One of the best-studied musculoskeletal problems is chronic neck pain. The most common cause of chronic neck pain is facet joint disease. The facet joints are the small joints in the spine. They act as hinge joints, allowing flexion and resisting to an extent extension and rotation. Facet joints can become “diseased” by a variety of means. They are most commonly acutely injured in whiplash incidents. This can happen as a result of a motor vehicle accident, football injury, or other accident in which the neck is rapidly forced backwards. When this happens, before the muscles have a chance to react to the forces involved and try to protect the joints in the spine, the joints are thrust backwards because of the velocity of the accident. As a result, the facet joints can become injured. Another way that facet joints can become injured is through normal wear and tear of the spine. Facet joints are joints similar to any other mobile joint such as the knee or hip. As such, they can develop arthritis and become painful.
Of note, there are facet joints at all levels of the spine from the cervical spine to the lumbosacral spine. When facet joints are painful, they don’t just hurt at the site of inflammation within the joint. They often have what is called referral pain patterns. We have discussed referral pain patterns before. What this means is that the pain generator (in this case the facet joint) causes pain in areas other than the joint itself. This happens in other body parts as well. When someone experiences a heart attack, they may report arm pain. Their arm is not diseased. Rather, their heart is being starved of oxygen and becoming painful, but the person may experience this pain as a pain in the arm, jaw, or other body region. This is because the brain gets confused by the pain signals and is unable to determine where the pain is truly coming from. This can happen with the facet joints in the cervical spine as well. One of the most common referral pain patterns from the upper cervical facet joints is pain going into the head. Typically, this pain begins at the base of the skull and radiates up the skull and sometimes even to the eye.
There are many causes of headaches. These causes include everything from muscle tension to migraine to cancer. Cervical spine arthritis is just one of many potential causes. If you have headaches, you should visit your doctor to arrive at an accurate diagnosis. The only way to diagnose the cause of headaches is with a comprehensive medical history, physical examination, and possibly imaging studies and diagnostic injection blocks. Again, if you are experiencing headaches, please talk with your doctor to achieve an accurate diagnosis. An accurate diagnosis is the first step in treating your symptoms and getting you back to your active, pain-free life.