What Are the Risk Factors for Developing a Cervicogenic Headache?
What is a cervicogenic headache?
A Cervicogenic headache is a common form of secondary headache, originating from the upper cervical spine. Although the exact presentation varies between patients, it often originates from the base of the skull and spreads toward the forehead and/or behind the eye. It is typically one-sided, but it can also be bilateral or alternate between sides.
Our upper cervical spine - specifically the top 3 vertebrae (C1-3) - share neural pathways with a specific area in our brainstem called the trigeminocervical nucleus. When joint stiffness, disc, muscle or ligamentous tightness or irritation occurs in the upper cervical spine, sensory signals will be sent into our brain via the trigeminocervical nucleus, causing pain projection into our head, resulting in cervicogenic headache.
What are the risk factors for developing cervicogenic headache?
Both males and females of all ages can develop a cervicogenic headache, though it is relatively more common in females. Prolonged forward head posture is a key contributing factor, as it places excessive mechanical stress and loading onto the upper cervical spine. Poor ergonomic workstation setups, excessive screen time, and habitual slumping often lead to this prolonged forward head posture. Additionally, joint changes—such as arthritis, disc injuries, and previous whiplash injuries—can contribute to the development of a cervicogenic headache.
What Is the Management for a Cervicogenic Headache?
The management of a cervicogenic headache generally involves a combination of hands-on physiotherapy to reduce muscle and joint stiffness in the upper cervical spine, alongside specific rehabilitation exercises aimed at restoring cervical stabilising muscle endurance and control. Physiotherapy management for cervicogenic headaches has been extensively studied and proven to be highly effective.
Hands-on Therapy: By using specific joint mobilisation techniques (such as the Watson Headache Approach) on the upper cervical spine, physiotherapists can often quickly restore joint mechanics and reduce headache symptoms within a single session. However, depending on the severity of the condition, sustainable improvement typically requires 4 to 6 treatment sessions over a 2 to 3 week period.
Rehabilitation Exercises: As symptoms gradually settle, a tailored rehabilitation program will be prescribed to obtain long-term relief and prevent recurring episodes. These exercises are designed to restore cervical and thoracic spine control and mobility. They also improve postural tolerance by optimising the activation and endurance of the deep neck stabilising muscles and the periscapular muscles.
Ergonomic Advice: Specific ergonomic guidance, such as adjusting workstation setups or correcting manual handling techniques, may also be utilised. Depending on the patient's occupation, these adjustments help minimise excessive loading onto the upper cervical spine.
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