Cervicogenic Headache: When the pain in your neck goes to your head


Everyone gets a headache from time to time, most often triggered by everyday tension or fatigue. Headaches that have no underlying medical or structural cause are called primary headaches, and migraines, no matter how sever, are included in that category.

Secondary headaches have a specific underlying cause that may include disease, infections, head injuries, vascular disorders, brain bleeds or tumors. When secondary headaches originate in the neck, they are called cervicogenic headaches.

Symptoms of Cervicogenic Headaches

Cervicogenic headaches are often mistaken for migraines, but the two have distinct symptoms and origins. Migraine symptoms often include nausea, vomiting and sensitivity to light and sound. While someone experiencing a cervicogenic headache may experience similar symptoms, the condition has its own unique set of symptoms, including:

  • Reduced neck range of motion
  • Pain and stiffness in the neck
  • Pain on one side of the head or face
  • Pain around the eyes
  • One-sided pain in the neck, shoulder or arm
  • Tightness in the neck and/or shoulders
  • Facial tightness
  • Head pain triggered by a change in position or certain neck movements
  • Migraine-like symptoms of blurred vision, nausea and sensitivity to light and noise

In a cervicogenic headache, pain originates at one side of the back of the head or neck and radiates toward the front.

Causes of Cervicogenic Headaches

Cervicogenic headaches are caused by myofascial tension and trigger points in the cranial muscles and neck. The headaches are usually preceded by some type of mechanical disruption, like a change in position or sudden sharp movement. They most often originate at the uppermost cervical vertebra, at the junction of C2 and C3.

Some common causes of cervicogenic headache include:

  • Working at a job that strains your neck, like working on a computer, driving, or doing manual labor. Hairdressers are often prone to cervicogenic headaches.
  • Injury to the neck, like whiplash from an auto accident.
  • Arthritis of the upper spine.
  • Vertebral fractures.
  • Infections.

Any of the above conditions can cause myofascial tension and produce trigger points. Myofascial tension means tense muscles (myo) and connective tissue (fascia). Fascia is made of tough thin sheets of tissue that encase and separate muscles and muscle fibers. The facia enables muscles to move independently of one another, without affecting neighboring tissues.

Trigger points are mini muscle spasms that usually occur at the neuromuscular junction, where muscle meets nerve. Myofascial trigger points can be caused by:

  • poor posture
  • physical inactivity
  • imbalanced muscle tension
  • unequal leg length
  • joint disorders
  • sleep disorders
  • nutrient deficiencies
  • overuse from sports or exercise

Cervicogenic Headache Treatment

Clearly, many things can contribute to a cervicogenic headache, and in some cases multiple causes may coexist. To treat the condition, the underlying causes must first be identified, and each patient must be diagnosed on an individual basis.

The main goal of treatment is to reduce myofascial pain and tension, and eliminate trigger points. Therapeutic massage may help reduce myofascial tension, but massage alone is not enough to fully eliminate trigger points.

The most effective treatment for eliminating myoafascial trigger points and resolving cervicogenic headache is ultrasound guided dry needling (USGN). Using the most technologically advanced high-resolution ultrasound, a thin needle is guided directly into the trigger point, causing the spasm to release and dissipating tension.

Ultrasound guidance enables treatment of trigger points buried deep within muscle tissue, where they cannot be detected with the naked eye. When combined with other treatments that target the causes of trigger point formation, cervicogenic headaches can be completely eliminated, never to return.

Headache Treatment in NYC

The clinic at NYDNR houses some of the most advanced technologies for treating a broad range of pain syndromes and disorders. We use ultrasound imaging and other innovative methods to get to the root of pain and eliminate it.

You don’t have to suffer ongoing headaches and neck pain. Contact NYDNR today, and get rid of your headaches for good, so you can live your very best life.

Research at NYDNRehab


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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