Neck Pain Causes

The neck is a complex structure consisting of multiple vertebrae, ligaments holding bones together and muscles to accommodate movement. Modern lifestyle is causing shoulders to slouch resulting in stiff neck, shoulders and headaches which is a common problem. Longer periods of screen time e.g., phone and laptop use, can also cause a lot of strain in the neck, shoulders, and surrounding muscles. There may also be other causes like whiplash, bad posture, arthritis or simply stress causing you discomfort. However, the most common reason for headaches is associated with your neck and shoulders. Pain that starts at the base of skull and radiates to the front of the skull, along with pressure behind the eyes and sometimes jaw stiffness are common symptoms of cervicogenic headaches.

Cervicogenic Headaches

A cervicogenic headache is simply another name for a headache which originates from the neck. It is one of the most common types of headache and although this type of headache can occur at any age, it is most commonly seen in patients between the ages of 20 and 60. Cervicogenic headaches are often called secondary headaches because they originate from a primary underlying neck disorder, frequently with nerve irritation. The good news is that by fixing your neck problem, your headache can be alleviated. Research has shown that upwards of 22% of all headaches seen clinically are cervicogenic. The upper part of your neck consists of cervical vertebra which support the skull and weight of your head, as well as being responsible for movements like flexing and extending your neck (looking up and down), as well as rotating your neck by looking left and right. Any dysfunction in the vertebral joints of the upper neck can limit the range of motion or fluidity of movement and result in nerve irritation. This could include the ligaments, tendons, and muscles that attach to the vertebra or even the cartilage discs between the vertebrae. Commonly a history of neck injury, especially whiplash, is found in people who suffer from cervicogenic headaches; although a traumatic injury is not necessary to cause damage to the neck structures. Repetitive or sustained poor postures can over time, also ‘damage’ these structures. The pain associated with this condition is an example of referred pain. This is where pain arises from a different source, in this case the neck. This occurs because the nerves that supply the upper neck also supply the skin overlying the head, forehead, jaw line, back of the eyes and ears. As a result, pain arising from structures of the upper neck or irritation of the nerves in this region, may refer pain to any of these regions, thereby causing a cervicogenic headache. Your headache can also be referred pain from surrounding muscles of your upper neck, the front and back of your neck. These muscles commonly refer pain to the temples and side of the head. Muscle spasm, weak or overloaded muscles from sustained poor postures can result in them developing trigger points and referring pain to the head and face.


Cervicogenic headaches typically occur due to activities placing excessive stress on the upper joints of the neck. This may occur traumatically due to a specific incident (e.g., whiplash or heavy lifting) or more commonly, due to repetitive or prolonged activities such as prolonged slouching, poor posture, lifting or carrying (especially in poor posture), excessive bending or twisting of the neck, working at a computer or activities using the arms in front of the body (e.g., housework).


It is important to diagnose this headache correctly and differentiate it from a migraine, as treatment plans are different for different headaches.

Symptoms Commonly Include:

  • Gradual onset of neck pain and headache during an activity that irritates the neck structures
  • Constant dull ache, normally situated at the back of the head, although sometimes behind the eyes or temple region, and less commonly, on top of the head, forehead, or ear region. Pain is usually felt on one side, but occasionally both sides of the head and face may be affected
  • Pain that’s made worse by neck movement or posture, neck pain, tenderness over the upper cervical joints
  • Stiffness and difficulty turning the neck
  • Pain, pins and needles or numbness may also be felt in the upper back, shoulders, arms, or hands, although this is less common
  • Occasionally you may experience other symptoms, including light-headedness, dizziness, nausea, tinnitus (ringing in the ears), decreased concentration, an inability to function normally, and sometimes depression
  • Not everyone’s neck will be sore or painful, but you can still experience cervicogenic headaches. It is important to remember that your neck joints may not be sore at rest or with general movements; but they may be tender to touch or painful when properly examined, or when ‘pushed’ to the end of their range of movement by a physiotherapist


A thorough examination from an experienced physiotherapist or doctor is usually sufficient to diagnose a cervicogenic headache. Unfortunately X-rays, CT scans and MRIs are not always diagnostic of a cervicogenic headache. You can suffer with a cervicogenic headache with or without abnormal findings on X-rays or scans. On examination, a physical therapist may find:

  • Increased tightness and trigger points in neck and upper back/shoulder muscle
  • Weakness of deep neck flexors
  • Increased or overactivity of the superficial neck flexor
  • Pain localised in the neck and occiput (base of the skull), which can spread to other areas in the head, such as the forehead, orbital region (eyes), temples, or ears, usually on one side
  • Pain starts or is aggravated by specific neck movements or sustained postures
  • Resistance to, or limitation of, neck movements
  • Changes in neck muscle tone, like muscle spasm
  • Abnormal tenderness of neck musculature


Although this type of headache may respond to medication including analgesics, anti-inflammatories, stronger opioid-based medication, even nerve blocking injections – these drugs usually treat the symptoms of the headache and not the primary underlying cause. Unless the origin of the headache i.e., the upper neck dysfunction, is treated and corrected, the headache will return in time. The treatment from the physiotherapists in Alton will focus on the soft tissue and joint restrictions in the upper neck as well as areas like the front of the neck and upper back area. It may also involve some exercises to strengthen weak muscles and stretch tight muscles.

Neck Pain Treatment in Alton includes:

  • Cervical spine (neck) manipulations and mobilisations
  • Myofascial release (a type of deep massage) to release tight structures and muscles in spasm
  • Trigger point therapy to release restricted tight muscles
  • Dry Needling, Acupuncture
  • Strengthening exercises of the deep neck flexors and upper back muscles
  • Thoracic spine (upper back) mobilisation and manipulation, posture correction and re-education of postural muscles
  • Treatments may include the use of electrotherapy for muscle release and pain relief as well as postural taping or bracing

Self Help

There are some simple steps you can take to decrease neck pain or avoid recurrence.

  • Good posture helps to decrease unnecessary stress on vertebral joints and surrounding muscles, especially while sitting in front of the PC, Laptop, or phone. To decrease the stiffness in the neck and shoulders, it is important to keep our head on top of the spine, rather than poking forward.
  • Sit fully supported on your chair, which means that the whole of your spine is touching your chair
  • The top part of the screen of your laptop or PC should be on eyebrow level, about 24-30 inches away
  • Your arms should not be reaching for the keyboard or mouse. If the keyboard is closer to you, then you will be taking off some strain and stress of the shoulders and neck muscles
  • Take a break if you are in front of PC for more than 90 minutes
  • Try a standing workstation