Why Physiotherapy is an effective cervicogenic headache treatment15 May 2017

20% of chronic headache sufferers experience cervicogenic headaches. Otherwise known as ‘secondary’ headaches (headaches caused by a specific injury or condition), cervicogenic headaches are caused by a referred pain from the neck area. Here we outline the causes and symptoms of these headaches, and how physiotherapy can work as an effective cervicogenic headache treatment.

What causes cervicogenic headaches?

There are two main causes of cervicogenic headaches:

  • A specific traumatic incident: Whiplash / blow to the head or neck.
  • Postural: Poor sitting posture can cause strain to the upper cervical joints in the neck area causing stiffening / irritation.

Trauma or irritation to the muscles and tissues around the neck area causes headaches when the sensory nerve fibres from the neck converge with the nerve fibres from the trigeminal nerve (face and scalp sensation). This causes a referred head pain, so it often feels more painful in the head than the neck.

cervical spineCervicogenic headache symptoms

There are a number of symptoms differentiating cervicogenic headaches from other types of headache (tension, cluster etc.) including:

  • Pain at the top of the neck and back of the head, sometimes spreading to the forehead or eye
  • A constant pain that tends to get worse throughout the day
  • Pain is often daily, usually on one side of the head and neck
  • Pain could be a dull ache, and/or sharp stabbing sensation

How can physiotherapy help?

Physiotherapy has been proven to provide an effective cervicogenic headache treatment by facilitating movement in the stiffened neck joints. Experienced therapists will carry out a physical and lifestyle assessment to ascertain the cause and symptoms of your head pain, before establishing a treatment plan. Treatment is generally a combination of techniques to alleviate the symptoms over the course of a number of weeks. These include:

  • Manual therapy techniques to the cervical spine and surrounding soft tissues. This helps to restore the range of motion and normal joint movement to the cervical spine.
  • Establishing an exercise program that can be carried out at home to work on the deep neck flexors, facilitating normal neck movement through sustained exercise of the affected area.

Studies have shown a 76% success rate using these physiotherapy interventions. 50% of patients report a decreased frequency of headaches, and 35% reported headaches disappeared after 7 weeks of treatment.

Can medication be used to treat cervicogenic headaches?

While anti-inflammatory / analgesic medication can be prescribed in conjunction with physiotherapy techniques, medication is unlikely to be effective when used as the sole method of treatment as it doesn’t resolve the root cause of the problem – i.e. the stiffening of the neck joints / muscles. If necessary, physiotherapists can liaise with your GP to prescribe medication alongside physiotherapy treatment.


As part of your treatment, your physiotherapist will address the likely causes of your headaches, and advise on lifestyle changes to prevent their return. Cervicogenic headaches can be prevented by:

  • Adopting a good sitting posture
  • Staying well hydrated
  • Getting regular exercise to stimulate circulation of blood to the head
  • Ensuring your head is level with your spine when sleeping. Ideally you should sleep on your side with your head supported, or on your back with a small pillow supporting your neck, and not on your stomach

At Harpenden Physiotherapy, our experienced physiotherapists work with patients to assess your symptoms, and work with you to develop an effective treatment plan. We advise on exercises and measures you can take at home or work to prevent pain from conditions such as Cervicogenic headaches returning. Visit our head, neck and upper back page for more information, or contact us either online or by calling 01582 761 448.

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Why Physiotherapy is an effective cervicogenic headache treatment

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