Is This a Migraine OR Could It Be Your Neck?



There are so many people who come to see us for Neck Pain who do not realize that the headaches that they have had off and on for years are related to their neck problem…they may even be a warning sign for their upcoming neck pain.


When someone comes in to see us with neck pain, they are very often surprised when I ask about their headaches…and that my concern for the exact pattern of their headaches is something that they have never been asked before.

Many of these people have had headaches that follow a specific pattern that have often progressed to a diagnosis of migraines, yet get very little relief from the medications…


…That’s because they aren’t really migraines, but are something called Cervical Headaches—and follow very specific patterns with very specific causes.


What is a Cervical Headache?


A cervical headache is just that, a headache caused by neck issues. They can happen before any development of neck pain, at the same time as the neck pain, or even a while after the neck pain.


They, also, tend to follow a pattern in time of day or activity dependency. Cervical headaches are most common at the end of the day, first thing in the morning, and/or after spending a lot of time on a computer or device.


At the end of the day, your neck muscles fatigue from the long days of holding your head up (most likely, not in an optimal position) while driving, working, lifting, cooking, reading my latest blog on your phone (or scrolling through Facebook), and just “life-ing”, which causes some very specific tightening of the muscles that can cause headaches.


The morning headaches can be slightly different and are caused by the same reasons as the headaches caused by working on the computer or looking at your device. Whether it’s the device or sleeping, your head has been still in a forward head position for a long time, which puts strain on your neck muscles, allows the slacked muscles to tighten, and causes a strain when they are pulled on. The curled-up posture DOES take more time to cause the pain than the slouched posture during the day, because during the day, your muscles have to fight gravity.


What is the Difference Between Cervical Headaches and Migraines?


Cervical Headaches are usually mechanical in nature and follow specific timing and activity patterns, such as at the end of the day or after computer usage. They, also, have some form of neck stiffness or neck pain associated with the headache. This neck stiffness may or may not be noticeable if you have ever had a history of neck injury or just are prone a neck stiffness that most of us just think it’s from “getting old”.


Cervical Headaches can also travel to the jaw, down the neck, or even down into the arm. This happens because of the involvement of the neck and the tight structures pulling on the jaw or pinching on the nerves that exit the neck and go down into the arm.


While Cervical Headaches are related to positioning and follow specific referral patterns that go into the eye or side of the head (we’ll get to these patterns soon), Migraines are more related to stress and eye fatigue. Migraines do not have a neck stiffness component, usually are on both sides of the head and do not follow the cervical referral patterns.