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Cervicogenic Headaches

Cervicogenic headaches, or headaches caused by structures in the neck, are caused by irritation or injury to the structures of the upper neck region, resulting in local neck pain as well as referred pain to the head. Referred pain may be perceived in the temporal (at the side of the eyes) or facial (on the cheeks and forehead) regions. This headache is often precipitated or aggravated by head and neck movements, by stress and tension, or by leaning on the upper neck muscles as when slouching in a chair.

After neck pain, headache is the most frequently reported complaint following whiplash injury.  In one study, those patients in whom headache was a dominant pain complaint, 53% were found to be caused by the C2-3 posterior spinal joints.


In another study, researchers set out to determine the effectiveness of spinal manipulation in the treatment of cervicogenic headaches.  Fifty-three patients were placed into one of two groups which received either,

  1. chiropractic spinal manipulation 2X/week for 3 weeks or,

  2. deep friction massage and low-level laser treatments in the upper back and neck region 2X/week for 3 weeks.


After 6 weeks, researchers found that those receiving the chiropractic spinal manipulation:

  1. decreased their use of analgesics by 36%, compared with 0% in the no-spinal manipulation group

  2. decreased the number of hours they experienced headaches during the day by 69%, compared with 37% in the no-spinal manipulation group

  3. decreased their headache intensity per episode by 36%, compared with 17% in the no-spinal manipulation group


  1. Lord S M, et al, Third occipital nerve headache: a prevalence study, Journal of Neurology, Neurosurgery & Psychiatry 1994, 57(10), 1187-1190.

  2. Nilsson N, et al, The effect of spinal manipulation in the treatment of cervicogenic headaches, JMPT. 1997, June;20 (5), 326-30.

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