Cervicogenic Headaches – When Neck Pain Becomes a Headache

If you’re experiencing a headache on one side of your head that tends to start or worsen when you move your head and neck, you may be experiencing a cervicogenic headache. 

Cervicogenic headache is a secondary form of pain developing from dysfunction in the upper cervical spine. This pattern of referred pain occurs because the nerves in the upper cervical region (C1, C2, and C3) connect to the nerves of the head.  

Cervicogenic headaches will usually present as pain on one side of the head that is brought on or worsened when you move your head. It is also common to experience this type of headache after a whiplash injury. 

Cervicogenic headaches are not exclusively characterised by pain. Other common symptoms that can originate from your neck include:

• Dizziness
• Nausea
• Blurred vision
• Sensitivity to light or sound 

Because of the wide range of symptoms, cervicogenic headaches can be confused for tension headaches or migraines. It is important to consult a healthcare professional so they can assess the type of headache you’re experiencing and determine the likely causes. 

Why Do You Have a Cervicogenic Headache?

There are multiple different causes that put strain on the soft tissue structures, joints, and nerves in the neck.  Some of the most common causes include:

1. Poor static neck posture
2. Whiplash associated injury
3. Prolonged neck flexion

Additional risk factors that can increase the likelihood of experiencing chronic headaches include caffeine, obesity, medication overconsumption, and poor sleep hygiene. 

How Can We Manage a Cervicogenic Headache?

There are a range of treatment options for cervicogenic headaches. Your physiotherapist will be able to use a combination of manual therapy techniques and therapeutic exercises to address the symptoms and movements patterns behind your neck pain and headache. 

Physiotherapy intervention can be effective in decreasing the frequency and intensity of headaches and neck pain.

What Can You Do At Home?

Below are home exercises to help you manage your cervicogenic headache by addressing the mobility, strength, and movement patterns in your neck and upper back.

Chin Tuck:

Sit upright and look straight ahead. Pull your chin and head straight back without bending your neck forward until you feel a stretch at the base of your skull and top of your neck. 

Hold this position for 5 seconds then repeat 5 times. 

This exercise can be done throughout the day e.g., when you’re sitting at your desk. 

If you find this too difficult, attempt the same movement while lying on the floor. You should aim to tuck your chin, track your head along the floor,  and feel the back of your neck touch the floor. 

The goal of this exercise is to strengthen the deep neck flexors and create more space between the upper cervical segments to offload the nerves (C1-C3) that trigger cervicogenic headaches. 

Chin Tuck in 4-Point-Kneeling with Shoulder Taps:

1. Start in a 4-point kneeling position on your hands and knees 
2. Bring your neck into a chin tuck position as described above
3. Alternate tapping each hand to the opposite shoulder 
4. Make sure to maintain your chin tuck and activate your core muscles to prevent your body from swaying side to side 

This exercise strengthens the neck flexors while also challenging the deep neck extensors as you work to keep your neck up in a neutral position. The addition of shoulder taps works to challenge your neuromuscular system to maintain your neck position while using your shoulder and core muscles as well. 

Shoulder Retractions:

1. Relax the tops of your shoulders and muscles around your neck while sitting or standing in an upright position 
2. Pull your shoulder blades down and back so that you are pulling them towards each other 
3. Hold for three seconds, then relax 
4. Repeat this exercise 10 times 

Progress this exercise by holding a resistance band with your palms facing up. This will provide additional resistance to the movement. 

Upper Trapezius Trigger Ball

• Find the corner of a wall
• Place the ball on the upper part of your trapezius muscle
• Bend forward and lean your weight into the ball 
• Find tender points in the muscle and hold the ball there for 30 seconds.
• Repeat 2-3 times

The insertion points of the upper trapezius muscle mean that it can contribute to neck stiffness and the onset of headaches. The goal of this exercise is to apply pressure to trigger points in the muscle causing them to contract and relax enough to allow blood to rush in and facilitate lengthening and relaxing of the muscle.

To Summarise

Cervicogenic headaches are a subset of headaches that are caused by dysfunctional segments in the upper cervical spine. These segments can be made more functional through the application of manual therapy techniques and strengthening of neck, shoulder, and upper back muscles. 

This Article

Was written by one of our great Physio’s at Precision Physio Concord – Maddy Elazzi. To work with Maddy or any of our talented team members, please get in touch.

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