Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment

Lancet Neurol. 2009 Oct;8(10):959-68. doi: 10.1016/S1474-4422(09)70209-1.


Cervicogenic headache is characterised by pain referred to the head from the cervical spine. Although the International Headache Society recognises this type of headache as a distinct disorder, some clinicians remain sceptical. Laboratory and clinical studies have shown that pain from upper cervical joints and muscles can be referred to the head. Clinical diagnostic criteria have not proved valid, but a cervical source of pain can be established by use of fluoroscopically guided, controlled, diagnostic nerve blocks. In this Review, we outline the basic science and clinical evidence for cervicogenic headache and indicate how opposing approaches to its definition and diagnosis affect the evidence for its clinical management. We provide recommendations that enable a pragmatic approach to the diagnosis and management of probable cervicogenic headache, as well as a rigorous approach to the diagnosis and management of definite cervical headache.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Clinical Trials as Topic
  • Humans
  • Neurosurgical Procedures / methods
  • Pain / etiology
  • Pain / physiopathology
  • Pain Management
  • Post-Traumatic Headache / diagnosis*
  • Post-Traumatic Headache / physiopathology*
  • Post-Traumatic Headache / therapy*


  • Adrenal Cortex Hormones