Cervicogenic Headache: When Neck Problems Cause Head Pain
Cervicogenic headache is head pain that comes from a problem in the neck. It can feel a lot like migraine, so finding the true source matters for treatment.
What is cervicogenic headache?
“Cervical” refers to the neck. A cervicogenic headache is a secondary headache, meaning it is caused by another problem rather than being its own disease. Here, the problem sits in the bones, discs, joints, ligaments, muscles or nerves of the upper neck. You feel the pain in your head even though it starts in the neck. Doctors call this referred pain.
The name is often used too loosely. Migraine and tension-type headache can also cause neck pain. In one study, about 89% of people with migraine had neck pain, and most of them had no structural neck problem. When neck pain shows up only during a migraine attack and fades when it ends, the brain is likely amplifying normal signals from a healthy neck. Treating the migraine often eases this kind of neck pain.
Common symptoms
- Pain that begins in the neck or back of the head and moves forward, sometimes to the forehead or behind one eye
- Pain that stays on one side
- A stiff neck, or less ability to turn and tilt your head
- Headache that worsens with certain neck movements or when pressing on certain spots in the neck
- Tender spots in the neck muscles
- Pain around the eyes, neck, shoulder and arm
- In some people, nausea, blurred vision, or sensitivity to light and sound
Some people have little neck pain at all, even though the headache comes from the neck.
What causes it
Many problems in the neck can lead to this headache:
- Neck injury, such as whiplash from a car accident or a sports injury
- Strained muscles or ligaments
- Arthritis and other wear-related changes in the neck, which become more common with age
- Long hours with the head held forward, such as when texting, eating or driving
- Loose or overly flexible joints, and some connective tissue disorders
- Less often, tumors, fractures, infections or rheumatoid arthritis in the upper neck
Not every case follows an injury. Many develop slowly over time. Cervicogenic headache can also occur together with occipital neuralgia, a nerve pain at the back of the head.
Neck and shoulder muscle pain
Tight, tender spots in the neck muscles, sometimes called trigger points or trigger areas, are a common finding in cervicogenic headache, and shoulder pain can be part of the picture. Releasing these tight areas is one part of the hands-on treatment that the sources describe, along with stretching, massage and dry needling (placing thin needles into tight muscle).
How it is diagnosed
There is no single test. A doctor will usually:
- Take a careful history of your headaches and neck pain
- Examine your neck, check how far it moves and look for tender spots
- Note where the pain spreads
- Rule out migraine, tension-type headache and other causes, such as a tear in a neck artery
X-ray, MRI or CT may be used, but they can look normal, since muscle tension, posture and joint irritation do not always show on scans. A test nerve block can help. The doctor numbs a nerve or joint in the neck, such as with an occipital nerve block or a facet joint block. If both the neck and head pain ease, that supports the diagnosis. A block can also bring relief, so it can serve as both test and treatment.
Treatment options
Treatment aims at the source of the neck problem and is usually done step by step.
First steps
- Physical therapy, posture retraining and neck stabilization exercises. An ongoing exercise program often gives the best long-term results.
- Hands-on care such as manual therapy, massage, chiropractic care, trigger point release and dry needling
- Stretching you learn to do on your own, which helps keep gains going between visits
- Medicines, which may include anti-inflammatory pain relievers or nerve pain medicines such as gabapentin, pregabalin, duloxetine or amitriptyline
If pain continues
- Occipital nerve blocks
- Cervical medial branch blocks and facet joint injections (injections at the small joints of the spine)
- Radiofrequency ablation (a procedure that targets the nerves carrying pain signals)
- Botox injections when muscles are involved
- TENS (a small device that sends mild electrical pulses) and neuromodulation
Surgery is rarely the first choice. It is usually reserved for people who have a specific problem in the neck that can be fixed and who have not improved with other care. Left untreated, cervicogenic headache can become disabling.
What patients say
5.0 from 21 Google reviews
★★★★★
If you are suffering from headaches, in my case mostly due to neck/back pain, I cannot recommend Dr Park enough and her method of treatment! She is very knowledgeable and thorough, and there is no hassle with insurance or bouncing around from different doctors and offices. I hope more people with head pain discover her!!! 10/10
Reviews are shared from Google in the patients’ own words. Individual experiences vary.
How Dr. Park can help
Dr. Hannah Park is a dual board-certified, fellowship-trained headache medicine neurologist with over 10 years of specialized experience, and she has lived with migraine herself. She treats cervicogenic headache, cervical myofascial pain, neck pain and strain, and occipital neuralgia.
Every patient starts with a 90-minute new patient consultation with Dr. Park ($520): a full history review, a neurological exam, a diagnosis and a personalized treatment plan. The practice focuses on targeted injection treatments rather than a cycle of prescription medications. In-office options include the occipital nerve block ($395), trigger point injections for tight neck and shoulder muscles ($395) and other peripheral nerve injections. If appropriate, an injection may be done during your first visit for an added fee. See services and fees.
Appointments are Monday to Friday, 9 a.m. to 6 p.m., usually within days. The practice is direct pay with no referral needed.
When to see a doctor
Talk with a headache specialist if your headaches seem to start in your neck, if neck pain keeps coming with your headaches, or if your symptoms are changing or your treatment is not working. Good questions to ask include whether your neck is playing a part, whether imaging makes sense, and whether physical therapy or a test injection could help.
Related
Sources
This page summarizes patient information from these organizations, in our own words. It is general education, not medical advice.
- What Is Cervicogenic Headache?, American Migraine Foundation
- Cervicogenic Headache, National Headache Foundation
- Neck Pain and Migraine, American Migraine Foundation
- Neck Pain, Migraine, and Headache: How Are They Related?, National Headache Foundation
- The Complete Headache Chart, National Headache Foundation
Last updated October 27, 2026.
Find out whether your neck is behind your headaches
Every patient starts with a 90-minute new patient visit with Dr. Park.