What is a cervicogenic headache?

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Typically, people who have cervicogenic headaches experience a headache accompanied by neck pain and stiffness. Certain neck movements can provoke cervicogenic headaches.

In most cases, cervicogenic headaches develop on one side of the head, starting from the back of the head and neck and radiating toward the front.

Some other symptoms of a cervicogenic headache include:

• pain around the eyes
• pain in the neck, shoulder, or arm on one side
• head pain from certain neck movements or positions

Cervicogenic headaches result from structural problems in the neck and are often due to problems with vertebrae at the top of the spine, called the cervical vertebrae. The C1-3 vertebrae are the most common site of problems resulting in these headaches.

Some people develop cervicogenic headaches due to straining their necks. People can also develop cervicogenic headaches after an injury to the neck. This is better known as whiplash.

Some medical conditions that can cause cervicogenic headaches include:

• tumors
• fractures
• infections
• arthritis of the upper spine
• whiplash or another injury to the neck

Cervicogenic headaches can be difficult to diagnose, and doctors will typically focus on excluding other causes of primary headaches and migraine.

After assessing a person’s symptoms and medical history, doctors may order tests to confirm a cervicogenic headache.

• Physical assessment: If physical manipulation of the head and spine alters or resolves symptoms, it may indicate a cervicogenic headache.
• Nerve blocks: A doctor may administer a nerve block to the neck if they suspect a cervicogenic headache. If this pain-numbing injection stops symptoms, it can confirm the neck as the root of the headache.
• Imaging tests: Imaging tests, such as MRI scans, can help assess the bone, tissue, and nerve structure of the neck. This can rule out physical malformations and aid diagnosis.

Treatments for cervicogenic headaches focus on removing the cause of the pain. Treatments vary depending on the person and the severity of their symptoms.

Some treatments for cervicogenic headaches include:

Physical therapy

Physical therapy is often the first line of treatment for cervicogenic headaches.

People can work with a physical therapist to develop specialized treatment programs. At the first appointment, a physical therapist will identify the source of the pain. From there, they may stimulate the soft tissue and move the joints around to relieve painful symptoms.

Learn more about physical therapy here.

Medications

A healthcare professional may recommend prescription or over-the-counter pain medications to relieve painful or uncomfortable symptoms. Medications that treat cervicogenic headaches include:

• nonsteroidal anti-inflammatories (NSAIDs) such as aspirin or ibuprofen
• muscle relaxers
• antiseizure medications
• antidepressants

Nerve blocks

A doctor can inject pain-numbing medication into nerves and joints in the head and neck. These often provide pain relief and can help determine the source of the pain.

Radiofrequency ablation

People with chronic headaches may benefit from radiofrequency ablation. Also called radiofrequency neurolysis, this procedure involves using radio waves to heat the tip of a needle.

A doctor will then apply the needle to the nerve that is causing the pain. The heat from the needle effectively deadens the nerve, interrupting the nerve’s ability to send pain signals to the brain.

Transcutaneous electrical nerve stimulation (TENS)

TENS units use small electrodes a doctor places on the skin to send small electrical signals to stimulate nerves near the source of pain.

However, a 2019 review found little concrete evidence as to the efficacy of TENS in treating neck pain.

Neuromodulation

Neuromodulation is a surgery that involves the use of certain devices, which may be non-invasive or invasive.

When connected to a pulse generator via a thin wire, electrodes stimulate the occipital nerve, which runs from the top of the spinal cord to the head. This therapy may help people with cervicogenic headaches when other treatments have not worked.

Home remedies

People can also try a form of physical therapy called sustained natural apophyseal glide (SNAG). SNAG involves using a towel to manipulate the areas of the neck that are causing painful symptoms. A physical therapist can teach a person how to do SNAG at home.

In 2022, a small randomized controlled trial found that SNAG techniques are effective in reducing pain and increasing range of motion in females with cervicogenic headaches.

People may also find that specific exercises and alternative treatments help with pain relief, including headaches. These include:

• deep breathing techniques
• yoga
• relaxation regimes

A cervicogenic headache can become debilitating without diagnosis and treatment.

Some people can also experience chronic or recurring cervicogenic headaches. If this happens to someone, they should contact their healthcare professional to discuss treatment options.

People should contact their healthcare professional if they experience a headache along with:

• severe pain
• fever
• rash
• nausea or vomiting
• confusion
• trouble speaking
• vision loss
• difficulty walking
• muscle weakness

Below are some commonly asked questions about cervicogenic headaches.

What does a cervicogenic headache feel like?

A cervicogenic headache can often be confused with other types of headaches, but the main symptom is a feeling of pain and stiffness around the neck area.

What is the red flag for cervicogenic headaches?

Aside from neck pain and stiffness, a red flag that a person is experiencing a cervicogenic headache is any of the following symptoms:

• fever
• weight loss
• confusion
• sudden onset
• having a previous history of headaches or changes in how a person experiences them

What mimics cervicogenic headache?

Occipital neuralgia is a type of headache that starts in the upper neck or back of the head and can radiate behind the eyes and over the scalp. It shares identical symptoms to a cervicogenic headache.

Other conditions that can mimic a cervicogenic headache include:

• tension headaches and migraine
• internal carotid or vertebral artery dissection
• Chiari malformation
• herniated intervertebral disc
• intramedullary or extramedullary spinal tumor
• spinal nerve compression or tumor
• arteriovenous malformation
• neck-tongue syndrome

A cervicogenic headache is a type of secondary headache that results from problems in the neck. Causes of a cervicogenic headache include malformations of the cervical vertebrae, injuries to the neck, inflammation, and other medical conditions.

Without treatment, a cervicogenic headache can worsen and become debilitating. People can experience chronic or recurrent headaches that do not respond to medication.

People can relieve their symptoms at home or through a combination of therapeutic, surgical, and medicinal methods.