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  • Dr. Donald Littlewood

Is turning your head a real pain? This could be your answer.

Cervicogenic headaches (CGH) are a very common diagnosis in my practice. But what are they?

CGH are considered secondary headaches. This means that they come from another place in the body, and the referred pain manifests as a headache.

They are also the headache-type that responds the best to chiropractic care.

But what exactly is a cervicogenic headache?

Cervicogenic Headache 101

A cervicogenic headache starts as neck pain. Often times this neck pain happens because of a bunch of little things piled on top of each other: a bad night’s sleep, poor posture when checking your phone, a wrong move at the gym, etc.

All of this causes stress on the structures of the neck. The joints stop moving as they should, the muscles get stretched or shortened, and then pain happens. But why does the pain travel to the head.

Referred pain pathways.

The same nerves that supply the muscles and joints of the neck, especially the upper neck, have fibres that go up into the head, behind the eye, and at the temple. The brain can’t determine exactly where the problem is, only what set of nerves it is coming from.

Hence the headaches.

Signs & Symptoms of Cervicogenic Headaches

Besides neck pain, there are other signs and symptoms to look out for if you think you are experiencing a cervicogenic headache.

  • Decreased range of motion. Because the structures of the neck aren’t moving properly, you’re going to find that you cannot move your neck as you could before.

  • Headaches generally increase when you move your neck.

  • You may also feel pain in other areas of the body, mainly the shoulder/arm and the mid back.

  • Cervicogenic headaches are often described as one-sided, dull and are usually given a 5-8/10 on the pain scale.

Forward Head Posture and Cervicogenic Headaches

There is a big relationship between forward head posture (FPH) and cervicogenic headaches. This is due to the increased tension that poor posture places on the structures of the neck.

FHP increases the stress on the muscles & ligaments of the neck by up to 30lbs. That is way more work than your body needs to be doing; no wonder your neck gets sore!

With FHP, the lower neck vertebrae are flexed, while the upper neck vertebrae are extended. This extra stress on the joints and muscles can cause pain to radiate up into the head.

Want to know more on how forward head posture affects your health? Check out this blog post I wrote for more.

Treatment of Cervicogenic Headaches

So you have neck pain and a headache… now what are you supposed to do about it?

The research is undeniable: chiropractic care can help relieve cervicogenic headaches.

So how do I treat cervicogenic headaches?

Before I go on, I must say – any form of treatment is discussed with the patient, and at the end of the day, the decision is made together. No treatment will be performed with which you are not comfortable.

Spinal Manipulative Therapy

Spinal manipulative therapy (SMT) is a fast, small movement performed by a chiropractor. The end goal is to get movement through the joint.

SMT is effective because part of the reason you are feeling pain is due to the joints not being able to move properly.

When the joints are moving properly the muscles don’t have to do as much work, and the neck & head don’t get as sore.

Soft Tissue Therapy

Soft tissue therapy is essentially an intense massage that is focused in the area.

With cervicogenic headaches, there are a lot of muscles that I treat, mostly in the side and back of the neck.

This loosens up the muscles enabling a bit more range of motion and ultimately less pain in the area.


Acupuncture has literally been around for centuries.

Putting a needle into a few very specific points has shown to be a great adjunct to decreasing headache sensations.

While a needle is the most effective, you can also use the pressure of your thumb in the same spots to get a similar result.

The main one is called LI-4. It is right in the meaty part of your hand between the thumb and index finger. Find the meatiest part of the area and apply a firm pressure from both the top and the bottom of your hand.

Specific Exercises

So we know that chiropractic care is safe and effective for cervicogenic headaches, but a complete treatment plan MUST include the right exercises.

A lot of people assume that all the muscles need to be strengthened. While that is true for some, there are shortened muscles involved that need to be stretched.

One of those muscles is almost always the upper trapezius.

How do you stretch the upper traps you may ask? Lucky for all, its super easy!

Start by sitting comfortably in a chair. Then with your right hand, grab the left side of the head right above the ear. Pull your head to the right and hold for 30-45 seconds.

When you are doing this, try to keep your shoulder down. This is going to make the stretch that much more effective.

If you find you can’t keep your shoulder down on your own, loosely hold onto the bottom of the chair.

Final Thoughts

Cervicogenic headaches can seriously ruin a day, a week, or a month. I know that a lot of people suffer in silence from these, but you really don’t have to.

Find a chiropractor you trust and chat with them about your headaches. Toronto folk – I’m your guy!

In health,

Dr. Donald Littlewood