Neck X-Rays, Headache and Migraine
Generally routine neck xrays are uninformative for headache or migraine sufferers. However, this does not exclude neck disorders as the source of headache or migraine.
Therefore xrays as a form of diagnosis are not highly regarded. Nevertheless it is very important that neck xrays be undertaken in the event of any significant head or neck trauma or injury.
It is information from structures supplied by the upper three cervical nerves which have access to the brainstem and therefore the potential to sensitise the brainstem. Consequently abnormalities seen on neck xrays, involving spinal segments below C3 (third cervical vertebra) are likely to be irrelevant. This is why it is crucial that when having a CT or MRI scan of your neck for headache that the upper 3 spinal segments are included.
Degenerative changes or spondylosis of C5-6 for example is irrelevant to the sensitisation process; information from this level does not have direct access to the brainstem.
Cheers
Dean
Consultant Headache and Migraine Physiotherapist; Adjunct Lecturer, Masters Program, School of Physiotherapy, University of South Australia; PhD Candidate, Murdoch University, Western Australia
Headache Migraine
References:
(Goldhammer L. Second cervical root neurofibroma and ipsilateral migraine headache. Cephalalgia 1993; 13:132
Jansen J, Markakis E, Rama B, Hildebrandt J. Hemicranial attacks or permanent hemicrania – a sequel of upper cervical root compression. Cephalalgia 1989; 9:123-30
Ward TN, Levine M. Headache caused by a spinal cord stimulator in the upper cervical spine. Headache 2000; 40:689-91)
