Cervicogenic Headaches: Understanding the Pain and How Interventional Treatments Can Help

John K. Hong, M.D. | 5/14/2025

Cervicogenic headache

Headaches are one of the most common complaints in medical practice—but not all headaches are created equal. One lesser-known but significant type is the cervicogenic headache, which originates from problems in the cervical spine (neck). These headaches can be debilitating, often mistaken for migraines or tension headaches, and are notoriously underdiagnosed.

In this post, we’ll explore what cervicogenic headaches are, what causes them, and how interventional pain management can offer long-term relief when other treatments fall short.

What Are Cervicogenic Headaches?

Cervicogenic headaches are secondary headaches, meaning they are caused by an underlying issue—specifically, dysfunction in the cervical spine structures such as:

• Facet joints (especially C2-C3 and C3-C4)

• Upper cervical discs

• Muscles or ligaments

• Nerve roots (especially the C2 and C3 nerves)

These headaches typically present as unilateral pain that starts in the neck or base of the skull and radiates forward to the forehead, temple, or around the eye. The pain may worsen with neck movement, sustained posture, or pressure on trigger points in the neck.

Symptoms of Cervicogenic Headaches

• Dull, non-throbbing headache that starts in the neck

• Pain on one side of the head/face

• Reduced range of motion in the neck

• Neck stiffness or muscle tightness

• Associated shoulder or upper back discomfort

  
  

Diagnosing Cervicogenic Headaches

A thorough clinical examination, medical history, and diagnostic blocks are often required. Imaging studies like MRI or CT scans can help rule out other causes and identify structural abnormalities in the cervical spine.

A key diagnostic method is a medial branch block or facet joint injection. If a patient experiences significant relief after numbing the suspected nerve, a cervicogenic source is likely.

Interventional Pain Treatments

If conservative therapies such as physical therapy, medication, or chiropractic care fail, interventional pain procedures can provide targeted, lasting relief.

1. Medial Branch Blocks

These injections target the nerves that supply the facet joints in the cervical spine. They serve both diagnostic and therapeutic purposes.

2. Radiofrequency Ablation (RFA)

For patients who experience good relief from medial branch blocks, RFA can provide longer-term results—often lasting 6 to 12 months—by using thermal energy to disable the small sensory nerves transmitting pain.

3. Cervical Epidural Steroid Injections

If inflammation around a nerve root is contributing to the headache, especially in cases involving disc herniation, an epidural injection may reduce both neck and referred head pain.

4. Occipital Nerve Blocks

These are especially helpful if the greater or lesser occipital nerves (which travel from the upper neck to the scalp) are contributing to the pain.

5. Trigger Point Injections

When muscle tightness or spasm in the cervical or upper back region contributes to referred head pain, localized anesthetic or dry needling into trigger points can reduce symptoms.

Complementary Therapies

• Physical therapy for posture correction and cervical stabilization

• Postural retraining to reduce cervical spine strain

• Dry needling or acupuncture

• Lifestyle modifications, including ergonomic changes and stress management

  
  

When to See an Interventional Pain Specialist

If you’ve been suffering from chronic headaches with accompanying neck pain—and over-the-counter medications or standard treatments haven’t worked—it may be time to see an interventional pain specialist. They can help pinpoint the source of your pain and develop a minimally invasive, image-guided treatment plan tailored to your needs.

Conclusion

Cervicogenic headaches are treatable, but they require the right diagnosis and targeted care. With advancements in interventional pain management, many patients can experience relief and return to a more active, pain-free life without relying solely on medication.

If you're struggling with chronic headaches and neck pain, contact your local pain specialist to explore whether these innovative treatments may be right for you.