What is a Cervicogenic Headache?

A Headache that Originates from the Neck

My Headache is Coming from My Neck
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If you experience headaches that seem to come from your neck, you may be suffering from a cervicogenic headache—a condition that still leaves many headache specialists scratching their heads.

Let's learn more about this unusual headache and how it's diagnosed and treated.

What Does A Cervicogenic Headache Feel Like?

A cervicogenic headache is located on one side of the head, like a migraine, and it is usually triggered by certain neck movements.

In addition to head pain, a person may also experience same-sided shoulder or arm pain. Nausea, vomiting, photophobia, and phonophobia can also occur but usually to a lesser intensity and frequency than in migraine attacks.

What Causes Cervicogenic Headaches?

Scientists and doctors are still puzzled by the precise cause of cerviocogenic headaches. That being said, the first three spinal nerves—known as C1-C3 of the upper or cervical spine where your neck lies— are thought to be involved in the majority of cases.

How is Cervicogenic Headache Diagnosed?

The diagnosis of this condition is challenging, as its symptoms overlap with other types of headaches. In addition, there is no consensus on exactly how this disorder is diagnosed. There are two sets of criteria described by different groups, the International Headache Society, or IHS and the Cervicogenic Headache International Study Group, or CHISG.

According to the IHS, there must be either a clinical sign (like a person who has pain when a doctor presses on his neck joints), an imaging sign (like a magnetic resonance imaging or MRI of the neck that shows an abnormality consistent with causing a headache), or a positive diagnostic blockade.

A diagnostic blockade is when an experienced doctor injects a numbing agent into the area of the neck causing the pain.

If the headache resolves with numbing of the nerve thought to be responsible, a diagnosis of cervicogenic headache is supported


What Else Could It Be?

If you suspect your head pain is being referred from your neck, a team of doctors can help differentiate cervicogenic headache from other headache disorders. Remember, migraines and tension-type headaches—two of the most common types of headaches—cause similar symptoms of neck pain and muscle tenderness in the back of the head or upper neck. Less common medical conditions, including occipital neuralgia and hemicrania continua, may also mimic cervicogenic headache. 

Other more serious, potentially life-threatening medical conditions that may cause neck pain and headache include:

Internal Carotid or Vertebral artery dissection
• Brain or Spinal Tumor
Meningitis

How is Cervicogenic Headache Treated?

Physical therapy is the initial treatment for cervicogenic headache. If this does not do the trick, a doctor may recommend a steroid or anesthetic injection into the neck.

Radiofrequency neurotomy is another form of therapy, in which radio waves are transmitted to the affected nerves through needles that create heat. The heat deactivates the nerve so it cannot send any more pain signals to the brain. Biofeedback, relaxation, and cognitive-behavioral therapy have also been examined as therapeutic options. Surgery is the last option for a patient when other treatment modalities fail.

A Word from Verywell

Due to the controversy—as well as complexity surrounding the diagnosis of this disorder—a team of doctors is usually needed to make the diagnosis of cervicogenic headache. Regardless, if you believe your neck is the source of your headache, speak with your doctor so you can undergo a proper evaluation.

Sources

Biondi David. Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies. J Am Osteopath Assoc. April 1, 2005 vol. 105 no. 4 suppl 16S-22S.

Biondi, D. & Bajwa ZH. Cervicogenic Headache. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.

Headache Classification Committee of the International Headache Society. "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia 2013;33(9):629-808.

Sjaastad O, & Bovim G. Cervicogenic headache. The differentiation from common migraine. An overview. Funct Neurol. 1991 Apr-Jun;6(2):93-100.

Sjaastad O, Fredriksen TA, & Pfaffenrath V. Cervicogenic headache: diagnostic criteria. The Cervicogenic Headache International StudyHeadache. 1998;38:442.

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