There are headaches commonly accepted as originating from the neck and they are called Cervicogenic Headaches. They come from bony structures and soft tissues of the neck. At least that’s the official National Institute of Health (NIH) stance. 

But, the neck is a lot more complex than simply causing headaches from an irritation of soft tissues and bony structures. Actually, I’m hard pressed to understand the bony structure aspect as bones themselves are not the typical cause of pain unless there is a fracture or a pathological process like a tumor. 

Here’s a related post of mine: What Causes Headaches and What to Do.

The Neck is a Special Structure

The neck is very special and very important for a number of reasons. Yes, headaches can come from irritation to the soft tissues of the neck. What do I mean by soft tissues? Typically we are talking about the muscles of the neck. 

But, there is much more to the neck and its role in headaches, even headaches not considered to be cervicogenic (Latin for coming from the neck). Shall we take a look at some of the more important aspects of the cervical spine and how they might relate to headaches?

• Upper Cervical Spine and Brainstem: the top of the neck is home to the brainstem. This is the control center for most of the automatic unconscious functions of the body such as heart rate, blood pressure, digestion, breathing rate, enzymes, neurotransmitters, hormones, sleep, recovery, healing. 

If there is tension or pressure on the brainstem it alters the balance of the Autonomic Nervous System consisting of the Sympathetic “Fight-or-Flight” System and the Vagus Nerve of the Parasympathetic “Rest and Digest” System. 

The result is overactivity of the Sympathetic System that causes things like:

• Increased tension in the muscles of the neck and shoulders
• Reduced quality sleep
• Stress hormones like cortisol and adrenaline
• Increased inflammation

It’s easy to see how any one of these could set the stage for headaches.

• Suboccipital Nerves: in the upper neck between the skull and the top 2 vertebrae are 3 pairs of nerves that leave the neck and travel into the head. There are 3 nerves on the right and 3 nerves on the left. One pair goes into the back of the head. Another pair goes into the temples and the third pair goes over the head to the forehead. 

When these nerves are pinched or inflamed they will often cause headaches in the back of the head, temples, or above the eyes. The headaches can be on one side or both. 

• Cervical Curve: take a look around at the majority of people. When you view them from the side you will notice that their head is in front of their shoulders. Also take notice of their posture when they are looking at their phones. Why is this important?

The human head weighs about 11 pounds. Looking from the side, every inch that the head moves in front of the center of the shoulder is equivalent to adding another 11 lbs to the weight the small muscles of the neck have to hold up. 

This repeated tension causes spasm and decreased blood flow to the muscles of the neck and is a common cause of headaches. 

• The Dural Membrane: the brain and spinal cord is encased in a tissue called the meninges. The outer layer of this is the dura. In the upper neck, recent discoveries have found that small slips of muscles are attached to the dura. Anything that increases tension of these muscles can pull on the dura and be a cause of pain. A loss of the cervical curve, locking of the upper neck bones, spasm of the suboccipital muscles are all common sources of irritation to the dura.

In the body rarely is there one single imbalance that happens. The body is in a continual effort to restore balance to any irritation or tension results in a chain reaction that over time complicates the situation. 

Imbalances cause compensations and over time what might have started out as a simple imbalance gets more and more complex. Over time imbalances in the neck cause the development of degenerative changes which become an additional source of imbalance and pain. 

What is the solution?

The 5 Absolutely Essential Keys

Key #1: Determine the Starting Point: there is no simple recipe for solving headaches originating in the neck. And, as I’ve noted the vast majority of headaches have some relationship to the neck even if they aren’t purely originating from the neck. 

You want to assess the health of the cervical spinal joints, motion of the joints, balance of the upper cervical spine, posture, balance of the Autonomic Nervous System and more as a starting point.

Key #2: Restore Structural Balance: it’s a common mistake to put all the focus on the neck when an imbalance down in the pelvis is going to contribute to increased tension and imbalance in the upper neck. Your body is forever seeking balance in an effort to function optimally and minimize stress. We want the pelvis level, shoulders level and head level. If the pelvis is not level there is little chance the head will be. And if the head is out of balance there will be increased tension in the cervical spine. 

Key #3: Balance the Upper Cervical Spine: Both of the top 2 vertebrae – C1 and C2 – have an intimate relationship with the brainstem. As I’ve noted, any added tension or pressure at the brainstem results in an imbalance of the Autonomic Nervous System which drives up tension through the neck and shoulders, increases inflammation, and interferes with quality sleep. It is easy to see how these three imbalances can set the stage for headaches. 

Key #4: Restore Proper Motion to the Cervical Spine: the neck is made up of 7 small bones that have to balance the weight of the head, which weighs about 11 pounds. Any loss of motion causes a cascade of events. The neck loses its normal curve and for every inch the head moves forward the neck is essentially holding up another 11 pounds. This added stress accelerates the breakdown of the joints causing arthritis. All of this further irritates the suboccipital nerves and the brainstem.

Key #5: Activate the Vagus Nerve: with any chronic condition like headaches there is an imbalance of the Autonomic Nervous System that results in lowered activity of the Vagus Nerve. As a result you lose the rest, relaxation, recovery, healing, and decreased inflammation that the Vagus Nerve promotes. It’s rarely enough to simply remove the irritation. The Vagus Nerve needs “exercise” to bring it back to full activity and balance the overactivity of the “Fight-or-Flight” system that promotes inflammation, muscle tension and spasm, and reduced sleep and recovery. 

Not all headaches are caused by the neck but in more than 35 years of clinical practice I’ve yet to find a case of chronic headaches in which the neck functioned optimally. Correction of the function of the neck is key to solving headaches that are caused by or contributed by the neck. 

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