Radiofrequency Ablation for Treatment of Cervicogenic Headache: Where do We Stand?

Cervicogenic headache (CH) is a syndrome characterized by unilateral head pain caused by a disorder of the cervical spine and its component bone, disc, and/or soft tissue elements, usually but not invariably accompanied by the neck pain[1]. It is often a consequence of head or neck injury, but may also occur in the absence of trauma. The prevalence of CH in the general population is between 0.4% and 4.0%. In pain management clinics, however, the prevalence is much greater -- as high as 20% of the patients diagnosed with headaches [2] and as high as 53% in patients with headache after whiplash injury[3]. The treatment of CH usually requires a multifaceted approach with pharmacologic, physical, manipulative, anesthetic, and surgical interventions[4]. Patients who have not improved with conservative management are considered candidates for interventional pain management, including anesthetic block, intraarticular/ medial branch corticosteroid injection, radiofrequency ablation (RFA), and, on occasion, surgical treatment