Cervicogenic headache is pain that starts in the neck and is referred to the head, so treatment targets the neck. An occipital nerve block usually comes first. It relieves the pain and finds its source. Physical therapy for the upper cervical spine (the top of the neck) does the lasting work.
A headache whose source is in the neck. Treat the head and it comes back. Treat the neck and it often does not.
What does a cervicogenic headache feel like?
Pain begins in the neck or the base of the skull and is referred forward — over the back of the head, behind the ear, sometimes to the forehead or around the eye. It is usually one-sided and stays on that side. Neck position or movement brings it on. So can long hours in a desk posture, or pressure over the upper cervical joints. Range of neck motion is often reduced on the affected side.
It frequently follows a neck injury, including whiplash, sometimes months later.
How is it different from migraine or occipital neuralgia?
Against migraine: cervicogenic headache lacks the throbbing, the nausea and the light sensitivity. Neck movements bring it on, not movement in general. Against occipital neuralgia: the pain is a deep ache rather than electric jolts, and the marked scalp tenderness is absent.
Overlap is common, and a nerve block is often what separates them.
How is cervicogenic headache treated?
An occipital nerve block is usually the first step. It relieves the pain and shows where it is coming from. If the source is the cervical facet joints (small joints at the back of the neck) rather than the occipital nerve, testing and treatment move to those joints instead. Physical therapy aimed at the upper cervical spine does much of the lasting work. Injections buy the window in which that becomes possible.
Booking online shows our scheduled openings. Call or text for hours that are not listed. Please contact us before coming in rather than arriving unannounced — we need to know what is happening to have the right treatment ready.
A note on coverage, and on timing. Same-day treatment and prior authorization do not run on the same clock. Many insurers take days to weeks to decide. Some acute headache treatments are not covered at all. Your headache will not wait for that process.
We will verify your benefits. Where a treatment needs prior authorization, we will try to obtain it. An authorization confirms that a service meets criteria for review — it is not a guarantee of payment. No clinic can make that promise on your insurer’s behalf. Some things are unlikely to be covered, or cannot be certified in time to treat you today. In those cases we will tell you before we treat rather than after, so the decision is yours. Payment is due at the time of service.
Frequently asked questions
Why won’t my cervicogenic headache go away?
Because the pain is generated in the neck, not the head. Treat the head and the headache comes back. Treat the neck and it often does not. Here that usually means an occipital nerve block first, to relieve the pain and confirm where it starts. Then physical therapy aimed at the upper cervical spine does the lasting work, in the window the injection opens.
What brings on a cervicogenic headache?
Neck position and neck movement are the usual triggers. So are long stretches in a desk posture and pressure over the upper cervical joints. It often follows a neck injury, including whiplash. It can start months after the injury itself. Range of neck motion is often reduced on the painful side.
How do I get relief from a cervicogenic headache?
Relief comes from treating the neck. An occipital nerve block is usually the first step: it relieves the pain and shows whether the occipital nerve is the source. If the cervical facet joints are the source instead, treatment moves to those joints. Physical therapy for the upper cervical spine then does much of the lasting work.
Is a cervicogenic headache on one side?
Usually, yes. It is typically one-sided and stays on that side. It starts in the neck or the base of the skull and spreads forward over the back of the head, behind the ear, and sometimes to the forehead or around the eye. Unlike migraine, it lacks the throbbing, the nausea and the light sensitivity.