Cervicogenic Headache
- unilateral pain that starts in the neck
- is referred from bony structures or soft tissues of the neck
- Arising from irritation caused by cervical structures innervated by spinal nerves C1, C2, and C3
- The C1-C3 nerves relay pain signals to the nociceptive nucleus of the head and neck, the trigeminocervical nucleus.
- This connection is thought to be the cause of referred pain to the occiput and/or eyes
| Cervical Spinal Nerves | Innervated Joints | Referred Pain |
| C1 | Atlanto-occipital joint | Occipital region of the head |
| C2 | Atlanto-axial and zygapophyseal joints | Occipital, frontotemporal, and periorbital regions of the head |
| C3 | Zygapophyseal joint | Occipital, frontotemporal, and periorbital regions of the head |
- most common in people who are 30 to 44 years old
- prevalence among patients with headaches is 0.4 to 4%
- usually complain of unilateral pain without a side shift.
- Pain topography usually stems from the neck, spreading to the oculofrontotemporal area with episodes of carrying duration or fluctuating continuous pain increased by head movement.
- Pain is of variable duration and moderate to severe intensity, but not excruciating or throbbing
- associated with a reduced range of motion of the neck and ipsilateral neck, shoulder, or arm pain.
- Patients will complain that the pain is not resolving with a triptan, ergotamine, or indomethacin.
- Autonomic symptoms such as photophobia, phonophobia, nausea, and vomiting are not as common
