What cervicogenic headache is
Cervicogenic headache is pain referred from the cervical spine, facet joints, intervertebral discs, or surrounding soft tissues to the head. It is typically unilateral, starting in the neck or occiput and radiating forward to the frontal or temporal region. The pain is often constant, worsened by sustained postures or neck movement, and may be associated with neck stiffness or reduced range of motion.
Precise differentiation from migraine and tension-type headache requires careful history and examination. Cervicogenic headache is aggravated by neck movement or sustained postures, may be triggered by pressure over the upper cervical spine, and does not meet full ICHD-3 criteria for migraine or tension-type headache.
- Unilateral pain starting in neck or occiput, radiating forward
- Worsened by neck movement or sustained postures
- Aggravated by pressure over upper cervical structures
- Does not meet ICHD-3 criteria for migraine or tension-type
Related: Headache Medicine → · Dr. Jitendra Knowledge Hub → · ICHD-3 Topic →
Differentiation and diagnosis
Migraine often presents with nausea, photophobia and throbbing quality that is not posture-dependent; cervicogenic headache is consistently aggravated by neck positions and does not have the full migraine accompaniments. Tension-type headache is bilateral and pressing without clear aggravation by neck movement. Diagnostic cervical medial branch blocks can confirm the facet joint as the pain source when clinical evaluation is uncertain.
Evaluation includes cervical spine examination, range of motion assessment, palpation of upper cervical structures, and neurological screening. Imaging of the cervical spine may be considered when structural pathology is suspected. Treatment targets the cervical source with physiotherapy, postural correction, and medication review.
- Cervical examination with range of motion and palpation
- Diagnostic blocks for facet joint pain confirmation
- Physiotherapy and postural correction
- Distinguished from migraine by posture-dependent aggravation