Headaches? A Real Pain In The Neck

Why do I always have neck pain with my headaches? Do your headaches start at the base of your head and wrap around to your temple? Do you wake up feeling stiff and as you start moving through your day you experience tightness with radiating pain? If so, you may have symptoms relating to cervicogenic headaches.

What is cervicogenic headache?

A cervicogenic headache is a headache that arises from the upper cervical spine.  Individuals can have neck pain that radiate to the temple on one side. Each episode can vary in duration with moderate to severe intensity. Symptoms of cervicogenic headaches can occur when moving the head or being in a certain position.  It can arise from awkward head positions when sleeping. Neck pain can cause headaches due to the pathway of the nerves. There are 3 cervical nerves, C1-3, that converge with the trigeminal nerve at the trigeminal-cervical-nucleus. The trigeminal cervical nucleus transmits information relating to pain up into the central nervous system. As a result when there is tightness and pain in the upper neck, the pain can be transmitted in the face or head such as a headache. In addition, individuals with jaw pain can have headaches as well.

How did this occur?

At times many of these symptoms can occur as a result of working and stress. The most common position for most individuals when stressed is leaning forward, shrugging shoulders, and clenching the jaw. All of these result from poor posturing and it is hard to correct when you are unaware of these habits.  Poor posturing leads to stiffness and tightness throughout the neck and shoulders. Posture is important to maintain normal alignment of the spine to decrease pressure on the joints.

The following exercises are some of the common exercises prescribed to you to alleviate cervicogenic headaches and to assist with bringing the shoulders for better posture.

Exercise 1: Scapular retraction

For this exercise, the demonstrator is lying on her stomach and squeezing her shoulder blades together. The goal is to pinch the shoulder back without shrugging the shoulders up. This exercise can be performed in sitting as well with the common goal of pinching the shoulder blades without shrugging the shoulders up.

Exercise 2: Suboccipital release with two tennis balls taped together.

For this exercise, the demonstrator is laying on her back with two tennis balls that are taped together placed at the base of the skull. This exercise is designed to relieve pressure from suboccipitals to decrease the intensity of the headaches.

These exercises can be helpful to treat these symptoms however an evaluation by a license Physical Therapy can provide further assistance to establish a plan of care that is tailored to you.  During an evaluation, measurements will be taken and an established HEP will be provided. For you plan of care, exercises will be performed to strengthen postural muscles, improve ROM, and manual therapy techniques will be targeted to decrease tension and stress and improve overall symptoms.


Submitted by Diana Lien, PT, DPT

About Dr. Lien

Dr. Diana Lien is a Doctor of Physical Therapy graduating from Temple University in Philadelphia, PA. She first completed her bachelor's degree at the University of Rochester with a degree in Cell and Developmental Biology.

Diana likes to establish a relationship with her patients so that she can be an advocate for obtaining meaningful outcomes in order to help them reach their goals. Diana also enjoys incorporating evidence-based practices and using effective manual therapy treatments to optimize efficiency and effective treatments.

She believes in furthering her knowledge and career by taking continuing education classes and staying up to date with her medical field. Diana is keen on reading literature and about different techniques to advance her career. She is certified in Trigger Point Dry Needling (TPDN) and working towards future certifications through Evidence in Motion.

Diana enjoys running, hiking, traveling and exploring the outdoors in Northern Virginia. Diana is a native to Rochester, NY and frequently likes to travel home to see her family.


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