Cervicogenic Headache

Written by Dr. Jason Ngan, DC

What is Cervicogenic Headache?

Cervicogenic headaches are headaches that originate from the cervical spine (neck). The International Headache Society estimates that cervicogenic headaches accounts for about 20% of all headaches.

What Causes Cervicogenic Headache?

There are many structures in the neck that can refer pain to the head. Dysfunction in the upper back and shoulders can also aggravate the neck and cause cervicogenic headaches.

  • Bad posture (slouching) causes weakness of neck muscles especially the longus capitis and longus coli.

    • Produce trigger points that refer pain to the head.

  • Pain in the joints especially C1-C3 travel up to the cortex of the brain. The brain then translates the pain as headaches.

    • C2 provides sensation to the upper area of the head

    • C3 provides sensation to the back of the head and side of the face

  • The nerve root of C2 gets entrapped at the bony structures (transverse processes) of the C1 vertebrae.

What are the Signs and Symptoms?

  • Headache usually in one side of the head

  • Neck hurts the same side of the headache (left side neck ache = left side headache)

  • Stiffness in neck

How is Cervicogenic Headache Diagnosed?

Cervicogenic headache diagnosed with a thorough medical history, physical examination, and orthopedic testing.

  • Decrease range of motion in the neck.

  • Tenderness in the neck.

  • Diagnostic imaging such as x-ray, CT, or MRI are not used to diagnose cervicogenic headaches but they can be used to rule out other pathologies.

What are the Treatment Options?

Headache types are often misdiagnosed. At Ngan Chiropractic, we carefully investigate the cause of the headache and treat appropirately. Chiropractic care is highly effective at treating cervicogenic headaches. Some options we provide are:

  • Chiropractic manipulation and mobilization

  • Flexion-distraction

  • Spinal traction

  • Soft tissue therapies

  • Gua-sha

  • Cupping

  • E-stim

  • Ultrasound

  • Ergonomic/postural/sleep counseling

  • Rehabilitative exercises and stretching

Other treatments that patients may seek (not provided at Ngan Chiropractic) include acupuncture and pain medication.  

References

  1. Al Khalili Y, Ly N, Murphy PB. Cervicogenic Headache. [Updated 2022 Oct 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507862/

  2. Chaibi A, Knackstedt H, Tuchin PJ, Russell MB. Chiropractic spinal manipulative therapy for cervicogenic headache: a single-blinded, placebo, randomized controlled trial. BMC Res Notes. 2017 Jul 24;10(1):310. doi: 10.1186/s13104-017-2651-4. PMID: 28738895; PMCID: PMC5525198.

  3. Chaibi, A., Russell, M.B. Manual therapies for cervicogenic headache: a systematic review. J Headache Pain 13, 351–359 (2012). https://doi.org/10.1007/s10194-012-0436-7

  4. Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011 Sep;6(3):254-66. PMID: 22034615; PMCID: PMC3201065.