Cervicogenic headache

Cervicogenic headache is head pain that starts in the neck. Moving the neck, holding a posture, or pressing on certain spots often brings the headache on or turns it up.

What it feels like

Pain usually starts in the neck or at the base of the skull and travels into the head, often on one side. The forehead, temple, or eye area can feel involved.

Turning, extending, or sustaining a desk posture can provoke it. Neck stiffness is common. Light and sound sensitivity are usually milder than classic migraine, though overlap happens.

Some people notice shoulder-blade ache or upper neck tenderness on the same side as the headache.

What is going on

Structures in the upper cervical spine (joints, discs, ligaments, and soft tissue) can refer pain into the head through shared nerve pathways.

Cervical facet joints are a frequent driver. When they are, a diagnostic medial branch block can help confirm the source.

This is different from primary migraine, even though both can coexist. Getting the driver right matters for the plan.

How we evaluate

We watch how neck motion and palpation affect your usual headache, and we compare that to migraine or occipital neuralgia features.

A cervical exam checks range of motion, facet loading, neurologic findings, and occipital nerve tenderness.

Existing imaging is reviewed when you have it. We order more when red flags appear or when the plan depends on structural detail.

What we may offer

Care often starts with activity guidance and physical therapy aimed at cervical mechanics, posture load, and soft tissue.

When the facets look like the driver, medial branch blocks can clarify the diagnosis. A positive block may lead to a discussion of radiofrequency ablation on the same pathway.

An occipital nerve block sometimes helps when occipital nerves are irritated alongside the neck pattern. Medication management can support flares while we treat the neck source. Botox is not the usual path for pure cervicogenic headache.

How is cervicogenic headache different from migraine?

Cervicogenic headache is driven by neck structures and often tracks with neck movement or posture. Migraine is a primary brain-based headache that may include aura, marked sensory sensitivity, and nausea. Some people have both.

When do medial branch blocks fit?

When the history and exam point to cervical facet joints as the headache source, a diagnostic medial branch block can test that idea before longer-term options like radiofrequency ablation.

Will physical therapy help?

Often yes when mechanics and soft tissue are feeding the pain. We coordinate PT with any injection plan so gains stick.