How do you know if it’s really a migraine?

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Transcript of Video:
Migraine Headache or Cervicogenic Pain?


Hello, I’m Dr. Shawn Phelan. I’m here to speak to you about head pain, primarily migraines, and another condition called cervicogenic headaches. In the general population, there is often some confusion about head pain. We often assume, or are being told, that we are suffering from a migraine, because we have a severe headache that is causing us nausea, sensitivity to light, ringing in our ears, a funny taste in our mouth, or funny things happening in our visual field. That is not always the case.

Migraine headaches are considered to be something that is either of vascular origin, something that’s caused by a chemistry issue in the brain, usually in the serotonin pathway, neurologic issue, or sometimes a combination of some of all of these issues. Migraine headaches caused by a serotonin imbalance, vascular, or neurologic issues are really rather rare. A true migraine sufferer should only have about seven migraines per year. If you are having more than seven migraines per year, there’s a pretty good chance that there’s an overlay of some sort.

Figure 1

Different conditions can cause overlays. The one am speaking about today is called the cervicogenic headache. So the question is, if we are suffering from migraines, is it truly amigraine that we’re suffering from, or is it possibly a cervicogenic headache?

So, let’s take a brief look at the anatomy. Figure 1 (left) shows the skull and two nerves that are coming out of the upper cervical spine. The first is the greater occipital nerve, and the second is the lesser occipital nerve. They exit the spine at the level of the upper cervical spine, and then they transit up into the head. Irritation of those nerves will cause head pain.


Figure 2

Figure 2 (right) shows us the skull with nerves traveling up into the face. That is another area that we often see pain generated from. Consider the fact that cervicogenic headache can cause all of the same symptoms that a migraine will cause. It will cause visual field disturbances, a funny taste in mouth, ringing in the ears, nausea, and sensitivity to light, called photophobia, but it is not really a migraine headache. It is a problem with the upper cervical spine.

So, if the upper cervical spine and the joints are irritated, inflamed or causing irritation to the nerves then it can cause all of the symptoms that a migraine sufferer will be familiar with. Yet, it is not a not a serotonin imbalance, vascular or neurological issue. It is simply a mechanical compression or mechanical irritation of the nerves in the upper cervical spine that is causing the headache.

Figure 3

Figure 3 (left) shows you the upper cervical spine and the facet joints that can become symptomatic and cause cervicogenic headaches. If you are a migraine sufferer, you should be examined by a professional to determine if there is a situation that is driving the cervical spine problem for you. Cervicogenic headaches can be fairly easily treated, and can help you get control of your symptoms, so that you are not at the whim of the migraines.

If you would like further information on cervicogenic headaches or migraines, please go to our website, If you would like to make an appointment to be examined at our office so that we can determine whether or not you are not you are suffering from cervicogenic head pain versus migraines, then please get in contact with us by calling 919-562-0302. We would be happy to help you. Thank you.