Head & neck
Cervicogenic Headache (Neck-Related Headache)
A headache that starts in the neck and spreads to the back of the head, temple or eye. Common in desk workers and often confused with tension headache.
Common symptoms
- Headache that begins at the base of the skull and spreads to one side of the head
- Pain behind the eye, at the temple or across the forehead on the same side
- Neck stiffness or reduced movement, especially turning
- Headache triggered or worsened by neck movement or a sustained position
- Tenderness when pressing the upper neck or base of the skull
- Pain in the same shoulder or arm in some people
- A tight-band feeling around the head when tension-type headache overlaps
Overview
A cervicogenic headache is a headache that is "referred" from the neck. The upper three joints of the neck share nerve connections with the nerves that supply the back of the head and face, so a stiff or irritated upper neck can be felt as a headache. It is typically one-sided, starts at the base of the skull and spreads forward towards the temple, forehead or behind the eye.
It is often mixed up with tension-type headache, which feels like a tight band around the head and is linked to stress and muscle tension. The two can overlap: tight neck and shoulder muscles contribute to both, and many people have features of each. The key difference is that a cervicogenic headache is reproduced or changed by neck movement or by pressing on specific neck joints.
Neck-related headaches respond well to treatment that targets the neck, which is why a careful assessment matters. Migraine is a different condition and is not covered here.
Causes and risk factors
- Prolonged forward-head posture at a desk, laptop or phone
- Stiffness in the upper neck joints, sometimes following whiplash or a fall
- Tight or overactive suboccipital, upper trapezius and neck muscles
- Stress, poor sleep and jaw clenching, which add to muscle tension
- Age-related change in the neck joints (cervical spondylosis)
- Weak deep neck flexor muscles
How we may be able to help
Assessment comes first. We take a careful headache history to separate neck-related headache from tension-type headache and migraine, check the movement of your upper neck joints, test the deep neck muscles and look at your posture. If anything in the history suggests a medical cause, we direct you to your GP first.
Treatment may include hands-on mobilisation of the upper neck, chiropractic spinal manipulation where appropriate, and dry needling for trigger points in the neck and shoulder muscles that refer pain into the head. A 3D posture scan can show how your head sits relative to your shoulders. We then build a programme of deep neck strengthening and posture work, which evidence suggests may help reduce how often headaches return.
What you can do at home
- Keep a simple headache diary: when it starts, what you were doing and what helped
- Raise your screen and bring the keyboard close so your head stays over your shoulders
- Do gentle chin tucks and upper-neck stretches a few times a day
- Apply a warm pack to the base of the skull and tops of the shoulders
- Prioritise regular sleep and movement breaks, which reduce muscle tension
- See your GP if headaches are frequent, changing or not responding to treatment
When to seek urgent help
If you have any of the following, call us straight away for an urgent same-day appointment — we can examine you and arrange fast-track X-ray or MRI through our imaging partner. If you cannot reach us, go to A&E. For loss of bladder or bowel control, numbness around the groin, chest pain, a sudden severe headache or rapidly worsening weakness, call 999 or go to A&E immediately:
- A sudden, extremely severe headache that reaches its worst within minutes
- Headache with fever, stiff neck, rash, confusion or drowsiness
- Headache with new weakness, numbness, slurred speech or visual loss
- A new or changing headache in someone over 50, or with a history of cancer
- Headache that is worse on lying down, coughing or straining, or wakes you from sleep
Frequently asked questions
How do I know if my headache is coming from my neck?
Clues include pain that starts at the back of the head, is mostly one-sided, is brought on or changed by neck movement, and comes with neck stiffness. We confirm this by examining your upper neck joints and seeing whether pressing on them reproduces your usual headache.
Is it a tension headache or a neck headache?
They can overlap, and both are linked to tight neck and shoulder muscles. Tension-type headache is usually both-sided and band-like; cervicogenic headache is usually one-sided and tied to neck movement. Treatment for the neck and shoulder muscles may help either type.
Do I need a scan?
Rarely for this type of headache. If your history includes any of the red flags above, or your headache pattern has changed, see your GP first. An online GP consultation can be arranged through the clinic if a referral is needed.
Can chiropractic treatment help with headaches?
Evidence suggests that spinal manipulation and mobilisation of the upper neck may help some people with cervicogenic headache, particularly when combined with exercise. Our chiropractor assesses suitability first and discusses the small risks and alternatives with you.
This page is general information, not a diagnosis. A clinician will assess you before recommending any treatment. Outcomes vary from person to person. Written with reference to NHS and other peer-reviewed guidance.
Ready to get started?
Book online in under a minute, or message us on WhatsApp if you have a question first.