Question
tuesday of last week I was doing my heaviest and longest squats excercise ever. With one set left I developed a headache, but I finished my workout. The headache continued until the next afternoon. I did not feel the headache again until I went back to the gym 2 days later on thursday at which point I got an extremley painful headache on my first set of bench press and had to leave the gym 5 minutes in and this headache lasted 12 hours and seems to come back whenever I exert myself. My doctor sent me to a CT scan, but if thats fine I'm thinking (based on what I've read online) that it could be a neck problem. I was wondering what you thought it might be and what I should do (assuming the CT results are fine)?
Thanks a lot for your professional opinion and valuable time.

Answer
Jamie,

I'm assuming your CT scan was of your head, attempting to rule out a brain/blood vessel problem.  If the CT scan is normal, then the next culprit is cervical spine - vis. a cervicogenic headache.  If your headache is one-sided, highly focussed on one spot such as behind your eye or at your temple, then I'd be more concerned.   If it's a whole head or a band of pain, then odds are it is coming from your neck.  There is a connective tissue bridge between some of the muscle at the base of your skull and the exterior lining of your spinal cord, called the dura matter or dura.  The muscles connect between the skull and first two vertebrae.  In theory, if strained, it can tug on the dura and cause headaches.  Other neck structures can cause headaches, including the interconnecting joint of the neck.   If you have no systemic symptoms such as nausea and vomiting, or neurologic symptoms such as blurred vision, difficulty articulating words, or loss of balance, then odds are you've just got a strained neck causing a bad headache.  The CT scan may have been a bit premature... Consider getting your neck examined by an expert - chiropractor - and correlate the physical exam findings.  Check blood pressure, cranial nerves, pupil reflexes, etc.  The chiropractor should do all of this (or else find another one).  

'Hope this was helpful.

Dr. G