Cervicogenic Headaches: Understanding the Link Between Neck Pain and Headaches

As a physical therapist, I often see clients who come to me complaining of persistent headaches that just won’t go away. While there are many types of headaches, one of the most commonly overlooked causes is cervicogenic headaches—a type of headache that originates from the neck. If you’ve been struggling with headaches that seem to stem from neck pain or stiffness, this blog post is for you. We’ll explore what cervicogenic headaches are, their causes, symptoms, and how physical therapy can help you find relief.

‍

‍

What Are Cervicogenic Headaches?

Cervicogenic headaches are secondary headaches, meaning they are caused by an underlying issue in the neck. Unlike migraines or tension headaches, which originate in the brain, cervicogenic headaches are referred pain from structures in the cervical spine (neck). These structures can include:

1. Joints: Facet joints in the neck can refer pain to the head.-
2. Muscles: Tight or overworked neck and shoulder muscles can trigger headaches.- *\*Nerves**: Irritation of the upper cervical nerves (C1-C3) can cause pain that radiates to the head.-
3. Discs: Degenerative changes or herniated discs in the neck can contribute to cervicogenic headaches.
4. Nerves: Irritation of the upper cervical nerves (C1-C3) can cause pain that radiates to the head.

The pain is typically felt on one side of the head, often starting at the base of the skull and radiating to the forehead, temple, or behind the eye. It’s often accompanied by neck pain, stiffness, and reduced range of motion.

Causes of Cervicogenic Headaches

Cervicogenic headaches are usually the result of dysfunction or injury in the neck. Common causes include:

• Poor Posture: Prolonged poor posture, such as slouching at a desk or looking down at your phone (often called "text neck"), can strain the neck muscles and joints, leading to headaches.
• Neck Injuries: Whiplash from a car accident, a fall, or sports-related injuries can damage the structures of the neck and trigger cervicogenic headaches.
• Muscle Tension: Overuse or tension in the neck and shoulder muscles, often due to stress or repetitive movements, can contribute to headaches.
• Arthritis or Degenerative Changes: Conditions like osteoarthritis or cervical spondylosis can affect the joints and discs in the neck, leading to referred pain in the head.
• Prolonged Static Positions: Holding your neck in one position for too long (e.g., working at a computer or driving) can strain the neck and cause headaches.
• Weak Neck Muscles: Weakness in the deep neck stabilizers can lead to poor neck mechanics and increased stress on the cervical spine.

‍

‍

Symptoms of Cervicogenic Headaches

Cervicogenic headaches can be tricky to diagnose because their symptoms often overlap with other types of headaches. However, there are some key characteristics to look out for:

• Unilateral Pain: The headache is typically felt on one side of the head, though it can occasionally affect both sides.
• Neck Pain or Stiffness: Pain often starts in the neck and radiates to the head.
• Reduced Range of Motion: Difficulty moving the neck, especially when turning or tilting the head.
• Pain Triggered by Neck Movements: Certain neck positions or movements can worsen the headache.
• Pain Behind the Eye: The headache may be felt behind the eye on the affected side.
• Tenderness: The neck muscles or base of the skull may feel tender to the touch.
• Associated Symptoms: Some people experience nausea, dizziness, or blurred vision, though these are less common.

Diagnosis of Cervicogenic Headaches

Diagnosing cervicogenic headaches requires a thorough evaluation by a healthcare professional. Here’s what the process typically involves:

1. Medical History: Your therapist will ask about your symptoms, medical history, and any recent injuries or activities that may have contributed to your headaches.
2. Physical Examination: A physical exam will assess your neck’s range of motion, muscle strength, and areas of tenderness. Specific tests, such as the cervical flexion-rotation test, may be used to identify dysfunction in the upper cervical spine.
3. Imaging Studies: While imaging (e.g., X-rays, MRI) is not always necessary, it may be used to rule out other conditions, such as herniated discs or fractures

Treatment and Rehabilitation Strategies

The good news is that cervicogenic headaches are highly treatable with the right approach. Physical therapy is often the first line of treatment and focuses on addressing the underlying neck dysfunction. Here’s a comprehensive plan for recovery:

1. Manual Therapy: Hands-on techniques, such as joint mobilizations, soft tissue massage, and cervical traction, can help reduce pain, improve joint mobility, and relieve muscle tension.
2. Postural Correction: Poor posture is a common contributor to cervicogenic headaches. Your therapist will work with you to improve your posture through education, ergonomic adjustments, and exercises.
3. Strengthening Exercises: Strengthening the deep neck flexors, upper back, and shoulder muscles can improve neck stability and reduce strain on the cervical spine. Examples include:
   • Chin Tucks: Gently tuck your chin toward your chest to strengthen the deep neck flexors.
   • Scapular Squeezes: Squeeze your shoulder blades together to strengthen the upper back muscles.
   • Resistance Band Rows: Use a resistance band to perform rows, targeting the upper back and shoulders.
4. Stretching Exercises: Stretching tight muscles in the neck, shoulders, and chest can help relieve tension and improve mobility. Examples include:
   • Levator Scapulae Stretch: Tilt your head to one side and gently rotate your chin toward your armpit to stretch the side of your neck.
   • Pectoral Stretch: Place your forearm against a doorway and gently lean forward to stretch the chest muscles.
5. Pain Management: Modalities like heat, ice, or ultrasound may be used to reduce pain and inflammation in the neck.
6. LifeStyle Modifications: Your therapist may recommend changes to your daily habits, such as adjusting your workstation, taking frequent breaks, or using a supportive pillow for sleep.
7. Dry Needling or Acupuncture: For some individuals, dry needling or acupuncture can help relieve muscle tension and reduce headache frequency.
8. Education and Self-Management: Learning about your condition and how to manage it is key to long-term relief. Your therapist will teach you strategies to prevent future episodes, such as stress management and proper body mechanics.

‍

Preventing Cervicogenic Headaches

Prevention is always better than cure. Here are some tips to reduce your risk of developing cervicogenic headaches:

• Maintain Good Posture: Keep your head aligned over your shoulders and avoid slouching.
• Take Frequent Breaks: If you work at a desk, take regular breaks to stretch and move your neck.
• Strengthen Your Neck and Upper Back: Incorporate strengthening exercises into your routine to support your cervical spine.
• Use Ergonomic Equipment: Ensure your workstation is set up to promote good posture.
• Manage Stress: Practice relaxation techniques, such as deep breathing or yoga, to reduce muscle tension.

‍

When to Seek Help? If you’re experiencing frequent headaches that don’t respond to over-the-counter pain relievers or are accompanied by severe neck pain, it’s time to consult a physical therapist or healthcare provider. Early intervention can prevent the condition from worsening and help you get back to living pain-free.

‍

Final Thoughts

Cervicogenic headaches can be debilitating, but they don’t have to control your life. By addressing the root cause of the problem—whether it’s poor posture, muscle tension, or joint dysfunction—you can find lasting relief. Physical therapy offers a safe, effective, and non-invasive approach to treating cervicogenic headaches, helping you regain your quality of life.

If you’re struggling with headaches or neck pain, don’t hesitate to reach out. As a physical therapist, I’m here to help you understand your body, address the underlying issues, and guide you toward a pain-free future. Take the first step toward relief today!

‍