Cervicogenic Headache: When Your Headache Starts in Your Neck

You've noticed a pattern. The headache always starts at the back of your head on the same side. It's worse after a long day at the computer, and your neck feels stiff when you check your blind spot. You may be dealing with a headache that starts in your neck.

What is a cervicogenic headache?

A cervicogenic headache is head pain caused by a problem in the neck. According to Cleveland Clinic¹, you feel the pain in your head, but it starts in your neck. "Cervical" refers to the neck, and "genic" means "coming from."

Headache experts describe it as a headache caused by a disorder of the neck's bones, discs, or soft tissues². It usually, but not always, comes with neck pain².

This kind of headache is less common than many people think. According to Cleveland Clinic¹, cervicogenic headaches affect between 0.4% and 4% of people who have headaches. Many headaches with neck tension are actually tension-type headaches. Headache experts classify headaches driven by tight neck muscles that way². Our headaches and migraines page compares the main headache types.

What are the symptoms of a cervicogenic headache?

The most common symptoms are one-sided head pain and a stiff neck. According to Cleveland Clinic¹, the pain may start at the base of the skull or the back of the head. It can spread along one side or toward the eye. Moving your neck may make it worse.

Headache experts list a few features that tend to set it apart²:

• Side-locked pain. It stays on the same side each time.
• Back-to-front spread. It starts at the back of the head and moves forward.
• Pain set off by the neck. Head movement or pressure on certain neck muscles brings on your usual headache.
• Less neck movement. Turning or tilting your head is harder than it used to be.

Some people also feel mild nausea or sensitivity to light and sound. These migraine-like symptoms can happen, but they're usually milder than in migraine². None of these features is unique to cervicogenic headache, though². That's why an exam matters.

Not sure which you have? Read migraine vs. tension headache or our guide to a headache at the base of the skull.

What causes a cervicogenic headache?

An injury or condition affecting the neck causes it. According to Cleveland Clinic¹, the source can be the bones, joints, ligaments, or nerve roots of the upper neck. Conditions linked to it include:

• Arthritis in the neck
• Pinched nerves
• Slipped (herniated) discs
• Muscle sprains and strains
• Whiplash from a crash, fall, or sports injury
• Fractures, which need medical care first

The nerves of the upper neck share pathways with nerves that carry pain from the head². That shared wiring helps explain how a neck problem can be felt as a headache.

Daily habits can feed the problem too. Long hours with your head tipped toward a screen keep the same neck muscles working without a break. So can long commutes and sleeping in an awkward position. If your headaches started after a crash, read about a headache after a car accident. For desk-related strain, see our guide for office workers.

How is a cervicogenic headache diagnosed?

An exam of your neck is the key step, because there's no single test that confirms it. According to Cleveland Clinic¹, these headaches are hard to diagnose because the pain is referred from the neck to the head.

Headache experts use a few clues to link a headache to the neck². The headache may start around the time a neck problem began. It may ease as the neck problem improves. Neck movement may be limited, and certain movements may make the headache worse.

Imaging has limits here. Findings in the upper neck are common in people who have no headaches at all². So a picture of your neck can suggest a cause, but it can't prove one. At our clinics, your doctor takes X-rays only when your exam calls for them.

Your doctor listens to your headache history first. Then your doctor checks how your neck and upper back move, where it's tender, and how your nerves respond. If your headaches sound like migraine or something that needs medical care, your doctor will tell you.

Does chiropractic care or exercise help cervicogenic headache?

Research supports neck exercises and, for some people, hands-on care. The evidence is promising but not settled, and it's fair to say so.

Exercise

Gentle, low-load exercises for the deep neck muscles and the muscles around the shoulder blades have the most consistent support. A care guideline for persistent headaches with neck pain recommends them³. Our guide to neck exercises for headaches covers the basics.

Hands-on care

The same guideline says clinicians can consider spinal adjustment, with or without gentle joint movement, to the neck and upper back³. It found no added benefit from combining adjustments, joint movement, and exercise³.

One well-known trial followed 200 people with cervicogenic headache for a year⁴. Hands-on care and exercise each reduced how often headaches came and how intense they were. The benefits lasted through 12 months⁴.

Where the evidence falls short

A 2022 review pooled 20 trials of hands-on care and exercise⁵. It found these approaches may reduce headache intensity, frequency, and disability⁵. The effects were larger in the short term and smaller over the long term⁵. Many of the trials had a high risk of bias, and the authors called for better studies⁵.

In plain terms, many people improve with exercise and hands-on care. But not everyone does, and the research can't yet say who will. Your doctor talks through these options with you, and you decide. If you'd rather not have your neck adjusted, say so. Gentle joint movement, gentle muscle work, and exercise are other options. Have safety questions? Read chiropractic adjustments for headaches.

When should you see a doctor about a headache?

Mayo Clinic⁶ also advises medical attention for a headache that's set off by changing your head position, coughing, sneezing, or bending. The same goes for a headache that begins after a head injury. A new kind of headache after age 50 also needs a medical checkup⁶. Even when a headache seems to come from your neck, these checks come first.

Find out what's behind your headaches

You've tried a new pillow, a better chair, and more water. The headache still starts in the same spot at the back of your head. You want to know whether your neck is part of the story.

We're here to help you find out. Chiropractic Company has cared for Greater Milwaukee since 1982, with 400,000+ patients, 1,400+ five-star Google reviews, and 20+ neighborhood clinics. Our doctors care for headaches and neck pain every week. We look for the cause of your pain, not just the symptoms. Your care is designed around your headaches, your medical history, your daily routine, and your goals. You choose your care, and you see the same doctor as it continues.

Care is natural and drug-free. Treatment begins at your second visit, or the same day in acute cases if your doctor decides it's appropriate. Some plans add physical therapy at our Menomonee Falls, Waukesha, and West Allis North clinics, or massage therapy at Hales Corners and Oconomowoc.

We're in-network with most insurance companies and accept Medicare and auto accident claims. Eligible new patients can start with the $29 new-patient special, which includes a consultation, an exam, and X-rays if needed. *See offer terms.

Visit one of our 20+ neighborhood clinics across Greater Milwaukee: Milwaukee East, Milwaukee North, Milwaukee Third Ward, Shorewood, Glendale, Mequon, Cedarburg, Grafton, Germantown, Brookfield, Menomonee Falls, Waukesha, Oconomowoc, New Berlin, West Allis, West Allis North, Greenfield, Hales Corners, Franklin, Muskego, and Cudahy.

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