How a pain in your neck can become a cervicogenic headache

The term ‘cervicogenic headaches’ sounds complicated and serious but it simply means a headache caused by ‘referred’ pain – i.e. pain felt in a part of the body other than its true origin.

They are often caused by problems in the upper cervical spine (upper neck) region, usually involving the C1-C3 vertebrae.

One of the most common types of headaches associated with sports injuries and whiplash, they are linked to postural changes to the neck and upper thoracic spine.

Types of headaches:
There are many differing headaches including tension, migraine and cluster, for example. In fact, the International Headache Society identifies 14 different types.

All fall into 2 basic categories:

  • Primary headaches including those of vascular origin (cluster and migraine headaches) as well as muscular origin (tension-type headaches).
  • Secondary headaches result from another source including inflammation or head and neck injuries.

Cervicogenic headaches are therefore categorised as secondary headaches.

Signs & symptoms
Indications that you are suffering from cervicogenic headaches can include:

  • Pain in the neck with head pain
  • Pain progressing from the back of the head, at the point where the neck joins the skull
  • Pain that spreads to the top or side of the head, into the forehead region and sometimes around the back of the eyes
  • Pain on one or both sides
  • Associated arm/ hand symptoms 
  • Neck stiffness
  • Tender neck and upper shoulder muscles

When to seek urgent medical attention
The following symptoms are known as the ‘5Ds’ and are red flags indicating that you should access your local A&E service as soon and as safely as possible:


  • Dizziness
  • Drop attacks: Fainting
  • Dysarthria: Loss of speech
  • Dysphagia: Loss of ability to swallow
  • Diplopia: Blurred vision

Other reasons to seek medical attention quickly:

  • Neck and head pain caused by a trauma (i.e. a car accident or fall)
  • Continuing worsening headaches
  • Headaches associated with fever, stiff neck or rash
  • Jaw pain with or without chest and or left arm pain

How do we diagnose cervicogenic headaches at KTB?
Your physiotherapist will begin with a thorough assessment, firstly to exclude any red flags or ‘5Ds’. We’ll then discuss the history of your headaches and any possible contributing factors such as neck or other head pain or existing illnesses.

Next, we’ll check your posture and range of motion both actively (how you move) and passively (how you move with full assistance).

A full neural examination will help identify any issues with the upper or lower cervical spine and special tests will help pinpoint any upper cervical and head pains.

Palpation – i.e. using the fingers to feel soft tissues–  will reveal any muscular issues or problems with neck flexibility.

What treatments are available?
There are many different approaches to managing your pain. Our physiotherapists can offer and advise on:

  • Pacing techniques – ways of maintaining steadiness and control during activity
  • Tips and techniques for good posture
  • Adjusting sleeping positions
  • Help with identifying trigger points
  • Talking to your GP about pain medication
  • When to use heat or ice treatment
  • A programme of stretches and exercises
  • A course of regular massage
  • Recommendations for acupuncturists

With a combination of physiotherapy-led treatment and self-care, there is no reason why cervicogenic headaches should continue to disrupt your daily life.