A Cervicogenic headache is a “headache caused by a disorder of the cervical spine and its component bony, disc, and/or soft tissue elements, usually but not invariably accompanied by neck pain” 

What is a Cervicogenic headache?

According to the International Headache Society, a Cervicogenic headache is a “headache caused by a disorder of the cervical spine and its component bony, disc, and/or soft tissue elements, usually but not invariably accompanied by neck pain”.

What are the symptoms? 

Cervicogenic headaches typically start at the neck and base of the head and works its way up to the eye like a question marks, as seen in Figure 1.  

Figure 1. Cervicogenic Headache Pain Pattern (Source: https://www.ccsbismarck.com/cervicogenicheadaches/) 

What causes it? 

Around the neck level, there are several nerves which innervates the structures on the upper neck that joins with a nerve that supplies structures at the front of the face, thus when the upper neck nerve is irritated it can cause the pain to travel to the front of the face.  

How is Cervicogenic headaches diagnosed? 

The major criteria which may indicate that it is indeed Cervicogenic headache includes: 

• Restriction of neck range of motion. 2 
• Pain or tenderness upon touch of the neck. 2 
• Typically one-sided neck, shoulder or arm pain that does shift sides. In rare cases it may occur on both sides. 2 
• Reproduction of symptoms by neck movement and sustained awkward head positioning.2 
• Moderate to severe non-throbbing pain. 2 

Whilst these are some of the criteria to rule in a Cervicogenic headache, there is overlap between other types of headaches such as tension or migraines. Therefore, it is essential to get a health professional, such as a physiotherapist, to assist in differentiating the different types of headaches as the management strategies for each type is different.  Our physiotherapists at Elevate Physio and Pilates are exceptional at differentiating the different types of headaches through a thorough verbal and physical assessment.  

Managing your symptoms 

While it may be worrying to have the pain move towards to the front of the face, Cervicogenic headaches are not serious and can be exceptionally managed by physiotherapists. 

The Role of Physiotherapy 

Physiotherapy is considered the first-line treatment of Cervicogenic headaches. Physiotherapy treatment includes manual therapy around the neck and shoulders in conjunction with an exercise program. Research has found that a 6-week program of manipulative therapy and supervised exercise reduced the symptoms and frequency of Cervicogenic headaches, with the effects being maintained in the long-term.3 

If you think you have a Cervicogenic headache come and see us at Elevate Physio and Pilates in Balwyn for an initial assessment, where we provide a comprehensive evaluation, explain the diagnosis, and highlight the different management options! 

References 

1. https://ichd-3.org/11-headache-or-facial-pain-attributed-to-disorder-of-the-cranium-neck-eyes-ears-nose-sinuses-teeth-mouth-or-other-facial-or-cervical-structure/11-2-headache-attributed-to-disorder-of-the-neck/11-2-1-cervicogenic-headache/#:~:text=Description%3A,invariably%20accompanied%20by%20neck%20pain. 
2. Hall, T., Briffa, K., & Hopper, D. (2008). Clinical evaluation of cervicogenic headache: a clinical perspective. Journal of Manual & Manipulative Therapy, 16(2), 73-80. 
3. Jull, G., Trott, P., Potter, H., Zito, G., Niere, K., Shirley, D., … & Richardson, C. (2002). A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine, 27(17), 1835-1843.