A headache that starts in your neck.
Cervicogenic headache is head pain that originates in the bones, discs, or soft tissue of the upper cervical spine — not in the brain itself. It's one of the most commonly misdiagnosed headache types, and because the source is structural, treating the headache without addressing the neck rarely works for long.
Your doctor may call this a neck-origin headache or referred headache from the cervical spine.
Often seen within a few days — sometimes as soon as tomorrowRequest your first visit
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What cervicogenic headache really is.
Cervicogenic headache is a secondary headache — meaning it's caused by another condition, in this case a problem in the neck. The upper three cervical vertebrae (C1, C2, C3) share nerve connections with the trigeminal nerve, which serves the head and face. When a structure in the upper neck is irritated — a joint, disc, or nerve root — pain can be referred upward and felt as a headache. This nerve-sharing pathway is why neck problems produce genuine head pain, not just neck pain.
Cervicogenic headache typically begins at the back of the head, then spreads forward toward the forehead or behind the eye, usually on one side. Unlike a migraine, it doesn't throb — it tends to be a steady, aching pressure. Neck movement often aggravates it. Sustained postures, like looking at a screen for hours or sleeping in an awkward position, are common provocations. The condition is more common after whiplash or a neck injury, but can develop from degenerative changes in the cervical spine as well.
The good news
Because the source is structural, cervicogenic headache responds well to treatments aimed at the neck itself. A diagnostic nerve block can pinpoint exactly which joint or nerve root is driving the pain. Physical therapy, cervical injections, and in some cases radiofrequency ablation of the responsible joint's nerve supply can produce meaningful, lasting reduction in headache days.
Confirming the cervical source
Diagnosis is established when the headache can be provoked or relieved by provocative maneuvers at the neck, and ideally confirmed by temporary pain relief following a diagnostic block of a cervical structure — most often the C2–3 zygapophyseal (facet) joint or the third occipital nerve. This block-confirmed approach is the gold standard because it identifies the specific pain generator and guides whether cervical medial branch blocks or radiofrequency ablation are appropriate next steps.
Common signs we treat.
Headache starting in the neck
Pain that begins at the base of the skull or in the upper neck and radiates forward — often to the forehead, eye, or temple, typically on one side.
Reduced neck motion
Turning or tilting the head often aggravates the headache or triggers it — a hallmark that distinguishes cervicogenic headache from most primary headache types.
One-sided steady pain
A non-throbbing, steady ache on one side of the head — different from the pulsating quality of migraine and often worse with prolonged sitting or screen time.
From hurting to healed.
We work from the least-invasive options upward, escalating only if you need it. Most patients improve well before surgery is ever discussed.
Diagnose the cause
A physician examines you and, if needed, reviews imaging to pinpoint exactly what's driving the pain.
Calm it down
Targeted physical therapy, activity guidance, and medication to settle the irritation and reduce inflammation.
Image-guided injections
If pain persists, a precisely targeted injection delivered to the source under imaging.
Advanced options
For the few who need more, minimally invasive interventional procedures — with surgery as a last resort.
Treatment is matched to your specific diagnosis at your visit. The options shown reflect NASPAC's general approach and should be confirmed against the practice's verified procedure list.
Still have questions?
Yes — and it's more common than most people realize. The upper cervical spine shares nerve pathways with the trigeminal nerve, which serves the head and face. Irritation of a joint, disc, or nerve root in the upper neck can send referred pain upward into the head. This is why cervicogenic headache is real head pain, not simply neck pain that "spreads" — the mechanism is a genuine referral pathway, not just proximity.
Diagnosis starts with a careful history and physical exam — including an assessment of neck range of motion, palpation of the upper cervical joints, and provocative maneuvers that reproduce or change the headache. Imaging helps rule out structural pathology. The most definitive step is a diagnostic nerve block targeting the suspected cervical structure: if a small injection of local anesthetic temporarily relieves the headache, it confirms that structure as the pain source.
Physical therapy targeting the upper cervical spine is often the first step — improving posture, mobility, and muscle balance reduces the mechanical load on the irritated structure. Cervical facet injections or medial branch blocks can provide relief and confirm the diagnosis simultaneously. For patients with sustained relief from repeated blocks, radiofrequency ablation of the responsible nerve supply can produce longer-lasting results. Most patients don't need surgery.
Several features distinguish cervicogenic headache from migraine: the pain is usually steady and aching rather than throbbing; it is consistently worse with neck movement or sustained postures; it doesn't typically come with nausea or vomiting; and it doesn't improve with migraine-specific medications like triptans. That said, the two can coexist, which is why a thorough evaluation matters — treating only one when both are present limits how much improvement you get.
Stop living with the headache.
Book with a board-certified pain physician near you — most patients are seen within days.
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