Posted by: Levery | 2011/11/28

Cervical Headaches (Encroachement between C4 and C5)

My name is Levery and I am a 24 yer old female. For the past 9 years I have been suffering from severe headached and back pain resulting in huge medical bills, spectacles and numerous visits to the GP.

Early this year I was diagnosed with cervical headaches and decided to undergo physiotherapy and that seemed to work. Recently the headaches and back pain returned and a friend suggested I see a homeopath and reflexologist specialist. She sent me to do an xray after suspecting misaligment of the spine resulting in muscles overcompensating to keep ,e upright rersulting in muscle strain and headaches. She also detected an underactive parathyroid.

Fast track to the results of the xray, the report indicates significant narrowing of the right C4 and C5 exit foramina as well as the left C4 exit foramina. There is also significant bilateral foraminal encroachement involving the left C4 and right C4 and C5 foramina.

Is the above the cause of the headaches and what is the corrective action for issue?

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Our expert says:
Expert ImageHeadache expert

Dear Levery,

At The Headache Clinic we regularly see patients with the kind of cervical wear and tear that you have described. In our experience, it is usually caused by chronic muscle tension of the neck muscles, which also play an important role in headaches in some people. It is the muscle tension that causes the wear and tear of the cervical vertebrae, and it is also the muscle tension that causes headaches. In patients with muscle tension – even neck muscle tension – we get excellent results with an appliance that fits into the palate and relaxes both the jaw and the neck muscles. The neck wear and tear then goes no further. Having said that, there may also be other sources for the pain, and they all have to be treated to get the best result. To get to the root of the problem, you need what is called a “multidisciplinary assessment”, which should include a neurological examination to rule out any serious underlying condition. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension, and of the external carotid vasculature to determine whether there is an arterial element to the pain.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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