Why Working From Home is Becoming a Pain in the Neck

Ever wonder if sitting all day could be causing your headaches? The option to work from home can be a win, but it also increases time at your desk. And it’s no secret that a lack of movement is poor for your overall health. Research shows that if you spend most of your day seated, you have a higher risk¹ of developing diabetes, obesity, cardiovascular disease, and deep-vein thrombosis.

Approximately 47% of the global population suffers from headaches. Among office workers, that number is even higher. 15-20% of those headaches are known medically as cervicogenic headaches (CGH)².

A cervicogenic headache involves pain in one place (the head), but it originates somewhere else (the neck). Medically, this is known as referred pain. The prefix “cervic” can refer to the neck, sometimes called “cervical spine” or the “neck” of any organ. For example, the cervix is the neck of the uterus.

This article explains how pain or inflammation in your neck could be putting you at risk for a cervicogenic headache (CGH) and what to do about it.

Desk workers have a higher risk of CGHs

Research shows that office workers are more likely to develop neck pain than the general population. In a study³ from Hong Kong University, 47% of office workers suffered from neck pain (with 62% of women reporting neck pain and 38% of men).

In a Swedish cross-sectional study⁴, 63% of 464 medical secretaries experienced neck pain, with 51% experiencing lower back pain.

A study⁵ of bank workers showed that 20% experienced CGHs.

These studies indicate that increased risk for cervicogenic headaches often relates to the position of the head and neck—particularly a forward head posture. The head and neck tend to be in uncomfortable positions for extended periods for workers seated at desks. These postures can create or worsen head and neck problems.

Nearly 1 in 5 headaches are cervicogenic headaches

Dr. Ottar Sjaastad coined the term cervicogenic headache in 1983. CGHs usually occur on one side and begin at the spine (usually the neck) then advance.⁶ This type of headache may include jaw pain, neck pain, and stiffness.

CGHs are estimated to affect 2.2% of the population worldwide, which accounts for 15-20% of all headaches.⁵

Normal headache or cervicogenic?

According to the International Headache Society, there are 14 different types and sub-classifications of headache disorders.⁷ Regardless of the exact type, they are divided into two main categories: primary and secondary.

Primary headaches are either vascular (related to blood vessels) such as cluster and migraine headaches or muscular, such as tension headaches.

Secondary headaches result from inflammation from another source, including head and neck injuries, and are the category that CGHs belong to.

Your doctor is the best person to diagnose CGHs, and it is essential to rule out other headache causes. If you or someone you know are experiencing a severe headache, call your health care provider, or visit the nearest hospital.

Cervicogenic headache signs and symptoms

CGHs may feel like non-throbbing pain at the back and base of your skull. The pain will sometimes extend downwards to your neck and between your shoulder blades. Although the issue originates in the neck, pain is often more commonly felt on one side of the head.

If you are experiencing a CGH, you may also feel discomfort in your arm and have a reduced range of motion in your neck.⁶ The pain can be moderate to severe.

Key symptoms, along with head and neck pain, include:

• Limited neck movement

• Mobility issues  

• Dizziness

• Blurred vision

• Pain in one or both arms

Less common symptoms include:

• Nausea and/or vomiting

• Light and noise sensitivity

Interestingly, the pain can mimic symptoms of both primary headache syndromes, including tension headaches and migraine headaches.⁸

While it can be difficult to tell the difference, there are a few things to look out for:

• People with a CGH are less likely to experience light and noise sensitivity – which is typical with migraine headaches.⁸

• Symptoms like nausea and vomiting are also uncommon in those experiencing a CGH.⁸

4 ways to prevent cervicogenic headaches

1) Avoid chin pointing posture

The position of your head is essential to keep in mind, especially if you sit at a desk for a large part of your workday.

For desk workers, it’s crucial to avoid a head forward posture, otherwise known as “chin pointing.”

Sitting with your chin pushed forwards is a very aggravating posture for CGHs.⁹ That’s because the posture compresses the upper cervical vertebrae ––  the part of your spine directly below your skull.

When your head is jutting forward, you’re also continuously stretching shoulder muscles that run from the neck to the shoulder blades. This strain can be painful and cause headaches. 

Additionally, those muscles may spasm which increases the pulling forces on the spine, resulting in more pain.

To avoid chin pointing, make it a habit to check in with your body every hour. If you find yourself sitting in a head forward position, bring your head gently back to a neutral alignment. And if you find it hard to hold that posture, it may be time to evaluate your desk and chair setup.

Keep in mind that a physician or physiotherapist is the best person to advise you on proper head and neck posture. 

2) Check your chair

If you spend the majority of your day sitting, it’s worth ensuring that you’re both comfortable and your head and neck are in alignment. Having the correct posture can help you avoid injuries and reduce your risk of experiencing CGHs. 

Take a look at your current desk chair, its height, and its relation to your desk. If you find yourself slouching, straining, or in a chin-pointing position throughout the day, your desk setup could be to blame. 

Additionally, it might be time to adjust your chair’s height or get a new chair altogether. The height of your desk, keyboard, mouse, and computer are all critical factors. 

The ideal seated posture is where your spine is in a straight, neutral position. Meaning your feet are flat on the floor, and your feet and knees are roughly hip-width apart. 

Your shoulders should be gently pulled back and down (many people roll their shoulders forward) with arms resting flat on the desk. Your neck should be in a neutral position with no chin pointing.

The most important thing is to focus on keeping your neck and back straight when you sit.

Sitting with improved posture may feel odd at first, but your body will adapt. If possible, consult a physiotherapist or other trained health practitioner who can give you guidance and helpful tips relevant to your posture habits.

3) Treat yourself to a massage

Massage therapy can be relaxing and relieve muscle tension involved in CGHs. Massage treatment might also be part of a plan to prevent CGHs in the first place. To achieve the best results, seek a registered massage therapist who has experience treating neck pain. 

4) Check your pillow and mattress

We spend a third of our lives in bed. Therefore, when it comes to neck inflammation, we ought to consider our pillow and mattress and how they might be contributing.

If your pillow is old, it’s probably too soft and not supporting your neck in the way it needs to. The same goes for your mattress.

The right pillow allows your neck to stay in line with your back –– so shop around until you find the right one for you.

Are you at risk for cervicogenic headaches?

Generally, the risk of CGHs is related to excessive stress on the neck. While there’s a strong correlation with continuous desk work, there are other risk factors. These include sleep issues, fatigue, neck injuries, poor posture, or cervical disc problems in the spine.

Pain can be triggered by a sudden event such as a sneeze or movement while exercising.¹⁰ Other risks include athletic weightlifting, whiplash from car accidents, and movements associated with certain professions like hairdressing, carpentry, and truck or tractor driving.⁶

While CGH can occur at any age, one study found that the most affected age group was between 31 and 40 years of age.⁵

Another study indicated that females are four times more likely than males to experience CGHs. Some researchers suggest that hormonal fluctuations may be a factor.⁶

Getting a CGH diagnosis

If you suspect you are experiencing a CGH, or you have any neck or head discomfort, it’s essential to seek help from a registered health care professional. A doctor is the most important first line of treatment for a headache, or to diagnose CGH. That’s because CGHs can mimic other headaches, like migraines.

To diagnose a CGH, your doctor will perform a physical and neurological examination while taking into account your medical history.

Testing and diagnostics may include X-rays, CT Scans, nerve block injections, and MRI scans.

If your doctor diagnoses you with a CGH, it’s important to know that there are a range of things that can help.

To manage pain temporarily, your doctor will likely recommend pain relief drugs like non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin or ibuprofen.

In most cases, your doctor will also refer you to a physiotherapist who can aid in targeted physical therapy, which has been shown to be very effective.

Physical therapy is the most successful treatment

Research suggests that physical therapy is the most effective treatment for CGHs, though your outcome will depend on other factors, including the severity of your condition. Physical therapy includes therapeutic movements performed by a professional alongside an exercise regimen.

A physical therapist can:

• Relieve muscles through tension release

• Manipulate the body to ease joints and muscles 

• Assess posture

• Advise about sitting and sleeping positions

• Provide physical exercises to retrain muscles

Fortunately, the physiotherapy results are promising. One study found that 72% of patients had a 50% or more reduction in headache frequency at a 12-month follow-up. While 42% of patients reported an 80% or higher relief from symptoms.¹¹

The lowdown

While desk workers are at a greater risk of experiencing neck problems, including CGHs, there are effective ways to prevent and treat the condition.

For those who work at a desk, paying attention to posture and head position is critical in preventing the onset of neck pain. In addition, assessing office ergonomics, getting the right pillow and mattress, and using massage to relieve tense muscles can also be very helpful.

If CGHs are already occurring, the best course of action is to seek a doctor for a formal diagnosis and a treatment plan.

While experiencing a CGH can be painful, physical and manipulative therapies are particularly effective treatment options.

The information provided is designed to support, not replace, the relationship that exists between a patient/site visitor and their existing health care professional(s).

Sources:

1. Worldwide surveillance of self-reported sitting time: a scoping review (2020)

2. The global burden of headache: a documentation of headache prevalence and disability worldwide (2007)

3. A study on the prevalence of and risk factors for neck pain among university academic staff in Hong Kong (2002)

4. Neck and shoulder disorders in medical secretaries. Part I. Pain prevalence and risk factors (1991)

5. Disability in bank office workers due to cervicogenic headache (2016)

6. Cervicogenic headaches: An evidence-led approach to clinical management (2011)

7. International classification of headache disorders 2nd edition (2004)

8. Cervicogenic headache (2022)

9. Cervicogenic headaches in the desk-bound office worker | HR Daily Community

10. Cervicogenic headaches start in the neck | Spine Universe

11. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache (2002)

Chloe Garnham is a writer exploring a broad range of topics, including healthcare, education, and technology.