Treatment of cervicogenic headache with cervical epidural steroid injection.

Abstract

Cervicogenic headache (CGH) is defined as referred pain from various cervical structures innervated by the upper three cervical spinal nerves. Such structures are potential pain generators, and include the atlanto-occipital joint, atlantoaxial joint, C2-3 zygapophysial joint, C2-3 intervertebral disc, cervical myofascial trigger points, as well as the cervical spinal nerves. Various interventional techniques, including cervical epidural steroid injection (CESI), have been proposed to treat this disorder. And while steroids administered by cervical epidural injection have been used in clinical practice to provide anti-inflammatory and analgesic effects that may alleviate pain in patients with CGH, the use of CESI in the diagnosis and treatment of CGH remains controversial. This article describes the neuroanatomy, neurophysiology, and classification of CGH as well as a review of the available literature describing CESI as treatment for this debilitating condition.

• Authors: Eugene Wang, Dajie Wang
• Journal: Current pain and headache reports (Curr Pain Headache Rep) Vol. 18 Issue 9 Pg. 442 (Sep 2014) ISSN: 1534-3081 [Electronic] United States
• PMID: 25091129 (Publication Type: Journal Article, Review)

Chemical References

• Anesthetics, Local
• Steroids

Topics

• Anesthetics, Local (therapeutic use)
• Cervical Vertebrae (anatomy & histology, drug effects, physiopathology)
• Diagnosis, Differential
• Humans
• Injections, Epidural (methods)
• Neck Injuries (drug therapy, physiopathology)
• Nerve Block (methods)
• Pain Measurement
• Patient Selection
• Post-Traumatic Headache (drug therapy, physiopathology)
• Quality of Life
• Spinal Nerves (anatomy & histology, drug effects, physiopathology)
• Steroids (therapeutic use)
• Treatment Outcome