprain or strain. The inflammation from these injuries can spark headache.
Cervical Spine Misalignment
When the upper vertebrae are out of proper alignment, it disturbs normal nerve function and blood flow to the head. Chiropractors treat misalignments that contribute to headache.
Thoracic Spine Issues
The thoracic spine is the middle portion where the ribs attach. Like the neck, problems in this area can radiate upward and trigger headaches.
Thoracic Herniated Discs
Similar to the cervical discs, thoracic discs can sometimes herniate and impinge nerves that communicate pain signals to the head.
Thoracic Spine Misalignment
The thoracic spine has less movement compared to the neck, but thoracic misalignments can still happen. These put abnormal forces on the spine that lead to headaches.
Upper Back Pain
Chronic upper back pain, such as from muscle tension or joint dysfunction, can increase sensitivity to existing headache triggers. The upper trapezius muscle between the neck and shoulders is often involved.
Lumbar Spine Issues
The lowest portion of the spine is called the lumbar spine. Lumbar issues causing headaches tend to stem from referred pain and increased muscle tension.
Herniated Lumbar Discs
While less common, lumbar disc herniations can refer pain into the head in some cases. This depends on the location of the herniation along the spine.
Referred Low Back Pain
Referred pain means pain that radiates to other areas of the body. People with chronic low back problems sometimes get headaches because of referred pain signals.
Increased Muscle Tension
Low back pain causes many people to develop elevated shoulder, neck, and head muscle tension. This muscle tension can worsen headaches or provoke new ones.
Other Contributing Spine Factors
Some other spinal issues that can be tied to headaches include:
– Adjacent segment disease: After spinal fusion surgery, disc problems may start above or below the fused vertebrae. This can lead to headaches in some cases.
– Spinal tumors or infections: Abnormal growths or spinal infections can cause inflammation that translates into headache pain.
– Vertebral fractures: Fractures from osteoporosis, trauma, or cancer may impinge nerves and aggravate headaches.
– Ankylosing spondylitis: This inflammatory arthritis can cause vertebrae fusion and headache.
– Fibromyalgia: This chronic widespread pain syndrome Often coincides with chronic headaches and neck pain.
– Scoliosis: Severe scoliosis may alter nerve function, strain the neck, and lead to headaches.
Diagnosing the Cause
Determining if spine abnormalities are contributing to headaches involves a detailed medical evaluation. Important components include:
– Medical history – The doctor asks about headache patterns, duration, location, severity, triggers, and associated symptoms. Information about spine problems and treatments is obtained.
– Physical exam – Muscle tension, range of motion, alignment, gait, reflexes, and sensory changes are assessed to pinpoint potential spinal sources of headache.
– Imaging – X-rays, CT, and MRI scans help identify disc, bone, joint, ligament, and soft tissue problems.
– Diagnostic injections -Injections like nerve blocks can confirm if a particular spinal issue is causing headaches.
– Referral to a specialist – Neurologists, physiatrists, chiropractors, or physical therapists may help diagnose and treat spinal headache triggers.
How Spinal Problems Cause Headaches
There are a few ways that spine abnormalities can provoke headaches or make existing headaches worse:
Nerve Compression
When vertebral discs, bones, or tissues put pressure on nerves in the cervical, thoracic, or lumbar spine, it can cause pain signals to be sent to the head. This is due to shared nerve innervation in these areas.
Muscle Tension
Spinal issues lead to increased muscle tension and trigger points in the shoulders, neck, and head. This muscle tension contributes to headaches.
Reduced Blood Flow
Irritation of the sympathetic nerves stemming from the upper spine can cause vasoconstriction in the head. This reduced blood flow and oxygen triggers headaches in some people.
Altered Biomechanics
Spinal misalignments or problems with facet joints alter weight distribution. This abnormally stresses the spine and leads to inflammation that sensitizes headache pathways.
Chemical Changes
Spinal nerve compression results in several chemical changes like Substance P release. These chemical changes make the head more sensitive to pain.
Spine-Related Headache Treatments
Once a spinal cause for headache is established, the goal is treatment aimed at the underlying spine issue. This may include:
Medications
Medications like NSAIDs, muscle relaxers, or neuropathic pain drugs can provide relief in spine-related headaches. Narcotics should be avoided.
Spinal Injections
Targeted steroid injections into the cervical, thoracic, or lumbar spine help reduce inflammation pressing on nerves.
Spinal Decompression
Techniques like traction or inversion therapy take pressure off compressed spinal nerves. This can relieve associated headaches.
Chiropractic Adjustments
Chiropractic spinal manipulation and mobilization help realign vertebrae and take pressure off nerves that may produce headaches.
Massage Therapy
Massage techniques like trigger point therapy loosen up tense muscles in the neck, shoulders, upper back, and head to alleviate headache.
Exercise and Stretches
Low-impact exercises improve spinal flexibility and strengthen core muscles for better spine and headache pain control.
Physical Therapy
Working with a physical therapist can improve range of motion and correct poor posture aggravating spinal issues linked to headache.
Surgery
If conservative measures fail, surgery like spinal decompression or fusion may be warranted for refractory spinal headaches.
Prevention Tips
Some proactive tips for avoiding spine-related headaches include:
– Maintain proper posture and ergonomics when sitting at a desk or using electronic devices. Slouching strains the neck and upper back.
– Avoid carrying heavy bags that distribute weight unevenly and stress the spine.
– Do neck and upper back stretches regularly to keep muscles flexible.
– Get sufficient rest. Poor sleep hygiene exacerbates muscular headaches.
– Use good body mechanics and proper lifting techniques to prevent injury. Keep the back straight and lift with the legs when moving heavy objects.
– Stay active with low-impact exercise a few times a week to build core and postural muscle strength. This supports the spine.
– Limit alcohol, which causes dehydration headaches. Also drink plenty of water daily.
– Avoid taking unnecessary medications like opioids that have frequent headache side effects.
When to See a Doctor
It’s advisable to consult a doctor for evaluation if headaches are severe, persistent, worsening, or accompanied by other alarming symptoms. Seek emergency care for headaches along with:
– Fever, stiff neck, nausea, and vomiting
– Confusion, difficulty speaking, vision changes, loss of coordination, weakness
– Head injury or trauma
– Sudden, severe head pain unlike previous headaches
– New headache after age 50
These may indicate a serious underlying medical issue requires imaging and diagnosis. For most people with occasional headache related to spinal problems, conservative treatment helps relieve pain. But recurrent or debilitating headaches interfering with normal activity warrant medical assessment.
Conclusion
Headaches have many different causes. Given the intimate connections between the spine and head, spinal abnormalities are a potential contributor to headache development that should not be overlooked. From cervical spondylosis to low back pain, a surprising number of spine conditions can radiate symptoms upward and result in head pain or exacerbate primary headache disorders. Being aware of these possible associations allows for targeted treatment. A combination of medications, spinal injections, chiropractic methods, physical therapy, massage, and exercise usually improves spinal issues that translate into headache. With proactive spine care and healthy lifestyle habits, many headaches originating from the spine can be avoided or successfully managed.
