Having neck pain alone is challenging enough, especially if it involves neck stiffness and reduced head mobility. When headache is also present, additional problems may include increased pain, visual disturbances, concentration issues, dizziness, or others.
Several conditions can cause neck pain and headache. Some conditions may start as a neck problem and then send symptoms up to the head, whereas other conditions begin in the head and send pain down to the neck. Getting an accurate diagnosis is important in order to create a treatment program to successfully manage the condition and reduce pain.
Headaches Caused by a Neck Problem
Headaches stemming from a neck problem are usually chronic and vary in type depending on the cause. Common examples include:
- Cervicogenic headache (CGH). CGH usually begins as a dull ache in the neck and radiates upward along the back of the head, almost always affecting just one side. Pain may also spread to the forehead, temple, and area around the eyes and/or ears. CGH is caused due to an underlying disc, joint, muscle, or nerve disorder in the neck.
- Occipital neuralgia. Occipital neuralgia is characterized by sharp, painful, electric-shock-like sensations on the back of the head, neck, and ears. The pain is typically one-sided and begins in the upper neck and spreads to the head. Occipital neuralgia is caused due to irritation or injury to the occipital nerve.
Headaches such as CGH that result due to another underlying condition are called secondary headaches. Headaches that are not associated with another underlying condition are called primary headaches.
Headaches That May Cause Neck Pain
Certain headaches may cause pain to be radiated to the neck. Examples of headaches causing neck pain are:
- Tension headache. Tension headache is a common headache characterized by moderate to severe non-throbbing pain in the forehead, scalp, and neck. Tension headache occurs when muscles of the scalp and neck become tense, such as from tension, stress, fear, and/or emotions.
- Migraine headache. A migraine is a recurring headache that causes moderate to severe throbbing and pulsating pain on one side of the head. Other symptoms may include nausea and sensitivity to light and/or sound. Neck pain associated with migraines are common and may start before the migraine attack or occur during a migraine attack.
- Temporomandibular joint (TMJ) headache. TMJ headache is a dull ache starting at the temples and around the TMJ and may resemble an earache. Disorders of the TMJ that can cause headaches include degeneration of muscles, ligaments, and/or bone of the TMJ; injury to the TMJ, or dislocation of the TMJ. Neck pain can occur due to muscle fatigue or weakness in the TMJ. The involuntary grinding and/or clenching of teeth, known as bruxism, leads to tired and tight TMJ muscles causing face and neck soreness. Individuals are usually unaware of this condition because bruxism can be involuntary and may also occur in sleep.
- Hemicrania continua is a primary headache of unknown origin characterized by one-sided continuous headache of moderate intensity. The condition also exhibits exacerbations of severe intensity during which pain spreads to other areas including neck, shoulder, and area around the ear.
Other types of headaches or problems in the head may also lead to neck pain.
Diagnosing and Treating Neck Pain and Headache
Clinicians use information from the features of headache, physical examination, and diagnostic tests to make an accurate diagnosis of the type of headache. It is also possible for two headaches to occur together. Treatment of primary headaches include medications for both immediate relief and sustained relief (by preventing future attacks). Treatment of secondary headaches focuses on the underlying condition to control symptoms.
When Is Headache and Neck Pain Serious?
Immediate medical attention is advised in neck pain and headache associated with one or more of the following symptoms:
- Pain and numbness radiating down one or both arms
- Stiff neck with high fever and/or headache
- Headache triggered by coughing, sneezing, running, bending, straining with a bowel movement, or Valsalva maneuver (attempt to expel air with the mouth shut and nostrils pinched tight)
- Seizures, slurred speech, loss of balance and blurry vision
- Unintended weight loss or nausea
These symptoms may indicate serious underlying conditions such as aneurysms, meningitis, stroke, or tumor. Neck pain as a result of trauma to the base of the skull (such as from motor vehicle accidents or sports) must be considered as an emergency and treated without delay.