ABSTRACT
Neck pain and cervical muscle tenderness are common and prominent symptoms of primary headache disorders. Less commonly, head pain may actually arise from bony structures or soft tissues of the neck, a condition known as cervicogenic headache (CeH). Upper neck pain and cervical muscle tenderness and tightness are common and often prominent in primary headache disorders, especially tension-type and migraine headaches, and are not CeH merely because of occipital or posterior location. It is insufficient to label posterior headache with neck pain as cervicogenic because such complaints can be found in virtually all ages. Occasionally, CeH presenting characteristics may be difficult to distinguish from primary headache disorders such as migraine, tension-type headache, or hemicrania continua. Shoulder and arm pain are considered under first major criteria in the 1998 CeH revised criteria. CeH pathophysiology and source of pain have been debated, but the pain is likely referred from one or more osseous, articular, muscular, neurogenic, or vascular structures in the neck.
