Cervicogenic Headache Overview

If you experience headaches that seem to come from your neck, you may be suffering from a cervicogenic headache, which is 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.

Symptoms

A cervicogenic headache is located on one side of the head, and it is usually triggered by certain head and neck movements or by awkward positions of the head.

Other features of a cervicogenic headache include:

• Constant, non-throbbing pain that radiates from the back of the head to the front
• Duration of pain is variable
• Intensity of pain fluctuates but is generally moderate to severe

In addition to head pain, a person may also experience the following associated symptoms:

• Neck stiffness
• Shoulder, neck, or arm pain on the same side of the headache
• Occasional migraine symptoms like nausea, vomiting, blurry vision of one eye (on the same side of the headache), dizziness, and a sensitivity to light and sound

Causes

Scientists and healthcare providers are still puzzled by the precise cause of cervicogenic headaches. That being said, the pain of a cervicogenic headache is felt to be referred from the first three spinal nerves—known as C1-C3 of the upper or cervical spine where your neck lies.

More specifically, certain occupations or head and neck injuries may trigger the development of cervicogenic headache. Some of these scenarios include:

• Experiencing whiplash or concussion injuries
• Engaging in work that requires sustained neck positions like hair-dressing, carpentry, and truck or tractor driving
• Engaging in hobbies like weight-lifting

Diagnosis

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. In fact, there are two sets of criteria described by different groups, the International Headache Society (IHS) and the Cervicogenic Headache International Study Group (CHISG).

According to the IHS, there must be one of the following three signs present for a diagnosis of cervicogenic headache to be made:

• Clinical sign (for example, a person who has pain when a healthcare provider presses on his neck joints)
• Imaging sign (for example, a magnetic resonance imaging (MRI) of the neck that shows an abnormality consistent with causing a headache)
• Positive diagnostic blockade (see below)

A diagnostic blockade is when an experienced practitioner 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 Your Headache Be?

If you suspect your head pain is being referred from your neck, a team of healthcare providers 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

Treatments

Physical therapy in the form of delicate and graded muscle stretching and manual cervical traction is the initial treatment for cervicogenic headache. If this does not do the trick, a healthcare provider 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.

High-velocity cervical manipulation techniques are not recommended for the treatment of cervicogenic headache, due to the risk of dissection of an artery in the neck and vertebrobasilar stroke.

A Word From Verywell

Due to the controversy, as well as complexity surrounding the diagnosis of this disorder, a team of practitioners 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 healthcare provider so you can undergo a proper evaluation.