Neck arthritis, medically known as cervical spondylosis, involves the progressive wear and tear of the discs, joints, and bones within the cervical spine. This degenerative process causes structural changes, such as bone spurs and disc dehydration, that can impinge upon nearby nerves. While this irritation often causes chronic pain and stiffness in the neck, it can also be the underlying cause of a specific type of head pain. This secondary headache, confirmed to originate from the neck, is medically termed a Cervicogenic Headache (CGH).
The Anatomical Link Between Neck Pain and Headaches
The link between neck degeneration and head pain is rooted in a neurological structure in the brainstem called the Trigemino-Cervical Complex (TCC). The TCC is a convergence point where sensory nerve signals from the head and face meet those from the upper neck. Specifically, nerve fibers from the upper three cervical spinal segments (C1, C2, and C3) relay information to the same area that receives input from the trigeminal nerve, which handles sensation in the face and head.
When arthritic changes, such as inflamed facet joints or compressed nerve roots, irritate the C1-C3 nerves, the brain receives a pain signal. Since neck and head signals share the TCC relay station, the brain can misinterpret the source of the pain. This is called referred pain, where discomfort originating in the neck is perceived as pain in the head or face, often felt behind the eye or the temple.
Recognizing the Signs of a Cervicogenic Headache
A Cervicogenic Headache (CGH) has distinct characteristics that differentiate it from other headache types, such as migraines or tension headaches. The pain originates in the neck or back of the head and spreads forward, often radiating to the forehead, temple, or around the eye. The head pain is described as a steady, non-throbbing ache that ranges from moderate to severe.
A key sign is that the pain is frequently unilateral, felt only on one side of the head. The headache can be triggered or worsened by specific neck movements, sustained awkward postures, or pressure applied to spots in the upper neck. Patients often experience restricted range of motion during an episode. Unlike a classic migraine, CGH is less likely to be accompanied by nausea, vomiting, or sensitivity to light and sound.
Managing Neck-Related Headaches
Management strategies focus on addressing the underlying neck dysfunction rather than only treating the head pain. Physical therapy is a primary non-invasive option, focusing on improving posture, strengthening deep neck muscles, and increasing range of motion. A physical therapist uses manual therapy techniques, such as joint mobilization and stretching exercises, to reduce stiffness and muscle tension in the cervical spine.
For temporary relief, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can help manage inflammation and pain in the arthritic joints. If conservative measures are inadequate, specialists may use targeted options. These include nerve block injections, which deliver anesthetic and sometimes a steroid near the irritated C1-C3 nerves or facet joints. If a diagnostic nerve block abolishes the headache, it confirms the neck as the source of the pain. For chronic cases, procedures such as radiofrequency ablation may be used to temporarily interrupt pain signals from the painful neck joints.