Cervical Spondylosis and Headaches: Is There a Connection?

Stress, headache, illness. Upset mixed race woman sitting on a sofa in living room with eyes closed, suffering headache, vertigo, migraine, having cramp in a templess, need treatment and rest
A photo of Dr Colum Nolan, Senior Consultant Neurosurgeon of Oxford Spine & Neurosurgery Centre

Dr Colum Nolan
Senior Consultant Spine & Neurosurgeon

MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)

Neck discomfort and headaches sometimes appear together, leaving many people wondering whether the two are linked. Cervical spondylosis—also known as wear and tear of the neck joints and discs—is a common condition, especially with age or long hours spent at a desk. For some, these changes may trigger headaches that feel persistent or hard to relieve. Read on to find out how they are connected, how to manage them, and when to seek medical attention.

What Is Cervical Spondylosis?

Cervical spondylosis refers to wear-and-tear changes that develop in the neck portion of the spine over time. These changes can include:
  • Reduced disc height
  • Formation of bone spurs
  • Thickening of the joints and supporting ligaments
  • Disc bulging
As these structures age, the space available for nerves may narrow, and the surrounding tissues that support head and neck movement may become strained. Although cervical spondylosis becomes more common with age, not everyone with these changes develops symptoms.

Can Cervical Spondylosis Cause Headaches?

Yes, cervical spondylosis can contribute to headaches, often referred to as cervicogenic headaches. These headaches occur when pain originating from the neck is interpreted by the brain as head pain. In other words, the problem does not start in the head itself but in the structures of the cervical spine. Headaches may develop due to several factors, including:
  • Muscle tension caused by neck strain
  • Irritation or inflammation of the upper cervical joints
  • Compression or irritation of cervical nerves
  • Reduced mobility or stiffness in the neck vertebrae
  • Poor posture that places prolonged stress on the neck and surrounding muscles
Depending on the severity, these headaches may occur alongside other symptoms such as neck stiffness, shoulder discomfort or pain radiating into the upper back or arms.

Common Symptoms of Cervical-Related Headaches

Cervical-related headaches can present differently among individuals, but several symptoms are frequently reported:
  • Pain that starts in the neck and spreads upward toward the head
  • Headache usually on one side, often triggered or worsened by neck movement
  • Neck stiffness or a noticeable reduction in range of motion
  • Pain or pressure around the base of the skull
  • Discomfort extending into the shoulder or upper back
  • In some cases, arm symptoms such as tingling or weakness may occur if nerves are affected
These symptom patterns can help differentiate cervicogenic headaches from other types of headaches, such as migraine or tension-related headaches.

Why Cervical Spondylosis May Lead to Headaches

The upper cervical vertebrae are closely linked to nerves that provide sensation to various regions of the head. When structures in the neck become irritated, strained or inflamed, the brain may interpret these signals as head pain. This is why headaches can occur even though the underlying issue originates in the cervical spine. Several mechanisms may contribute to these headaches:

1. Facet Joint Inflammation

Facet joints help guide and stabilise neck movement. With degeneration, these joints can become inflamed or irritated. Because they share nerve pathways with the head, pain signals from these joints may be referred upward, resulting in headache symptoms.

2. Muscular Tension

Tight or overworked neck muscles often develop due to posture habits, prolonged device use or structural changes from spondylosis. Many of these muscles attach near the base of the skull, so increased tension can create pressure and discomfort that radiates into the head.

3. Nerve Irritation

Compressed or irritated cervical nerve roots may send abnormal pain signals along their pathways. While nerve-related symptoms commonly extend into the shoulders or arms, irritation of the upper cervical nerves can also influence areas of the scalp and head, contributing to cervicogenic headaches.

4. Altered Spine Mechanics

Degenerative changes can limit normal neck mobility and alter how the cervical spine bears weight. These mechanical changes may increase strain on surrounding tissues, making headache episodes more likely during certain movements or positions.

Treatment Options for Cervical-Related Headaches

Treatment for cervical-related headaches varies based on symptom severity, imaging findings and the individual’s overall spine health. Many patients improve with conservative care, while others may require additional interventions.

Physiotherapy

A targeted physiotherapy programme is often the first step in treating cervical-related headaches. The goal is to restore healthy neck mechanics, reduce muscle tension and address the underlying factors that trigger pain. Your doctor may recommend a structured regimen that includes:
  • Strengthening exercises for the deep neck stabiliser muscles to improve support and control
  • Posture correction and ergonomic training to minimise strain during daily activities
  • Stretching routines to release tight neck and shoulder muscles
  • Manual therapy techniques to enhance mobility and ease stiffness
  • Nerve mobilisation exercises to reduce irritation along affected nerve pathways

Lifestyle and Ergonomic Adjustments

When daily habits or work routines are contributing factors to neck strain or worsening headache symptoms, certain targeted lifestyle and ergonomic adjustments can make a significant difference. Simple modifications that may be recommended include:
  • Setting up an ergonomically friendly workstation
  • Taking regular breaks from prolonged phone or computer use
  • Applying heat or cold packs to ease muscle tension
  • Using neck-supportive pillows or sleeping in positions that reduce stress on the neck

Medications

Medication is often used alongside physiotherapy and lifestyle adjustments to provide more comprehensive relief. Doctors may prescribe medications to help manage cervical-related headaches, especially when pain or inflammation interferes with daily activities. Common options include:
  • Anti-inflammatory drugs to reduce swelling around irritated joints or soft tissues
  • Muscle relaxants to provide relief when muscle spasms or tightness contribute to discomfort
  • Neuropathic agents to help reduce burning, tingling or radiating sensations, in cases where nerve irritation plays a role

Image-Guided Injections

If symptoms continue despite conservative care, image-guided injections may be considered. These targeted procedures, such as facet joint injections or trigger point injections, deliver medication directly to irritated joints or soft tissues. They can help reduce inflammation and provide symptom relief when other treatments have not been effective.

Surgical Options

Surgical intervention is typically reserved for cases where headaches are caused by significant nerve compression, spinal instability or structural problems. When conservative therapies have failed, surgery may be recommended to provide a more direct solution to the underlying issue. Possible surgical procedures include:
  • Cervical Decompression: This procedure relieves pressure on compressed nerves to reduce pain and related symptoms.
  • Cervical Fusion: This option stabilises a spinal segment that has become unstable due to degeneration or structural changes.
  • Disc Replacement: In selected cases, the damaged disc is replaced with an artificial one to maintain motion at the affected level.
The most appropriate procedure depends on the patient’s anatomy, the severity of symptoms and the findings from clinical evaluation and imaging.

When to Seek Medical Evaluation

You should consider consulting a specialist if you experience any of the following:
  • Persistent neck pain accompanied by headaches
  • Headaches that are triggered or worsened by certain neck movements
  • Numbness, tingling or weakness in the arm
  • Symptoms that continue to worsen despite rest or medication
  • Reduced neck movement that interferes with daily activities
Prompt evaluation can help identify the underlying cause and prevent symptoms from becoming more limiting. If you are unsure whether your headaches are related to cervical spine issues, you may consult our spine specialist for a thorough assessment. A personalised evaluation can guide you toward the most suitable and effective treatment plan for your needs.

Our Spine Specialist in Singapore

Dr Colum Nolan
Senior Consultant Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)

Dr Colum Nolan is a Senior Consultant Neurosurgeon and the Medical Director of Oxford Spine & Neurosurgery Centre. He undertook specialist neurosurgery training in Ireland and Australia, and later on completed a complex spine surgery fellowship at Addenbrooke’s Hospital in Cambridge, UK.

Dr Column held key leadership roles including Director of the Spine and Spinal Disorders Programme at the National Neuroscience Institute (NNI), as well as the Head of Neurosurgery Service at Sengkang General Hospital.

With his depth of experience, Dr Colum is committed to guiding each patient towards the safest and most effective treatment for their needs.

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