A Headache From a Pinched Nerve

Do you suspect that a pinched nerve in your neck is the culprit behind your headache? A pinched nerve in the neck – known medically as cervical radiculopathy – occurs when a nerve root in your neck is compressed or irritated. This condition is more common in men and most prevalent in people 50 to 54 years of age.

Generally speaking, a pinched nerve in the neck is caused by one of the following health conditions:

• Herniated disc: Rupture of the disc located between the vertebrae in your spine
• Cervical spinal stenosis: Narrowing of the spinal canal
• Degenerative disc disease: Impingement or irritation of the nerve by bone spurs when arthritis develops in the spine (this is the most common cause)

While often not the first symptom described, many individuals with a pinched nerve in the neck suffer from headaches. When the upper nerve roots are involved, the headache is described as a cervicogenic headache. However, headaches caused by lower nerves in the neck are more common.

Usually, the head pain is located on the same side as the affected nerve root, and described as aching in nature. Often times, the headache from a pinched nerve in the neck will move ("radiate") from the back of the head to the forehead, and there is tenderness present when pressure is applied to the muscles in the neck on the same side as the pinched nerve.

Additional symptoms of a pinched nerve in the neck may include:

• Muscle spasms
• Pain when moving the neck
• Same-sided shoulder and arm pain
• Numbness and tingling
• Weakness

Symptoms like fever, sudden weight loss, pain that is especially worse at night, or having a history of cancer or a suppressed immune system (along with this new pain) require immediate medical attention. This is because serious medical conditions like cancer, a spinal abscess, or a condition called cervical myelopathy can mimic that of radicular neck pain.

A thorough physical exam by your primary care physician may be all you need to diagnose a pinched nerve in your neck. One diagnostic test is called the Spurling maneuver, in which your healthcare provider will press down on the top of your head when it is turned to the affected side. If this downward pressure reproduces your symptoms (like pain, numbness, or tingling), then this is suggestive of a pinched nerve. Your doctor will also check your reflexes, as decreased deep tendon reflexes (especially of the triceps) may be present.

Imaging such as magnetic resonance imaging (MRI) or a computed tomographic myelography (CT myelography) can confirm the diagnosis of a pinched nerve but is not always necessary. Imaging is mostly used to rule out serious or even life-threatening causes for your neck pain like spinal cord compression or signs of infection, stroke, or cancer, or in the case of trauma (like after a car accident). 

In the end, if you believe your headache is a potential symptom of a pinched nerve, please see your doctor, so a proper evaluation can be performed.

Medications such as non-steroidal anti-inflammatories (NSAIDs) or muscle relaxants, like Flexeril (cyclobenzaprine) are generally prescribed for acute pain relief from a pinched nerve in the neck. 

Oral steroids are sometimes used, but long-term use should be avoided due to potential side effects. As always, please consult your doctor before taking any medication, as they all have potential adverse effects. For instance, muscle relaxants may cause sedation and NSAIDs can cause stomach ulcers and bleeding, kidney problems, and an allergic reaction in some people.

Physical therapy is a complementary treatment to medication for a pinched nerve, as is massage. Cervical nerve root blocks, in which steroids are injected into the affected nerve to relieve inflammation, are also sometimes used if a person continues to have pain despite medication and physical therapy. 

If people with cervical radiculopathy continue to have symptoms despite the therapies above (usually four to six weeks), they are often referred for imaging of the spine (if not done already) and/or to a spine surgeon. 

If you suspect a pinched nerve as the source of your headache, speak with your healthcare provider. Do not let this headache disrupt your life and restrict activities you enjoy doing.