This a controversial diagnosis mainly because most migraine patients have neck pain during an attack and for some, the pain seems to start in the neck. In fact, there is a “migraine center” in the base of the brain and when activated it stimulates the Trigeminal nerve. This nerve has branches to the posterior cervical muscles as well the surfaces of the brain, sinuses, face and jaw, explaining why some migraineurs believe they have sinus headaches. Patients with true cervicogenic headaches have chronic neck pain and their headaches may be relieved with pressure over the occipital nerves. Treatment options include physical therapy and injecting a local anesthetic in the area of the occipital nerves.
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