Cervicogenic Headache

June 2, 2014 | By | Reply

The term Cervicogenic Headache (CGH) was coined by Norwegian physician Dr. Ottar Sjaaastad in 1963. CGH is the headache originated from the cervical spine.

Cervicogenic Headache

Cervical spine consists of :

  • 7 cervical segment
  • 6 inter vertebral discs
  • Several ligaments & muscles to support the neck
  • Vascular structures for blood supply

Pain may arise majorly from first 3 (C0-C3) cervical segments. It can occur by degenerative disc disease of these segments, a disc injury or a repetitive strain like postural strain. Causes of CGH can be upper cervical facets, upper cervical muscles, C2-3 inter vertebral disc, vertebral and internal carotid arteries.

Cervicogenic Headache


  • Mostly one-sided headache, but can be spreading to the other side too
  • Aching type of pain
  • Associated with neck pain or stiffness
  • At times same side arm pain may also be present
  • Onset of pain – from the neck and then spreads to other areas
  • Pain localized to the sub-occipital, temporal or frontal area. Occasionally Tempero-mandibular joint (TMJ) involvement.

Cervicogenic Headache


Incorrect Posture

  • People with forward head posture. Very commonly seen in those who have a desk job or excessive usage of gadgets like mobile phones, laptops etc.
  • Increases stress on upper cervical segments.
  • Associated with weakness of deep neck core stabilizers

Cervicogenic Headache


  • Tight upper cervical muscles, & upper trapezius

  • Weak neck core stabilisers

  • Weak upper back muscles

  • Tight pectorals




Range of motion / flexibility restriction

  • People with restricted range of movement of the neck are also at risk.

Muscle length & weakness

  • Often tightness of upper trapezius, levator scapulae, sternocleidomastoid, pectoralis major & minor, suboccipital muscles & scalene muscles.
  • Weakness in the deep neck core stabilizers
  • This leads to a muscular imbalance causing cervical dysfunction.

Cervicogenic Headache

Vertebrobasilar artery insufficiency (VBI)

  • This artery starts from the base of the neck & then supplies blood to major areas in the brain. Any disturbance in the blood flow will also give symptoms of headache. Before any manual assessment the patient should be first assessed for VBI as it can lead to serious complications

Myofascial trigger points

  • High chances of having trigger points in the upper trapezius, sternocleidomastoid, levator scapulae, pectoralis major & minor which may give a referred pain as a headache

Other risk factors of CGH are

  • whiplash injury, cervical spondylosis, cervical instability, cervical rib


Pain management

  • Pharmacologic intervention – the efficacy of medicines have been limited in CGH
  • Modalities – Some modalities like ultrasound, cryotherapy, TENS will help to reduce pain & enhance healing
  • Dry needling , soft tissue release are helpful to release the tight muscles causing dysfunction

Manual therapy

  • Manipulation & Mobilization of the upper cervical segment
  • Manual therapy combined with exercise works well for a long term relief from CGH

Muscle stretches

  • Stretching of all the tight muscles will reduce the muscular imbalance

Therapeutic exercises

  • Training the deep core stabilizers of the neck
  • Progressive strengthening with thera-bands
  • It is also important the strengthen the other postural muscles like the scapular stabilizers & back extensors
  • Kinetic control of the neck and upper back

Postural awareness

  • Being aware about posture will help to relieve the undue stress on the cervical spine joints & muscles & thus reducing the CGH
  • A major role is played by the core muscles which helps in providing proprioception to maintain a good posture

A well planned exercise program can definitely help reduce CGH and will keep you more aware about your own body & posture. We at PHYSIOREHAB are trained in treating & guiding patients with CGH for a better quality of life.

Tags: , , , , , , ,

Category: Articles

Leave a Reply