The Neck-Head Connection: Why Your Headache Might Not Be in Your Head

Headaches are incredibly common, but not all headaches come from the same place. A cervicogenic headache is a headache that actually originates from the neck. The nerves, joints, muscles, and other structures in the cervical spine (neck) can all refer pain to the head, making it feel like a typical tension or migraine-type headache, even though the root cause is in the neck.

Understanding Cervicogenic Headaches

A cervicogenic headache happens when structures in the neck such as muscles, joints, discs, or nerves become irritated and refer pain upward into the head.

The upper cervical nerves (C1–C3) travel from the neck and connect with areas of the head, including the scalp, temples, and even behind the eyes.

You don’t have to have obvious (or any) neck pain to have this type of headache. Many people experience only subtle stiffness or tightness in the neck yet still develop headaches that feel like they come from the head itself.

What Can Cause Cervicogenic Headaches?

Several structures in the neck can contribute such as:

Tight muscles, including the suboccipitals
Irritated or degenerated discs
Painful facet joints in the cervical spine
Joint instability

Because the cervical nerves connect directly to the head, irritation in these areas can refer pain to the temples, behind the eyes, or even the forehead.

The small suboccipital muscles control subtle head movements and support the top of the neck. When these muscles are tight or irritated they can compress or irritate the upper cervical nerves, sending pain signals upward and amplifying headaches.

What a Cervicogenic Headache Feels Like

These headaches typically start in the neck or the base of the skull and can radiate forward into the head, temples, or even behind the eyes. The pain is usually one-sided, but it can sometimes affect both sides.

The pain can often feel like:

A dull, aching pressure at the back of the head
Pain that radiates from the neck to the forehead, temples, or behind the eyes
A tight or stiff neck, though sometimes subtle or barely noticeable
Pain that worsens with certain neck movements or prolonged postures
Occasional shoulder or upper back tension

Unlike migraines, cervicogenic headaches typically do not include nausea, vomiting, or visual aura, but they can still be severe and interfere with daily life.

How We Approach Cervicogenic Headaches

The goal is to reduce pain, address the root cause, and prevent recurrence. Our approach typically includes:

Soft tissue therapy: Massage or cupping to the neck, upper back, and suboccipital muscles to calm muscles and reduce headache intensity.
Joint mobilization or chiropractic adjustments: Targeted mobilization or adjustments of the cervical-thoracic spine help improve movement and relieve nerve irritation.
Strengthening exercises: Strengthening the neck and upper back muscles helps to stabilize (especially important if there is joint instability) and reduces stress on sensitive structures.
- Check out Dr. Grohmann's video to see an example of what these exercises can look like: https://www.instagram.com/reel/DL-5jrpB85k/?igsh=NjZiM2M3MzIxNA==
Targeted stretches: Specific stretches and movements for discs, nerves, and facet joints that can reduce pressure and improve mobility.
Self-management strategies: Managing your stress, eating an anti-inflammatory diet, identifying triggers, and activity modification at home help maintain relief and prevent future headaches.

Takeaway

Cervicogenic headaches are often overlooked because the pain feels like it’s coming from the head, not the neck. You don’t have to have neck pain to have this type of headache, even subtle nerve irritation or tight suboccipital muscles can trigger significant head pain. By identifying the underlying neck structures causing irritation, you can reduce headache intensity and frequency.