Neck Pain and Headache

At Nexus Pain Management we are experts in diagnosing and treating all facets of pain from the top of your head to the tips of your toes. We offer treatment solutions for any cause of pain from mechanical issues (such as joint, tendon, ligament damage, hypermobility), neuropathic pains (pain resulting from nerve damage or over-activation), pre- and post-surgical pain, acute to chronic pains and anything in between.

Neck pain, headaches, and facial pain are arguably the single most common group of pain conditions we tend to see these days; such is their prevalence. They can have many underlying causes, ranging from musculoskeletal issues to neurological and systemic conditions. These 3 regions (neck, head, face) will often overlap in their pain manifestations and so often must all be considered together.

The overlap of headache, neck pain and facial pain

Neck structures (especially in the upper neck) will commonly refer to the head and cause headache. Chronic headaches (such as migraine disorder) will very commonly lead to chronic tension and irritation through the upper neck and jaw (TMJ) areas causing pain there. Then each region can then start triggering the other and vice versa. We find that most people we see with a chronic primary migraine disorder have an associated chronic cervicogenic headache and/or occipital neuralgia. Often by treating the latter component it will help this component of their pain and even help reduce the number of times these triggers migraines, even without directly treating the primary migraine disorder (which we will also address).

Likewise, there is a structure called the Trigeminocervical Complex in the lower brainstem and upper cervical spinal cord. In this area the upper neck nerves (C1-3) enter the brainstem right next to the Trigeminal nerves from the face. Chronic overactivation of these nerves can lead to irritation and pain in the others nearby. Most commonly we find chronic neck pain/headache issues will start to trigger facial pains. Sometimes it will work the other way where chronic facial pains start setting off neck pain/headaches.

There is also important overlap between neck structures and the shoulder and arm that must be considered for effective treatment. However, I will not go into the details of these interconnections here.

Therefore, identifying the source of your pain and any of the above inter-connections is the first step toward effective treatment.

Below are the most common causes, grouped by category.

Musculoskeletal Causes

1. Muscle Strain & Tension

• Poor posture (e.g., prolonged screen time, forward head posture)

• Stress-induced muscle tightness

• Sleeping in an awkward position

• Overuse injuries (e.g., repetitive strain from work or sports)

2. Joint & Spine Disorders

• Cervical facet joint dysfunction

• Osteoarthritis (degenerative joint disease)

• Cervical disc herniation or bulging disc

• Cervical spinal stenosis (narrowing of spinal canal)

• Whiplash-associated injuries

3. Myofascial Pain Syndrome

• Trigger points in neck and shoulder muscles

• Tension-type headaches from muscle knots

• Referred pain from tight jaw or neck muscles

• Neurological Causes

4. Nerve Compression & Neuropathy

• Cervical radiculopathy (pinched nerve in the neck)

• Occipital neuralgia (irritation of the occipital nerves)

• Trigeminal neuralgia (facial nerve disorder causing sharp pain)

5. Headache Disorders

• Migraine headaches (neurological disorder with sensory disturbances)

• Tension headaches (muscle tightness-induced headaches)

• Cluster headaches (severe, cyclical headaches around one eye)

• Dental & Jaw-Related Causes

6. Temporomandibular Joint (TMJ) Disorders

• Jaw clenching and teeth grinding (bruxism)

• TMJ inflammation and dysfunction

• Arthritis affecting the jaw joint

7. Dental Issues

• Tooth infections or abscesses

• Malocclusion (misalignment of teeth)

• Post-dental procedure pain

• Systemic & Medical Causes

8. Inflammatory & Autoimmune Conditions

• Rheumatoid arthritis

• Fibromyalgia

• Polymyalgia rheumatica

9. Infections & Illnesses

• Sinusitis (infection causing facial pressure and pain)

• Meningitis (infection of the meninges causing severe neck stiffness)

• Post-viral or post-infectious neuralgia

10. Vascular & Circulatory Issues

• Cervicogenic headaches (originating from the neck structures)

• Other Contributing Factors

11. Psychological & Stress-Related Causes

• Anxiety and stress leading to muscle tension and pain

• Chronic pain syndrome with a psychological component

12. Lifestyle Factors

Dehydration leading to headaches

• Poor ergonomics at work or home

• Lack of physical activity