18/01/2026
Headaches that start in the neck are a different beast altogether.
Not all headaches are migraine, tension, or stress related.
A large portion of recurring headaches we see are actually cervicogenic, meaning the pain is referred from the cervical spine.
What defines a cervicogenic headache?
It’s a headache driven by dysfunction in the upper cervical joints (C0–C3), deep neck flexors, and surrounding neural structures.
The pain is real, but the source isn’t in the head.
Common features we see:
• Pain is often one-sided
• Starts at the base of the skull and travels forward
• Worse with sustained posture (desk work, driving)
• Aggravated after upper body or overhead training
• Reproduced or eased with specific neck movements
Why the neck causes head pain
The upper cervical spine shares neurological pathways with the trigeminal nerve. When joints, discs, or muscles in this region are overloaded or poorly controlled, the brain interprets it as head pain.
This is why treating the head itself rarely works.
Common contributors:
• Poor deep neck flexor endurance
• Excessive reliance on superficial neck muscles
• Reduced upper cervical mobility
• Limited thoracic extension forcing the neck to compensate
• High training loads layered on top of desk posture
Rehab focus:
• Restore controlled movement in the upper cervical spine
• Build endurance of the deep neck flexors, not just strength
• Improve thoracic extension so the neck isn’t doing extra work
• Gradually expose the neck to training loads it can tolerate again
Painkillers might reduce symptoms, but they don’t address the driver.
If your headaches consistently worsen with posture, training days, or neck stiffness, it’s worth considering whether the neck is the source, not the side effect.
This is one of those presentations where understanding the mechanism changes everything