What Medication is Good for Cervicogenic Headaches? An Expert Guide

October 11, 2025 •

3 min read

It's estimated that between 0.4% and 4% of all headaches are cervicogenic, originating from issues in the neck. For those suffering, finding effective relief is paramount, but pinpointing what medication is good for cervicogenic headaches requires understanding the condition's unique source.

Quick Summary

This guide details the medication options for cervicogenic headaches, from over-the-counter anti-inflammatories to targeted prescription drugs and interventional injections that address the underlying neck cause.

Key Points

Source of Pain: Cervicogenic headaches are caused by an underlying neck issue and are felt as referred pain in the head or face.
Multimodal Treatment: The most effective approach for managing cervicogenic headaches combines medication with physical therapy and other non-pharmacological methods.
Initial Medication Options: Over-the-counter NSAIDs like ibuprofen or naproxen and acetaminophen are typically the first line of drug treatment for pain and inflammation.
Prescription Medications: For more severe cases, doctors may prescribe muscle relaxants for tension or anti-epileptics like gabapentin for nerve pain.
Targeted Injections: Interventional procedures like nerve blocks provide temporary relief and can help confirm the headache's cervical origin.
Chronic Cases: For persistent symptoms, injections like Botulinum Toxin or radiofrequency ablation may be used when other treatments fail.
Prevent Medication Overuse: Be cautious with frequent pain reliever use to avoid medication overuse headaches and other adverse effects.

Understanding Cervicogenic Headaches

A cervicogenic headache (CGH) is a secondary headache caused by an issue in the cervical spine (neck), resulting in referred pain felt in the head, face, or behind the eye. This connection is due to shared nerve pathways between the upper cervical spinal nerves and the trigeminal nerve. CGH is typically one-sided and can be triggered by neck movements or poor posture. Common causes include whiplash, arthritis, pinched nerves, and muscle strain.

Medication-Based Treatment for Cervicogenic Headaches

There is no single medication specifically for CGH; treatment focuses on managing symptoms and the underlying neck problem. A healthcare provider will usually start with less invasive options.

Over-the-Counter Options

For mild to moderate pain, OTC medications can help reduce pain and inflammation:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Ibuprofen or naproxen can reduce inflammation in neck joints and muscles.
Acetaminophen (Tylenol): A pain reliever suitable if NSAIDs are not an option.

Prescription Oral Medications

If OTC options are insufficient, stronger prescription medications may be used:

Muscle Relaxants: Prescribed for neck and shoulder muscle tension and spasms.
Anti-Epileptic Drugs: Medications like gabapentin may treat nerve pain associated with CGH.
Tricyclic Antidepressants: Low doses may help manage chronic pain by affecting pain signals.

Interventional Procedures

For inadequate relief from conservative treatments, injections may be recommended for both diagnosis and therapy:

Nerve Blocks: Injections near specific neck nerves (like the greater occipital nerve or cervical facet joints) with anesthetic and/or corticosteroid can provide temporary pain relief and help confirm the diagnosis.
Botulinum Toxin Injections: May be used in persistent cases to relax muscles and reduce nerve pain.
Radiofrequency Ablation: This procedure can provide longer-term relief by using heat to target the specific nerve causing pain in chronic cases.

Comparison of Medication Treatments


Medication Type	Mechanism of Action	Best For	Pros	Cons
OTC NSAIDs	Reduces inflammation and pain.	Mild to moderate pain, initial treatment.	Widely available, low cost, relatively safe for short-term use.	Potential GI/cardiovascular side effects, risk of medication overuse headache.
Muscle Relaxants	Eases muscle tension and spasms.	Headaches linked to significant neck muscle tightness.	Can provide effective relief from muscular pain.	May cause drowsiness, dizziness, or fatigue.
Anti-Epileptics	Addresses neuropathic (nerve) pain.	Nerve-related pain unresponsive to other options.	Specifically targets nerve pain, which is common in CGH.	Limited evidence specifically for CGH, potential side effects.
Nerve Blocks	Numb nerves and reduce inflammation.	Diagnosing CGH and providing temporary relief.	Can pinpoint the source of pain; provides rapid, localized relief.	Relief is temporary, requires repeat injections, and carries a small risk of side effects like infection or nerve damage.

Beyond Medication: The Multimodal Approach

Effective long-term management of CGH requires addressing the underlying neck problem with a combination of medication and non-pharmacological interventions.

Key Non-Pharmacological Interventions

Physical Therapy: Considered essential, focusing on neck strengthening, manual therapy, and posture correction.
Manual Therapy: Techniques like spinal manipulation improve joint mobility and reduce muscle tension.
Posture Correction: Essential for reducing neck strain, particularly during prolonged activities.
Lifestyle Adjustments: Using supportive pillows and engaging in gentle exercise can help prevent and manage symptoms.

For more information on the diagnosis and management of cervicogenic headaches, review resources like the StatPearls article on Cervicogenic Headache.

Conclusion

Determining what medication is good for cervicogenic headaches involves selecting from various options aimed at managing symptoms and the underlying neck cause. Treatment ranges from OTC pain relievers to specialized nerve blocks. A proper diagnosis and a comprehensive treatment plan combining medication with non-pharmacological therapies are crucial for the best long-term outcome.

Important Note

Always consult a healthcare provider for diagnosis before starting any treatment. Be aware that self-medication and overuse of certain drugs can lead to adverse effects, including medication overuse headaches.

Frequently Asked Questions

The most common over-the-counter medications used for cervicogenic headaches are NSAIDs like ibuprofen and naproxen, and the pain reliever acetaminophen. Your doctor can help determine the most suitable option for your specific situation.

Yes, muscle relaxants can be helpful for cervicogenic headaches, especially when muscle tension and spasms in the neck and shoulders are contributing to the pain. A doctor can determine if this is an appropriate treatment for you.

Yes, nerve blocks are used both to diagnose and treat cervicogenic headaches. An injection of a local anesthetic and/or steroid near specific nerves in the neck can provide temporary relief from the referred pain.

Unlike a migraine, a cervicogenic headache is a secondary headache caused by a neck issue. The pain is typically one-sided and can be triggered by neck movement, and it often lacks the light sensitivity or aura associated with migraines.

Effective non-medication treatments include physical therapy, manual therapy (like spinal manipulation), posture correction, massage, and lifestyle changes. These therapies address the root cause in the neck.

Yes, Botulinum toxin (Botox) injections may be considered for cervicogenic headaches that are refractory, or unresponsive, to other conservative treatments.

Long-term use of analgesics can lead to medication overuse headaches, where the medication itself causes more headaches. NSAIDs also carry risks of gastrointestinal and cardiovascular side effects. It's important to use medication under a doctor's guidance to minimize risks.