Patients with cervicogenic headache usually experience a gradual onset of neck pain and headache during the causative activity. However, it is also common for patients to experience pain and stiffness after the provocative activity, particularly upon waking the next morning. The pain associated with cervicogenic headache can sometimes last days, weeks or even months.
Cervicogenic headache usually presents as a constant dull ache, normally situated at the back of the head, although sometimes behind the eyes or temple region, and less commonly, on top of the head, forehead or ear region. Pain is usually felt on one side, but occasionally, both sides of the head and face may be affected.
Patients with cervicogenic headache often experience neck pain, stiffness and difficulty turning their neck, in association with their headache. Pain, pins and needles or numbness may also be felt in the upper back, shoulders, arms or hands, although this is less common. Occasionally patients with cervicogenic headache may experience other symptoms, including: light-headedness, dizziness, nausea, tinnitus, decreased concentration, an inability to function normally, and depression
Patients with cervicogenic headache typically experience an increase in their headache during certain movements of the neck or sustained positions (e.g. sitting at a computer in poor posture). Tenderness on palpation to the upper part of the neck just below the base of the skull is often present along with muscle tightness in this region.

A thorough subjective and objective examination from a chiropractor is usually sufficient to diagnose a cervicogenic headache. Investigations such as an X-ray, MRI or CT scan may be required to confirm diagnosis.

Most cases of cervicogenic headache heal well with appropriate treatment. The success rate of treatment is largely dictated by patient compliance. Activities which place large amounts of stress through the upper neck should be minimized, including: sitting, standing or lying in poor posture, head looking down activities, shoulders forward activities and lifting. Resting from aggravating activities allows the body to begin the healing process in the absence of further tissue damage.
Ignoring symptoms or adopting a 'no pain, no gain' attitude is likely to lead to the headache becoming chronic. Immediate treatment for patients with cervicogenic headache is essential to ensure a speedy recovery. Once the condition is chronic, healing slows significantly resulting in markedly increased recovery times.
Patients with cervicogenic headache should perform early movement and postural exercises to prevent stiffness from developing and to ensure the neck is functioning correctly. The treating chiropractor can advise which exercises are appropriate and when they should be commenced. Patients with cervicogenic headache should also pay particular attention to maintaining good posture as much as possible to minimize stress on the neck. This is particularly important when sitting or driving.

Most patients with cervicogenic headache heal quickly and have a full recovery with appropriate chiropractic treatment. Recovery time varies from patient to patient depending on compliance with treatment and severity of the cervicogenic headache. With ideal treatment, patients with minor cases of cervicogenic headache may be pain free in as little as a couple of days, although sometimes it may take 2 – 3 weeks. In severe or chronic cases of cervicogenic headache, a full recovery may take weeks to months.

Cervicogenic headache is just another name for a headache which originates from the neck, and is one of the most common types of headache. It is important to note, however, that there are many types of headache. Another common type of headache is vascular headache (this includes migraines, although migraines may also be of cervicogenic origin).
The spine comprises of many bones known as vertebrae. Each vertebra connects with the vertebra above and below via two types of joints: the facet joints on either side of the spine and the disc centrally.
During certain neck movements or maintained postures, stretching or compression force is placed on the joints, muscles, ligaments and nerves of the neck. This may cause damage to these structures if the forces are beyond what the tissues can withstand. This damage can occur traumatically or gradually over time. When this occurs pain may be referred to the head causing a headache. This condition is known as cervicogenic headache.
Cervicogenic headache typically occurs due to damage to one or more joints, muscles, ligaments or nerves of the top 3 vertebra of the neck. The headache associated with cervicogenic headache is an example of referred pain. This occurs because the nerves that supply these structures also supply the skin overlying the head, forehead, jaw line, back of the eyes and ears. As a result, pain arising from these structures may refer pain to any of these regions causing a cervicogenic headache.
Cervicogenic headache typically occurs due to activities placing excessive stress on the upper joints of the neck. These activities most commonly include prolonged slouching), excessive bending or twisting of the neck or heavy lifting. Cervicogenic headache may occur traumatically (such as following a whiplash injury) or, more commonly, due to repetitive or prolonged forces (such as working at a computer).

Despite appropriate chiropractic treatment, a small percentage of patients with cervicogenic headache fail to improve and may require other intervention. This may include pharmaceutical intervention, corticosteroid injection, investigations such as an X-ray, CT scan or MRI, or referral to appropriate medical authorities who can advise on any intervention that may be appropriate to improve the condition.

• poor posture
• neck and upper back stiffness
• muscle imbalances
• muscle weakness
• muscle tightness
• previous neck trauma (e.g. whiplash)
• inappropriate desk setup
• inappropriate pillow or sleeping postures
• a sedentary lifestyle
• a lifestyle comprising excessive slouching, bending forwards or shoulders forwards activities.
• stress

Chiropractic treatment for cervicogenic headache speeds up the healing process, ensures an optimal outcome and decreases the likelihood of injury recurrence. Treatment may comprise:
• joint mobilization
• joint manipulation
• soft tissue massage
• dry needling
• anti-inflammatory advice
• activity modification advice
• ergonomic advice

The following exercises are commonly prescribed to patients with a cervicogenic headache. You should discuss the suitability of these exercises with your chiropractor prior to beginning them. Generally, they should be performed 3-5 times daily and only provided they do not cause or increase symptoms.

1) Shoulder Blade Squeezes (figure 5) – Begin this exercise for cervicogenic headache by sitting or standing tall with your back straight. Squeeze your shoulder blades together as hard and far as possible pain-free. Hold for 5 seconds and repeat 10 times.

2) Chin Tucks (figure 6) – Begin sitting or standing tall with your back and neck straight, shoulders should be back slightly. Tuck your chin in until you feel a mild to moderate stretch pain-free. Keep your eyes and nose facing forwards. Hold for 2 seconds and repeat 10 times.

3) Rotation in Sitting (figure 6) – Begin this exercise for cervicogenic headache by sitting with your back and neck straight and your shoulders back slightly. Turn your head looking over one shoulder until you feel a mild to moderate stretch pain-free. Keep your neck straight and don't allow your head to poke forwards during the movement. Repeat 10 times to each side.

Also of assistance are the following products:

• Balance board
• Ice/heat packs
• Omega 3 supplements
• Other supplements as advised by your chiropractor