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Cervicogenic Headaches

There are a number of different types as well as causes of headaches.  There are migraines, tension headaches, and cluster headaches to name a few, and headaches can be affected by sleep, nutrition, and even stress.  Not all headaches can benefit from physical therapy intervention, however there is one type of headache in particular that can see a significant improvement in frequency and intensity of symptoms and that is the cervicogenic headache.

What is a cervicogenic headache?

Cervicogenic headaches are a type of secondary headache (a headache caused by another medical or physical issue).  With this particular headache, the physical issue is related to the cervical spine or neck. Problems with the bones, discs, ligaments, or muscles in the neck can cause symptoms of referred pain into the head due to the close connection of nerves in this area of the spine.  

What causes cervicogenic headaches?

Cervicogenic headaches can develop slowly overtime related to recurrent poor posture or degeneration of the spine.  Cervicogenic headaches may also occur after a traumatic episode such as a car accident or sports injury.

How is a cervicogenic headache diagnosed?

There is not one test that can help to diagnose cervicogenic headaches, but rather diagnosis is commonly made based on the individual’s report of symptoms.  With this type of headache there are a few distinguishing factors:

  • symptoms are typically only on one side of the head
  • symptoms are consistently on the same side of the head
  • ram’s horn pattern of pain (starts at the base of the head and extends over the top of the head to the eye)
  • pain occurs with neck movements or prolonged postures
  • neck is frequently tender to touch
  • decreased mobility in the neck often present

How can physical therapy treat cervicogenic headaches?

  • Manual therapy to the cervical and thoracic spine: hands on techniques targeting the muscles and joints of the neck and mid-back can help to decrease pain and improve neck mobility
  • Strengthening of the neck and postural stabilizers: exercises can be taught that target strengthening the neck muscles, in particular the deep neck flexors, as well as the muscles that help us maintain proper posture
  • Posture Re-education:  as posture is often a contributing factor in both the development of cervicogenic headaches as well as a potentially aggravating factor, it is important to learn ways to maintain more positive postures.  Below are some of the most common poor postures that may be addressed:
    • Rounded shoulders and forward head in standing
    • Slumped sitting at a computer or on a couch
    • Looking down at a phone

If you have been struggling with cervicogenic headaches reach out to POST Physical Therapy and make an appointment today or contact for more details!


Cervicogenic Headaches: The Basics.  American Migraine Foundation.

Luedtke K, Allers A, Schulte L H, et al. Efficacy of interventions used by physiotherapists for patients with headaches and migraine- systematic review and meta-analysis.
Cephalgia. 2015;0(0): 1-19.
Page, P.  Cervicogenic headaches: an evidence-led approach to clinical management.  Int J Sports Phys Ther. 2011; Sep; 6(3): 254-266.