A headache that is actually a neck problem will not respond to migraine treatment, which is why cervicogenic headache is so often managed for years without improvement. It is a distinct diagnosis with a distinct target. At Remix Medical in Houston, our board-certified pain physicians identify it and treat the neck.
What is a Cervicogenic Headache?
A cervicogenic headache is a secondary headache: the pain originates in the upper cervical spine and is referred to the head. The upper neck segments share nerve pathways with structures in the head, which is why a joint problem at C2 or C3 is felt behind the eye.
It is typically one-sided, steady rather than throbbing, and provoked by neck movement or sustained posture. Neck stiffness and reduced range of motion usually accompany it. Those features distinguish it from migraine, which is a primary headache with its own pattern — though the two are frequently confused, and can coexist.
What Causes Cervicogenic Headache
1. Upper Cervical Joint Dysfunction
Problems in the C1–C3 segments are the most common source.
2. Prior Neck Trauma
Whiplash is a well-recognized precipitant, sometimes months after the injury.
3. Cervical Facet Arthritis
Age-related arthritis of the small neck joints refers pain upward into the head.
4. Sustained Forward-Head Posture
Desk work and prolonged driving load the upper cervical structures for hours at a time.
5. Cervical Disc Disease
Degeneration or a prolapsed cervical disc can irritate the nerves supplying the region.
How Remix Medical Can Help
Diagnosis follows the ICHD-3 criteria: evidence of an upper cervical disorder, plus supporting features such as a temporal link to the neck problem, reduced neck range of motion, headache provoked by neck maneuvers, or resolution after a diagnostic block.
That last point is worth understanding. A diagnostic block is a small anesthetic injection targeting the specific joint or nerve suspected of driving the pain. Substantial relief afterward both confirms the diagnosis and identifies exactly what to treat — which is why it is considered a major diagnostic criterion rather than merely a treatment.
| Approach | What it involves |
|---|---|
| Physical therapy + posture correction | Neck strengthening and ergonomic change addressing the dysfunction driving the headache — the mainstay of treatment |
| Medication management | Anti-inflammatories and nerve-pain agents |
| Occipital nerve blocks | Target the greater and lesser occipital nerves carrying pain from the upper neck to the scalp |
| Cervical facet and medial branch blocks | Confirm which joint level is responsible and provide relief |
| Trigger point injections | For the suboccipital and trapezius muscle tension that accompanies most cases |
| Radiofrequency ablation | Durable relief when diagnostic blocks have confirmed the source |