Headaches from the neck (cervicogenic headache)

What is a cervicogenic headache?

"Cervicogenic" means coming from the neck. In a cervicogenic headache, the pain is felt in the head, but it comes from the joints, muscles or nerves of the upper neck.

It's different from migraine and tension-type headache, though people can have more than one type. Working out which type you have is an important first step.

Signs that a headache may be coming from your neck

• the headache is usually on one side, and on the same side each time
• it starts at the back of the head or neck and may spread forward
• it comes with neck pain or stiffness
• certain neck positions or movements, or long periods in one posture, bring it on or make it worse
• pressing on the upper neck may reproduce the headache

When a headache is an emergency

See a doctor if your headaches are new, changing, getting worse, wake you from sleep, or come with other symptoms such as vision changes, numbness or weakness.

How it's diagnosed

At your Maana Spine assessment, your physiotherapist asks about your headache pattern, triggers and other symptoms, checks how your neck moves, examines the joints and muscles of the upper neck, and screens for warning signs. If your headache doesn't fit a neck-related pattern, or there are any warning signs, we'll advise you to see a doctor.

→ What happens at your spine assessment

What the research says

A key trial. In a 2002 randomised trial of 200 people with cervicogenic headache, both hands-on (manual) therapy and a specific low-load exercise programme reduced how often headaches happened and how bad they were, and reduced neck pain, compared with no physiotherapy. The benefits lasted to 12 months. Combining the two wasn't clearly better than either alone.

Guideline. The 2017 neck pain guideline from the American Physical Therapy Association suggests manual therapy with neck mobility and upper-back strengthening exercises for headaches that come from the neck.

Shockwave therapy (ESWT) for trigger points. Reviews show ESWT reduces pain from neck and upper-back (trapezius) trigger points more than sham treatment. Evidence that it beats other active treatments is weaker, and these studies looked at muscle pain, not headaches specifically.

Practical tips

• Break up long spells in one position, especially at screens and on your phone.
• Keep a headache diary. Noting when headaches start and what you were doing helps your physiotherapist spot triggers.
• Keep up your exercises. In the research, the benefits came from a specific, regular exercise programme.
• Don't overuse painkillers. If you're taking painkillers often for headaches, talk to your doctor.

These are general tips, not a substitute for an assessment.

When to book a spine assessment

Book an assessment if your headaches regularly start in your neck or come with neck pain or stiffness. Spine assessments are available at all five Maana Spine clinics in Kochi, Kozhikode, Thiruvananthapuram, Aluva and Perinthalmanna. The consultation fee is ₹250, and no doctor's referral is needed.

Book a Spine Assessment · or call or WhatsApp +91 99950 09403