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Cervicogenic headaches: a real pain from the neck!

D I A G N O S I S 


Cervicogenic Headache is a type of persistent headache that originates from the upper neck region 

It is a type of secondary headache that is caused by underlying issues around the neck and upper back, such as stiffness, tightness or previous injuries. 

The headache is usually felt on one side from the occiput (base of skull) to the eyes, but can vary. 

W H A T I S I T ?

The cervical spine (neck) is composed of 7 vertebrae (C1- C7), with 8 cervical nerves (C1-C8) exiting from adjacent to each vertebrae. 

The facet joints between each of the top vertebrae (C1- C3), and their associated nerves and muscles can relay pain signals from the neck up to the head, causing referral pain that is perceived as headache 

Cervicogenic headache can be worsened by over activity or tightness of muscles that attach to the neck and occiput, such as Upper Trapezius, Levator Scapulae, Scalenes, Suboccipital extensors and Sternocleidomastoid.


The headache is often accompanied by neck pain and stiffness, and potential pain referring from the neck down to the shoulder on the same side 

This condition can be caused by multiple factors that may contribute to neck stiffness, such as: 

  • Sudden twisting or rotation at the neck 
  • Poor postural habit 
  • Sleeping and pillow position 
  • Repetitive neck movement 
  • Increased muscular demand at the neck 

H O W T O F I X I T ?


  • In the early stage, physiotherapy focuses on relieving muscle tension and joint stiffness using cervical (neck) and thoracic (upper back) joint mobilisation 
  • Soft tissue release AKA massage 
  • Postural stretching and mobilisation 

Self Management 

  • Avoid complete rest 
  • Stay active and continue with normal daily activities as much as possible 
  • Consider increasing healthy activities such as walking, running, swimming which can all help to free up your thoracic spine and improve your posture 
  • Avoid prolonged sitting, and schedule regular stretch or walking breaks 
  • Avoid end of range neck movements or stretching as this can overload the joints in the neck 

Postural correction 

  • Take regular movement breaks
  • Maintain appropriate neck and upper back postures during functional activities 
  • Keeping shoulders back and chest tall 
  • Maintaining long and neutral spine 
  • Avoid bringing head forward 
  • Sit with buttocks against the backrest of the chair 

Correct your ergonomic setup 

  • Poor desk and computer setup can lead to suboptimal sitting posture and contribute to the development of cervicogenic headaches. If you work or study at a computer for long periods, consider making the following changes: 
    • Top of computer screen set at eye-level – elevate with books if necessary 
    • Chair tucked all the way in so that belly touches desk (remove arms of chair if necessary) If using a laptop, utilise a remote keyboard and mouse 
    • Ensure screen and keyboard are centred with chair to prevent twisting 
  • Beyond the above, the research shows that the best thing you can do for yourself is to REGULARLY MOVE. We recommend setting an alarm and taking a brief movement break every 30 minutes.


  • Specific targeted exercises are essential to reduce pain, increase mobility and improve posture and function 
  • Your physiotherapist will provide an individualised programme.
pilates stretch woman


  • To prevent future recurrence, it is important to address any underlying postural dysfunction. Once the headache and neck movement have improved, later stage rehabilitation involves individualised, targeted exercises to strengthen the muscles of your neck and upper back 


  • Migraine is sometimes accompanied by aura, visual disturbance, photophobia, sound sensitivity, nausea or vomiting 
  • See your GP for migraine management if you have any of the above symptoms.
  • Stress management and exercise also play a vital role in managing migraine 


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