What causes headache? Cervicogenic headache is a common cause.

Occipital headache, at the very back of your head, makes this a likely cause. If however, this is a morning headache, which resolves when you get out of bed, make sure you have your blood pressure measured.

Hypertension has to be pretty severe to cause headache, like over 200/110.

Sinus headache from the sphenoid sinus, can also be occipital.

All these different types of headaches can feel pretty much the same.

The proof of cervicogenic headache is improvement after neck treatment, but you can get a fair idea from the examinations below...

Examining your neck.

To decide whether you have cervicogenic headache,firstly you can assess the overall movement of your neck. Observe yourself in a mirror, tipping to each side, looking for differences in the range of movement.

Observe your neck movement ranges

Perhaps hold onto the handbasin to keep your shoulders still as you move your head. Tip fully both ways and see how close your ear gets to your shoulder, or look at the angle your eyes have tilted to.

Have you tilted equally to right and left? How did your neck feel at the extreme of movement each way?

To assess your range of rotation you can close one eye and see where your nose gets to in relation to your shoulder on each side.

Alternatively you can sit down in a straight backed chair and have someone look down on your head as you rotate it fully to both sides.

Again observe any discomfort at the extreme of movement on either side.

Cervicogenic headache from Levator scapulae muscle?

Headache stretching from one side of the forehead to the back of the head on the same side, is likely to come from a muscle at the base of the neck called Levator scapulae.

Reach over your shoulder with the other hand, and feel the bone at the back in roughly the same position as the collar bone in front. This is the shoulder blade.

Now move your fingers about half way from this to the neck, and press around to find a tender spot.

If pressure here causes a faint pain in your forehead, you are definitely on the right spot. A neck headache, so to speak.

If you have found a decently tender spot, you may as well attend to it now.

Place another finger behind the one you are pressing with, to help. This isn’t easy on the finger. Use the weight of your arm to exert the pressure via the hooked fingers. Wait until the pain eases or you feel the muscle give way under your finger.

Alternatively have a friend push the sore spot with their thumb.

This is likely to take a couple of minutes at least

Finding levator scapulae

Pressing on a muscle splays it out under your finger, stretching the fibers sideways as they curve around. Tight muscle fibers usually take up to two minutes before they relax.

You can also stretch it by the sideways neck stretch in the neck pain pages.

Another stretch is done as illustrated below, which rotates your shoulder blade so as to pull down Levator scapulae insertion and lengthen the muscle.

stretching levator scapulae superioris

Or your upper trapezius muscle

You can slip your thumb under the front edge of this muscle and pinch along it to test for tender, swollen areas. Treat it by continuing the pinch until it relaxes.

examination of upper trapezius

Or your upper cervical musculature?

This is very likely to be tight and sore, contributing to headache.

A method for examination is on the first neck pain page.

The stretches for this area, are on further neck pain pages.

Or from your Occipital nerves - Occipital neuralgia ?

You can feel your own Greater Occipital nerve an inch or two from the midline over the hard bone at the very back of your head on each side.

Rub a finger from side to side a little, pressing firmly against the bone. Step your finger across until you run across a vertical cord under the skin, more or less attached to the bone.

Compare the two sides for tenderness.

Continuous pain with sharp shooting aggravations, on one side at the back of your head, may be attributed to this nerve being irritated or compressed.

I don't believe this is a common condition, because I have not needed to treat this nerve. I have treated the cervical spine joints and neck muscles instead.

To my mind this is mostly cervicogenic headache

Occipital nerve stimulation is being tried for lots of people with resistant chronic headaches, and good results have been seen. See blog and chatroom at Adventures in Occipital Nerve Stimulation. Any success of this treatment doesn't prove the nerve was abnormal, but suggests it was involved in the pain pathway.


If you work at a desk all day, your workplace ergonomics may need to be re jigged. Faulty posture at work is a common contributor.

You may need to reduce tension during the day with mini meditations, or get out for a walk at lunch time.

Whenever you go to the toilet, do a few shoulder rolls.

Link to return from cervicogenic headache page to the home page.


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