Cervicogenic headache is a headache caused by a problem in the neck, such as the joints, muscles or nerves of the upper spine. The pain usually starts at the back of the head or neck on one side and spreads forwards, and it is often linked to neck stiffness or certain neck movements. Research suggests that hands-on treatment and specific neck exercises may help many people.
Also known as headache from the neck, neck-related headache
Symptoms
- Headache that starts in the neck or base of the skull and spreads to the forehead, temple or around the eye
- Pain that is usually on one side and does not swap sides
- Reduced or painful neck movement
- Headache brought on by certain neck positions or sustained postures
- Tenderness at the top of the neck
- Sometimes ache into the shoulder or arm on the same side
Causes and risk factors
- Irritation of the joints, discs or muscles of the upper neck
- Previous neck injury, such as whiplash
- Long periods with the head held in one position, for example at a screen
- Neck stiffness or reduced strength in the deep neck muscles
- Arthritic changes in the upper neck in older adults
What the evidence says helps
- A 2022 systematic review and meta-analysis found that manual therapy, such as spinal manipulation and mobilisation, reduced headache intensity, frequency and disability compared with sham treatment. Many trials had a high risk of bias, but analysis of the better-quality trials still showed small benefits.1
- A separate 2023 review found moderate-certainty evidence that manual therapy may reduce headache frequency and intensity in the short term, although the benefit over sham was not maintained at 12 months.2
- Specific neck exercises, including deep neck flexor and shoulder blade exercises, may offer longer-lasting improvement in headache intensity, based on individual trials.2
- Both reviews concluded that more high-quality trials are needed, so treatment usually combines hands-on care, exercise and advice tailored to the individual.12
- Because other headache types can look similar, a careful assessment to rule out other causes and identify red flags is an important first step, in line with NICE headache guidance.4
Things you can try at home
- Keep your neck moving with gentle, comfortable range-of-movement exercises through the day
- Change position regularly and set up your screen at eye level
- Try simple chin tuck exercises to work the deep neck muscles, stopping if they increase symptoms
- Use heat on the neck and shoulders for short-term comfort
- Note which postures or activities bring on your headache and adjust them
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Call 999 for a sudden, severe headache or neck pain, especially with dizziness, double vision, slurred speech or difficulty swallowing
- Call 999 if you have new weakness, numbness or loss of coordination in your arms or legs
- Get urgent help (NHS 111 or A&E) for headache with fever, a stiff neck or a rash
- See a GP urgently if headache and neck pain follow a fall, accident or head injury
- See a GP urgently if you are over 50 with a new headache, scalp tenderness or jaw pain when chewing
- See your GP if you have neck pain with unexplained weight loss, night sweats or a history of cancer
How Apollo can help
Our osteopaths take a full history and examine your neck to see whether it is likely to be contributing to your headaches, and screen for signs that need medical review. Care may include hands-on techniques such as mobilisation, alongside a progressive neck and upper back exercise programme and advice on posture variety and workload. If your symptoms do not fit a neck-related pattern, we will explain why and signpost you to your GP.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Can a stiff neck cause headaches?
Yes, problems in the upper neck can refer pain into the head. This is called cervicogenic headache and is usually one-sided, linked to neck stiffness or certain positions. A clinician can help work out whether your neck is involved.
How is cervicogenic headache different from migraine?
Cervicogenic headache usually starts in the neck, stays on one side and is linked to neck movement. Migraine is a brain-based condition that often comes with nausea and sensitivity to light and sound. The two can overlap, so a proper assessment matters.
Is manipulation of the neck safe?
Serious complications are rare, but they can occur, so clinicians screen carefully before using neck manipulation. Gentler mobilisation and exercise are effective alternatives, and your practitioner should discuss the options and risks with you first.
References
- Bini P, Hohenschurz-Schmidt D, Masullo V, Pitt D, Draper-Rodi J (2022). The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis. Chiropractic & Manual Therapies. View source
- Demont A, Lafrance S, Gaska C, Kechichian A, Bourmaud A, Desmeules F (2023). Efficacy of physiotherapy interventions for the management of adults with cervicogenic headache: a systematic review and meta-analyses. PM&R, 15(5), 613–628. View source
- Mingels S, Granitzer M, Jull G, Dankaerts W (2025). The occurrence of cervicogenic headache: a mapping review. Musculoskeletal Science and Practice, 77, 103290. View source
- National Institute for Health and Care Excellence (2012, last updated 2025). Headaches in over 12s: diagnosis and management (CG150). NICE. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
