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Spine Care

Cervico genic headache( CGH) 

What You Need to Know About Cervicogenic Headache 

Cervicogenic headache is a secondary headache, which arises from a musculoskeletal dysfunction in the upper three cervical segments (Bogduk N) 1997). The pain may start in the neck (at the back of the head) and radiates all the way to the front of the head. It could be perceived in one or more regions of the head or face.

Cervicogenic Headache vs Migraine: How to Differentiate? 

One of the common diagnostic challenges in headache evaluation is to distinguish Cervicogenic from other headache forms. Indeed, studies that an incorrect headache diagnosis may occur in more than 50% of cases (Hall 2007). Migraine and CGH both can present with pain around the neck and and head howeverMigraine usually presents with aura and has distinctive symptoms, such as flickering lights or spots in the field of vision, numbness,or pins and needles, all of which are fully reversible, lasting less than 60 minutes. (Kirchman 2006)wheareas CGH does not present with the above symptoms.

How Physiotherapy helps in managing Cervicogenic Headache? 

Physiotherapy often delivers the best results in treating cervicogenic headaches. A full assessment will be carried out by the physiotherapist to determine if the symptoms match with cervicogenic headache. This includes the examination of other parts of the body including the muscles and joints of the upper cervical region

Various treatment method will be used to achieve the best results in managing cervicogenic headache, following are some examples::


Manual therapy such as joint mobilization and massage are frequently used to relieve the symptoms for such conditions. Mobilization of the cervical joint eases the pressure in the neck joint reducing nerve irritation. Such specific manual technique gives best outcome when paired with exercises.


Specific exercises are often prescribed as part of the treatment plan to retrain the muscles to improve posture and movement of the neck. These exercises may include:

  • Strengthening of the deep flexors muscles
  • Stretching of the thoracic spine
  • Re-education of craniocervical flexion (CCF) movement
  • Retraining the Scapular Muscles
Postural Education  

Poor posture such as rounded shoulders and forward head postures puts the necks and upper back in a stress position. Re-education of posture includes creating awareness through movements. Such movements train muscle coordination, ensuring that the muscle fires in the correct sequence.