What is it?
In a headache coming from the neck, the problem lies not in the head but in the upper part of the neck. The first three vertebrae, the joints between them and the muscles attached to them produce the pain. It starts at the back of the neck and spreads on the same side to the back of the head, the temple, the forehead and at times behind the eye. Not swapping sides between attacks is a typical feature.
There is an anatomical explanation for the pain being felt in the face. The upper neck nerves and the nerve carrying sensation from the face meet in the same group of nuclei in the brainstem. At this shared stop, a signal arriving from the neck can be read as though it came from the face. Because signals from the chewing muscles use the same route, you may come to a dentist with this pain.
Several findings are seen together at the examination: restricted neck movement, your familiar pain waking up when a particular point in the upper neck is pressed, and the pain appearing after you stay in the same posture for a long time. The pain is most often dull, and throbbing is not in the foreground.
Signs
You will not necessarily have all of these at once.
Why does it happen?
- 01
The upper neck joints and discs
Changes that develop over the years in the joint surfaces and the discs make this region sensitive to pain. The pain appears with movement and eases in part with rest.
- 02
Posture and staying still for long periods
When your head is held forward, the neck muscles work constantly to carry its weight. Desk work, sewing, long drives and looking down at a phone repeat this load every day.
- 03
A past neck injury
This pain can start even months after a sudden acceleration and deceleration type of neck strain. Telling your doctor about an accident or a fall changes the assessment.
- 04
Sleeping position and pillow
A pillow arrangement that folds the neck to the side or forward strains the upper neck joints all night. In these people the pain is more marked on waking and eases somewhat through the day.
How does it progress?
- 1
Pain from strain
It appears after a long stretch at a screen, a journey or an unsuitable pillow. Once the posture is corrected and you rest, it eases within a few days.
- 2
Recurring pain
The pain on the same side comes back a few times a month. Neck movements start to be limited and morning stiffness becomes noticeable.
- 3
Constant pain
The pain is there on most days and its severity rises and falls. At this stage muscle tension and restricted movement feed each other, and the assessment should not be delayed.
How is it treated?
For this condition the address for treatment is a physical medicine and rehabilitation department; neurology comes in when the diagnosis needs to be told apart from others. A headache coming from the neck is not treated in dentistry. Going along with a note of which movement brings the pain on and how it changes through the day makes the assessment easier.
What to expect there is measurement of neck movement, hands-on assessment of the upper neck joints and, if needed, imaging. The steps that follow are an exercise programme, hands-on treatment and adapting the way you work. A block aimed at the relevant nerve may be considered to support the diagnosis; the doctor in charge makes that decision.
The dentist's role is to tell things apart and to state the limit. Chewing muscle pain and neck-related pain can strike the same area, and the two can also be present together. If the examination shows a share belonging to the chewing muscles, that is dealt with separately, but a headache coming from the neck is not expected to be solved with an appliance in the mouth.
- Weakness, numbness or clumsiness in an arm along with neck pain
- Neck pain and headache that appear after a fall or a blow
- Fever and a stiff neck coming with the headache
How is it prevented?
- Raise your screen to eye level, keep the keyboard at elbow height and do not work with your head bent forward.
- Get up before the hour is out and loosen your shoulders and neck with slow movements.
- Let your pillow be at a height that neither pushes your neck up nor folds it forward.
- Do not carry a heavy bag on one shoulder, and raise your arm when you look at your phone.
Frequently asked questions
- I feel the pain in my face, so why would the problem be in my neck?
- The upper neck nerves and the nerve carrying sensation from the face meet in the same region of the brainstem. Because of this shared stop, a signal arriving from the neck can be read as though it came from the face. So where the pain is felt and where it comes from may be different, and the examination is what tells them apart.
- Will a night guard clear this pain as well?
- A night guard is used to reduce the load falling on the chewing muscles. If part of your pain comes from the chewing muscles, that part may ease, but a headache coming from the neck is not expected to go away with a guard. When the two conditions are present together, each is dealt with by its own method.
- Is this pain migraine or the tension type?
- Neck-related pain is most often one-sided and does not swap sides, it appears with neck movement, and neck movement is restricted. In migraine, sensitivity to light and sound and nausea come first; tension-type pain is usually on both sides. Telling them apart for certain calls for assessment by a doctor.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.