Headache Originating from the Neck — Cervicogenic Headache
Table of Contents
What is cervicogenic headache
Cervicogenic headache is a secondary headache caused by structural or functional abnormalities of the cervical spine. Pain signals originating from the joints, discs, muscles, and ligaments of the upper cervical spine (C1–C3) merge with the trigeminal nucleus caudalis and are referred to the head. In Korean medicine, it is understood that stagnation of qi and blood in the neck region obstructs the ascent of clear yang (清陽), which leads to headache.
Differentiation from migraine
- Features of cervicogenic headache: Starts in the unilateral occipital region and spreads to the temple or behind the eye, worsening with neck movement. The hallmark is that headache intensity changes with neck posture.
- Difference from migraine: Migraine is pulsating and accompanied by light/sound hypersensitivity, whereas cervicogenic headache is squeezing in nature with only mild nausea.
- Suboccipital tenderness: In patients with cervicogenic headache, pressing on the suboccipital muscles characteristically reproduces the usual headache.
- Difference from tension-type headache: Tension-type headache is bilateral and is often unrelated to neck movement.
Korean medicine treatment strategy
Cervicogenic headache fundamentally improves only when the underlying cervical problem is addressed.
- Acupuncture: Fengchi (GB20), Tianzhu (BL10), and Wangu (GB12) are core treatment points for cervicogenic headache. Precise needling of the suboccipital muscles and upper cervical joints often produces immediate relief of the headache.
- Upper cervical chuna: Corrects functional impairment of the C1-C2 (atlanto-axial) joint. Since this region accounts for 50% of total cervical rotation, restoring its function is very important.
- Pharmacopuncture: Anti-inflammatory pharmacopuncture is administered to the suboccipital region to deactivate myofascial trigger points.
- Herbal medicine: Cheonggungdajosan (川芎茶調散) modified with added Pueraria (葛根) improves circulation in the neck and nape and relieves headache.
Self-care and prevention
Daily self-massage of the suboccipital muscles and chin-tuck exercises can reduce recurrence. If the pillow is too high or too low during sleep, it places strain on the upper cervical spine, so it is important to choose a pillow of appropriate height that maintains cervical lordosis.