Several headache syndromes are associated with disorders of the cervical spine or neck. In general, there is radiation of pain from the upper neck region to the back of the head and certain neck movements worsen the pain.

Criteria for diagnosing headaches associated with the neck are the following:

A. Pain is localized to the neck or the occipital region (the back of the head). The pain may project to the forehead, orbital region, temples, vertex, or ears.

B. Pain is caused or made worse by specific head movements or positions. C. At least one of the following occurs:

1. Resistance or limitation of passive neck movement.
2. Change in neck muscle contour or tone.
3. Abnormal tenderness of the neck muscles.

D. X ray examination reveals at least one of the following:

1. Movement abnormalities of flexion or extension.
2. Abnormal posture.

E. Fractures, congenital abnormalities, bone tumors, rheumatoid arthritis, or other distinct pathologies (not spondylosis or osteochondrosis).