Cervicogenic Headache

What is a cervicogenic headache?

A cervicogenic headache is head pain caused by a cervical spine (neck) issue. The pain you feel is referred pain. This happens when you feel pain in a part of your body that’s different from the pain source. With a cervicogenic headache, the pain you feel in your head originates from the bony structures or soft tissues in your neck.

It’s a type of secondary headache, which is a headache caused by an underlying condition. For example, it could be caused by a nerve impingement (pinched nerve) in your neck.

Is a cervicogenic headache serious?

Some causes of a cervicogenic headache are serious. They may happen after an injury, like a broken bone in your neck or an underlying condition. Feeling pain can significantly affect your ability to function and move. If you experience a headache after an injury or have a headache that doesn’t go away or gets worse, contact a healthcare provider.

How common is a cervicogenic headache?

While it’s common to experience headaches, cervicogenic headaches aren’t as common. They affect between 0.4% and 4% of people who have headaches worldwide.

What are the symptoms of a cervicogenic headache?

The symptoms of a cervicogenic headache include:

• One-sided head pain. It may start at the bottom of your head and radiate up one side or start at the back of your head and radiate to the front, behind your eyes.
• Limited movement or range of motion in your neck. Your headache may get worse with neck movement.

You may or may not have neck pain at the same time as head pain.

When do cervicogenic headache symptoms happen?

Cervicogenic headaches can happen at any age or after certain events like an injury. Studies show that symptoms usually begin after age 30, but many people don’t seek care for these headaches until their late 40s.

What causes a cervicogenic headache?

An injury or condition that affects your cervical spine or neck causes a cervicogenic headache. Specifically, anything that affects the following pain-sensitive areas of your cervical spine can cause symptoms:

• Bones (C1 to C3 vertebrae).
• Joints.
• Ligaments.
• Nerve roots.
• Vertebral arteries.

Common conditions potentially associated with cervicogenic headaches include:

• Arthritis.
• Fracture (broken vertebra).
• Pinched nerve.
• Slipped disk.
• Sprained muscles.
• Tumor.
• Whiplash.

How is a cervicogenic headache diagnosed?

A healthcare provider will review your symptoms during a physical exam and offer testing to confirm a diagnosis.

It’s difficult to diagnose cervicogenic headaches due to referred pain. In addition, symptoms can easily be mistaken for other types of headaches, like tension headaches or migraines, for example.

Your provider will offer tests to rule out conditions with similar symptoms. The most common tests are imaging tests like an X-ray, CT scan (computed tomography scan) or an MRI (magnetic resonance imaging). These may pinpoint injuries or conditions that affect the cervical spine.

However, an unremarkable scan doesn’t always rule out a potential cervicogenic contribution to your headache. The reason for this, in part, is that the scan only looks at structure and not function or mobility and range of movement. Your provider will assess these factors by a manual (hands-on) examination.

Your provider will also verify if your symptoms match the diagnostic criteria provided by the International Classification of Headache Disorders (ICHD-3).

How do you get rid of a cervicogenic headache?

Your healthcare provider will offer different treatment options to manage the cause of cervicogenic headaches. These could include:

• Physical therapy.
• Medications (oral or injected).
• Radiofrequency ablation.
• Surgery.

Your provider will try different treatment options before surgery since it’s a last-resort measure.

What medications treat a cervicogenic headache?

The following medications may treat different causes of cervicogenic headaches:

• A local anesthetic and steroid injection (nerve blocks).
• Serotonin and norepinephrine reuptake inhibitors (duloxetine or venlafaxine).
• Antiseizure medications (gabapentin and pregabalin).

Your healthcare provider will recommend medications specific to your symptoms. They’ll also let you know if there are any side effects so you can make an informed decision about your health.

Can a cervicogenic headache be prevented?

You can’t prevent all causes of a cervicogenic headache. But you can reduce your risk by:

• Using safety precautions to prevent injuries, falls and accidents.
• Adjusting your posture to avoid slouching.
• Sleeping on a supportive pillow and mattress.
• Getting a massage.
• Exercising regularly.

What can I expect if I have a cervicogenic headache?

Cervicogenic headaches can interfere with how you go about your day, but you don’t have to deal with the pain forever. There are treatment options available for many different causes. Your provider will help you find one or a combination specific to your situation.

How long can a cervicogenic headache last?

This varies depending on the type of treatment you receive. You may feel immediate relief after medication injections for cervicogenic headaches. Relief with injections may be temporary, so it’s possible to need more than one injection to treat the pain.

A lot of people find success in physical therapy to manage these headaches. One study reported that 72% of people saw at least 50% fewer headaches 12 months after starting physical therapy. While physical therapy may be beneficial, you may notice worsening headaches when treatment begins. Your physical therapist will pace exercises and stretching in a way to prevent this from happening.

When should I see a healthcare provider?

It can be easy to simply ignore a headache, but frequent headaches may be a sign of an underlying condition. Visit a healthcare provider if you experience headaches without a known cause. Let your provider know right away if these headaches get worse or you experience other symptoms with headaches, like pain in another part of your body.

What questions should I ask my healthcare provider?

Questions you may want to ask your provider include:

• What’s the cause of the headaches?
• What type of treatment do you recommend?
• Are there side effects of the treatment?
• How long before I feel pain relief?

Is a cervicogenic headache the same as a migraine?

No. A cervicogenic headache may feel like a migraine with one-sided head pain. But you won’t have additional symptoms common with a migraine, like light sensitivity, sound sensitivity, nausea or vomiting.

A note from Cleveland Clinic

When you have a headache, you might immediately think there’s something wrong with your head. In fact, head pain can start in other parts of your body. With cervicogenic headaches, an issue in your neck actually causes these headaches. No one wants their day ruined due to a headache, so you don’t have to just deal with the pain. A healthcare provider can help to determine what’s causing your headaches. There are several treatment options available to fit your needs and reduce how often these headaches affect you.