Cervicogenic Headaches: Causes, Symptoms, and How Physiotherapy Can Help

Reviewed by the Physiotherapy Team at Waterloo Sports Medicine Centre  Do you experience headaches that seem to begin in your neck or the base of your skull, especially after sitting for a long time? Your symptoms may be related to a cervicogenic headache, a type of headache caused by issues involving the joints, muscles, or nerves of the upper neck. 

While headaches can have many different causes, some headaches are linked to dysfunction in the cervical spine. Physiotherapy for cervicogenic headaches can help address contributing factors such as reduced neck mobility, muscle weakness, posture, and movement patterns to reduce symptoms and improve daily function. 

What Is a Cervicogenic Headache? 

A cervicogenic headache is a headache caused by a disorder or irritation of structures within the cervical spine (neck), including the joints, muscles, discs, and surrounding tissues. Pain signals from the upper neck can travel through shared nerve pathways, causing pain that is felt in the head or face. Cervicogenic headaches commonly involve: 

• Pain that starts in the neck or base of the skull 

• Pain that spreads toward the forehead, temples, or behind the eyes 

• Reduced neck movement 

• Symptoms that worsen with certain neck movements or positions 

• Neck stiffness or muscle tenderness

Because symptoms can overlap with other headache types, such as migraines and tension-type headaches, a proper assessment is important to identify the likely source of symptoms

What Causes Cervicogenic Headaches? 

Cervicogenic headaches can occur when structures in the neck become irritated, overloaded, or restricted. 

• Poor posture, especially prolonged forward head posture 

• Neck muscle tension or weakness 

• Reduced mobility of the upper cervical joints 

• Previous neck injuries, including whiplash 

• Repetitive neck movements 

• Long periods of sitting or desk work 

Activities such as prolonged computer use, phone use, or sustained postures may increase stress on the neck and contribute to symptoms. 

Risk Factors 

• Previous neck injury 

• Ongoing neck pain or stiffness 

• Repetitive work or sport-related neck movements 

• Poor neck and shoulder muscle endurance 

• Prolonged sitting or reduced movement throughout the day 

Common Symptoms 

• Headache that begins in the neck or back of the head 

• Pain that travels toward the forehead, temple, or eye 

• Neck stiffness 

• Reduced ability to rotate or move the neck 

• Tenderness in the neck and shoulder muscles 

• Headaches triggered by certain neck movements or positions 

How Can Physiotherapy Help? 

• Education on posture, ergonomics, and activity modification 

• Manual therapy techniques to improve neck joint mobility 

• Exercises to strengthen deep neck muscles 

• Upper back and shoulder strengthening 

• Mobility exercises for the neck and upper spine 

• Movement retraining 

• Strategies to manage flare-ups and prevent recurrence 

Research suggests that a combination of manual therapy and exercise therapy may help reduce headache intensity, frequency, and disability in individuals with cervicogenic headaches.

Looking for treatment for neck pain and headaches in Waterloo? The physiotherapy team at Waterloo Sports Medicine Centre can help. Our experienced physiotherapists provide evidence-based assessments and personalized treatment plans to improve movement, reduce symptoms, and support your return to the activities you enjoy.