How are cervicogenic headaches and occipital neuralgia treated when pain at the base of the skull triggers dizziness?

How is cervicogenic headache different from occipital neuralgia?

Occipital neuralgia is sharp, shooting or electric pain along the occipital nerves at the back of the head, often with tenderness over the nerve. Cervicogenic headache is a duller, aching referred pain linked to neck joint and muscle problems. They can overlap. Occipital neuralgia is often managed medically, for example with nerve blocks, while cervicogenic headache responds well to physical therapy.

Why can a neck headache come with dizziness?

The same upper neck problems that refer pain to the head can disturb the position signals the balance system uses, causing unsteadiness². Migraine and vestibular migraine also commonly occur with neck pain. Sorting out which is driving your symptoms is part of the evaluation.

What does treatment involve?

Treatment combines manual therapy for the upper neck with deep neck flexor and shoulder blade strengthening, an approach a randomized trial showed reduces headache frequency and intensity, with benefits maintained at long-term follow-up¹. We add posture and desk changes, and a pain neuroscience approach when headaches have lasted for months³.

Where can I get cervicogenic headache treatment in Alpharetta or Cumming?

We treat neck-related headaches at our Cumming and Alpharetta clinics, serving Johns Creek, Milton, Roswell, Suwanee and Forsyth County. New, sudden or severe headaches, or headaches with neurological symptoms, need medical evaluation first.

Where can I get help in Alpharetta, Cumming and nearby?

Dr. Manan Patel, PT, DPT, TPS and our team of physical therapists see patients from Alpharetta, Johns Creek, Milton, Roswell, Cumming, Suwanee, Sugar Hill, Buford, Duluth and Forsyth County at two North Atlanta clinics. Every visit is 60 minutes, one-on-one, and urgent appointments are available within 48 hours. We are in-network with Traditional Medicare, BCBS / Anthem and Tricare, and offer a $129 rate per visit for self-pay and out-of-network plans. Not sure where to start? Take the free symptom self-check, or visit our Alpharetta clinic or Cumming clinic page.

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References

1. Jull G, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002.
2. Reiley AS, et al. How to diagnose cervicogenic dizziness. Archives of Physiotherapy. 2017.
3. Blanpied PR, et al. Neck Pain: Revision 2017. Journal of Orthopaedic & Sports Physical Therapy. 2017.

Answered by Dr. Manan Patel, PT, DPT, TPSDoctor of Physical Therapy, Certified Vestibular Specialist and one of the few certified Therapeutic Pain Specialists in North Atlanta, with 15+ years of outpatient care. About Dr. Patel

This answer is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor. Call 911 for sudden severe dizziness with trouble speaking, weakness, numbness, double vision or a severe headache.