13/01/2026
Why is Cervicogenic Headache so Under-Recognised?
Cervicogenic headache (CGH) remains widely under-recognised not because it is uncommon or unimportant, but because current diagnostic frameworks, education, and research priorities are poorly suited to how it actually presents.
Diagnostic systems often require visible structural lesions, yet many cervical contributors to headache are functional or microstructural and invisible on imaging, leading to systematic under-diagnosis. This is compounded by limited clinician training in skilled assessment of the upper cervical spine and a research landscape that favours pharmaceutical models over mechanically and neurophysiologically complex conditions like CGH.
Despite strong evidence showing that cervical afferent input can sensitise the trigeminocervical complex and influence both Cervicogenic and Primary Headache, CGH continues to fall between clinical disciplines.
Addressing this gap requires updated diagnostic thinking, improved clinical education, and stronger interdisciplinary collaboration to ensure cervical contributions to headache are identified and treated appropriately.
If you would like to explore Watson and colleague's discussion Click the link https://bit.ly/4jC7lDh to go to OC3 in Headache Matters to read Edition 41 - "Why is Cervicogenic Headache so Under-Recognised?" [3 minute read time].
