Headache From the Neck (Cervicogenic Headache): Symptoms, Causes & PT Treatment
Updated October 20261 minute read
A cervicogenic headache is a headache that actually starts in the neck and is felt in the head — typically one-sided, often beginning at the base of the skull and spreading toward the forehead or behind the eye. Neck movement or sustained posture can trigger it. It responds well to physical therapy that targets the neck joints and muscles. A sudden, severe "worst-ever" headache or one with neurological symptoms needs emergency care.
What is a cervicogenic headache?
It's a headache referred from the structures of the upper neck — joints, muscles, or nerves — rather than originating in the brain. Treating the neck typically relieves the headache.
Symptoms
Common features are a one-sided headache that starts in the neck or base of the skull and spreads forward, reduced neck motion, and headaches triggered by neck positions or sustained postures. Unlike migraines, it usually lacks strong nausea or light sensitivity.
What causes it / risk factors
Upper-neck joint and muscle dysfunction, prolonged forward-head posture (desk and phone use), prior neck injury, and stress contribute.
How it's diagnosed
Diagnosis is clinical — a therapist or physician reproduces the headache by examining the upper neck and rules out other headache types.
Physical therapy treatment
What a PT does. Your therapist mobilizes and strengthens the upper neck, retrains posture, and addresses contributing muscle tension. Exercises & progression (overview). Deep neck strengthening, upper-back and posture work, and joint mobilization. PT is well supported for cervicogenic headache. Recovery timeline. Many people improve over several weeks.
Treatment options compared
PT is first-line. Posture and ergonomic changes help. Medication targets symptoms but not the neck cause.
Red flags
Seek emergency care for a sudden severe "worst-ever" headache, or headache with slurred speech, vision changes, weakness, fever, or confusion.
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Frequently asked questions
Clues include one-sidedness, starting in the neck, reduced neck motion, and triggering by neck positions — a PT can confirm.
Sources (5)
- Jull G, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002. — PubMed
- Blanpied PR, et al. Neck Pain: Revision 2017. J Orthop Sports Phys Ther. 2017. — PubMed
- MedlinePlus: Headache. — NIH/MedlinePlus
- Koonalinthip N, et al. The Comparative Efficacy of Treatments for Cervicogenic Headache: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials. Eur J Pain. 2026. — Eur J Pain
- Gross A, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015. — Cochrane
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.