Pain from Cervical Spine

Pain from cervical structures referred to the head is called cervicogenic headache. It can be experienced in the occipital, parietal, frontal, or orbital regions. The sensory axons from C1, 2, and 3 converge on dorsal horn neurons that also receive afferent supply from the trigeminal nerve. Hence pain mediated by the C1, 2, and 3 nerves is perceived in areas supplied by the trigeminal nerve. A common cause of cervicogenic headache, particularly in patients after whiplash injury, is pain from the C2-3 facet joint mediated by the third occipital nerve. The source of pain can be diagnosed using controlled diagnostic blocks. Facet intra-articular injection with steroid and more so radiofrequency neurotomy is effective in relieving pain.

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