Cervicogenic Headache vs. Migraine: How to Tell the Difference & Get Relief
You wake up, and it’s already there—that familiar, throbbing pain taking over your head. You immediately start doing the mental math: Do I have enough ibuprofen to get through the workday? Do I need to cancel my plans tonight? Can I just go back to sleep in a dark room?
If you suffer from chronic headaches, you’ve probably called them “migraines” at some point. It’s the word we tend to use for any headache that is severe enough to ruin our day. But what if the pounding in your head isn’t actually a migraine at all?
What if the root cause of your headache isn’t in your head, but in your neck?
This is called a cervicogenic headache, and it is incredibly common. The problem is that cervicogenic headaches mimic migraines so closely that people spend years taking the wrong medications and getting the wrong treatments, wondering why nothing is working.
At Twin Cities Chiropractic in St. Paul, Dr. Scot Sorum has spent over 25 years helping patients figure out exactly what is causing their head pain. Let’s break down the difference between a cervicogenic headache and a migraine, how to tell which one you have, and most importantly, how to finally get relief.
What is a Migraine?
To understand the difference, we first need to understand what a true migraine is.
A migraine is a neurological condition. It’s not just a “bad headache”—it is a complex event happening inside your brain involving nerve pathways and brain chemicals. Migraines are often triggered by environmental or internal factors: hormonal changes, certain foods (like aged cheese, alcohol, or chocolate), weather changes, stress, or lack of sleep.
Classic signs that you are having a migraine:
- Throbbing or pulsing pain: It usually feels like a heartbeat inside your skull.
- One-sided pain: It often affects just the left or right side of your head, though it can shift.
- Sensory sensitivity: Normal light feels blinding, and normal sounds feel deafening. You probably just want to lie in a dark, quiet room.
- Nausea and vomiting: Many migraine sufferers feel sick to their stomach during an attack.
- Aura: About 25% of migraine sufferers experience visual disturbances (like flashing lights, zig-zag lines, or blind spots) right before the headache hits.
If you take migraine-specific prescription medications (like triptans) and they work, you are likely dealing with true neurological migraines.
What is a Cervicogenic Headache?
The word cervicogenic literally means “originating in the neck” (cervical = neck, genic = origin).
Unlike a migraine, which is a neurological event, a cervicogenic headache is a mechanical problem. It happens when the joints, muscles, or nerves in your upper neck are damaged, misaligned, or severely tight.
Your upper cervical spine (the very top of your neck, right at the base of your skull) is packed with sensitive nerves. When a vertebra is stuck out of alignment, or when the surrounding muscles are locked in a spasm, it puts pressure on those nerves. Because of the way your nervous system is wired, your brain interprets that neck distress as pain in your head. We call this “referred pain.”
Classic signs that you are having a cervicogenic headache:
- It starts at the base of the skull: The pain usually begins at the back of your head or upper neck and radiates forward to the front of your head, temples, or behind your eyes.
- Neck stiffness: Your neck feels tight, stiff, or painful. You might have trouble turning your head to check your blind spot while driving down Lexington Parkway.
- Movement triggers the pain: Turning your head, keeping your neck in one position for too long (like staring at a computer), or pressing on the back of your neck makes the headache worse.
- One-sided pain: Like migraines, the pain usually stays on one side of your head, but it rarely shifts sides.
- Medication doesn’t help much: Over-the-counter painkillers might take the edge off, but the headache keeps coming back because the mechanical issue in your neck hasn’t been fixed.
The “Tech Neck” Connection
Why are cervicogenic headaches becoming so common? Look at how you are reading this article right now.
Are you looking down at your phone? Is your head jutted forward toward a computer monitor?
Your head weighs about 10 to 12 pounds. For every inch your head moves forward out of alignment (what we call “forward head posture” or “tech neck”), it adds an extra 10 pounds of stress on the muscles and joints of your upper neck.
If you sit at a desk for eight hours a day or spend hours scrolling on your phone, you are putting massive, constant strain on your cervical spine. Over time, those joints get restricted, the muscles develop painful trigger points, and the nerves get irritated. The result? A pounding cervicogenic headache that feels just like a migraine.
Other common causes include old auto accident injuries (like whiplash that never fully healed), sports injuries, or simply sleeping on a terrible pillow that doesn’t support your neck.
How to Tell the Difference: The Quick Checklist
Still not sure which one you have? Ask yourself these questions:
- Does moving your neck make the headache worse? If yes, it’s likely cervicogenic. Migraines are worsened by physical exertion (like running up stairs), but not specifically by neck movement.
- Do you get an “aura” or visual changes before the pain starts? If yes, it’s almost certainly a migraine.
- Is your neck incredibly stiff when you have a headache? If yes, lean toward cervicogenic.
- Does bright light or loud noise make you feel physically ill? If yes, lean toward migraine.
- Does pressing firmly on the base of your skull trigger or worsen the head pain? If yes, it’s highly likely to be a cervicogenic headache.
Note: It is entirely possible to have both. In fact, the muscle tension and nerve irritation from a neck problem can actually trigger a true migraine in people who are prone to them.
How We Treat Cervicogenic Headaches Without Drugs
If your headache is caused by a mechanical problem in your neck, chemical solutions (like ibuprofen or prescription pills) are never going to fix it. They just temporarily numb the alarm system. To get lasting relief, you have to fix the mechanics.
This is exactly what we do at Twin Cities Chiropractic.
When you come into our St. Paul office, Dr. Scot Sorum doesn’t just ask about your head—he examines your spine. With over 25 years of clinical experience, Dr. Sorum knows exactly how to identify the specific vertebrae and muscle groups in your neck that are triggering your head pain.
Here is how our comprehensive headache treatment approach works:
1. Specific, Gentle Chiropractic Adjustments
Dr. Sorum uses precise, gentle chiropractic adjustments to restore proper movement to the restricted joints in your upper cervical spine. By getting the joints moving correctly again, we take the pressure off the irritated nerves. Many patients feel the pressure in their head begin to lift almost immediately after an adjustment.
2. Targeted Massage Therapy
You can’t fix the joints if the muscles are still locked in a spasm. That is why we integrate therapeutic massage into your care plan. Our Licensed Massage Therapist, Joy Vang, specializes in deep tissue work, myofascial release, and trigger-point therapy. She works specifically on the tight muscles in your neck, shoulders, and the base of your skull, releasing the tension that is referring pain into your head.
3. Posture Correction and Ergonomics
We don’t want you to just feel better today; we want to stop the headaches from coming back tomorrow. Dr. Sorum will help you identify the daily habits—like your desk setup, your sleeping position, or your posture—that are stressing your neck, and give you specific stretches to strengthen your cervical spine.
Stop Living in a Dark Room
You don’t have to just “learn to live with” chronic headaches. You don’t have to spend your weekends locked in a dark, quiet bedroom waiting for the pain to pass, and you shouldn’t have to rely on daily pain medication just to get through your workday.
If you suspect your “migraines” might actually be cervicogenic headaches stemming from your neck, it’s time to get a proper evaluation.
Ready to find the real cause of your head pain? Call Twin Cities Chiropractic at 651-224-1921. Dr. Sorum provides drug-free headache relief at 506 N. Lexington Parkway in St. Paul. With over 25 years of experience, we can help you get your life back. Call today or book your appointment online.