Tension Headache vs. Cervicogenic Headache: What’s the Difference?

August 4, 2026

Headaches are extremely common, but not all headaches have the same cause.

Two types of headaches that are often confused are tension headaches and cervicogenic headaches. Both can involve neck pain, muscle tightness, and discomfort around the head, but they are not exactly the same.

Understanding the difference matters because the most effective treatment depends on what is actually causing your symptoms.

At Gordon Physical Therapy, we frequently help people throughout Spokane Valley who are dealing with recurring headaches, neck pain, stiffness, and tension. In many cases, the neck plays a major role in why headaches keep coming back.

What Is a Tension Headache?

A tension headache is one of the most common types of headaches. It is often described as a dull, aching pressure or tightness around the head.

Many people describe it as feeling like a tight band around the forehead, temples, or back of the head.

Tension headaches are commonly associated with:

• Stress

• Muscle tension

• Poor posture

• Long hours at a computer

• Jaw clenching

• Neck and shoulder tightness

• Fatigue

Tension headaches may affect both sides of the head and are often linked to tight muscles in the neck, shoulders, upper back, and jaw.

What Is a Cervicogenic Headache?

A cervicogenic headache is a headache that originates from the neck.

The word “cervicogenic” means that the headache is coming from the cervical spine, which is the medical term for the neck. These headaches occur when joints, muscles, nerves, or other structures in the neck refer pain into the head.

Cervicogenic headaches are commonly associated with:

• Neck stiffness

• Reduced neck mobility

• Pain at the base of the skull

• Pain on one side of the head

• Headaches that worsen with neck movement

• Previous neck injury or whiplash

• Poor posture or prolonged computer work

Unlike many tension headaches, cervicogenic headaches are often more clearly connected to neck movement or neck position.

Tension Headache vs. Cervicogenic Headache: Key Differences

Although these headaches can feel similar, there are some important differences.

Tension Headaches Often Feel Like:

• Pressure or tightness around the head

• Pain on both sides of the head

• A dull, aching sensation

• Tightness in the neck, shoulders, or jaw

• Headaches that worsen with stress or fatigue

Cervicogenic Headaches Often Feel Like:

• Pain starting at the base of the skull

• Headache pain on one side

• Pain that travels from the neck into the head

• Symptoms that worsen with neck movement

• Headaches associated with neck stiffness or limited motion

One simple way to think about it is this:

A tension headache is often more related to muscle tension and stress, while a cervicogenic headache is more directly related to neck dysfunction.

However, there can be overlap. Some people experience both tension-type headaches and cervicogenic headaches at the same time.

Can Neck Pain Cause Both Types of Headaches?

Yes. Neck pain and headaches frequently occur together.

Tight muscles in the neck and shoulders can contribute to tension headaches. At the same time, stiffness or irritation in the joints of the upper neck can contribute to cervicogenic headaches.

This is why a thorough evaluation is so important. If you only treat the headache itself without identifying what is happening in the neck, symptoms may keep returning.

If you are dealing with recurring headaches and neck pain, our team at Gordon Physical Therapy can help determine whether your neck may be contributing to your symptoms.

Learn more about our Neck Pain & Headaches Treatment Program here:
https://physicaltherapyspokane.com/neck-pain-headaches-treatment/

Common Causes of Tension and Cervicogenic Headaches

Several factors can contribute to both tension headaches and cervicogenic headaches.

Poor Posture

Forward head posture places increased stress on the muscles and joints of the neck. Over time, this can contribute to muscle tension, joint stiffness, and recurring headaches.

Computer and Phone Use

Long hours looking at a screen or repeatedly looking down at a phone can strain the neck and upper back. This is sometimes referred to as “tech neck.”

Stress

Stress commonly causes people to tighten the muscles of the neck, shoulders, and jaw. This can contribute to headaches, stiffness, and ongoing discomfort.

Whiplash or Previous Injury

Car accidents, sports injuries, and falls can create lingering neck dysfunction that contributes to headaches long after the original injury.

Weakness or Poor Movement Control

When the muscles that support the neck are weak or not working properly, other muscles may overwork. This can increase strain and contribute to recurring symptoms.

How Physical Therapy Can Help

Physical therapy can be very helpful for both tension headaches and cervicogenic headaches, especially when neck pain, posture, muscle tension, or movement limitations are involved.

At Gordon Physical Therapy, treatment begins with a detailed evaluation to determine what may be contributing to your symptoms.

Your treatment plan may include:

• Hands-on manual therapy

• Joint mobility work

• Soft tissue treatment

• Postural education

• Neck and upper back strengthening

• Mobility exercises

• Ergonomic recommendations

• Home exercises to prevent symptoms from returning

The goal is not simply to temporarily reduce pain. The goal is to identify the underlying cause and help your body move and function better.

When Should You See a Physical Therapist?

You may benefit from a physical therapy evaluation if:

• You have frequent headaches

• Your headaches are associated with neck pain

• You feel stiffness or tightness in your neck or shoulders

• Your headaches worsen after computer work

• You have pain at the base of your skull

• Your headache symptoms began after an accident or injury

• Medication provides only temporary relief

• Your headaches keep returning

If these symptoms sound familiar, your neck may be playing a role in your headaches.

Frequently Asked Questions

Are tension headaches and cervicogenic headaches the same thing?

No. Tension headaches are often related to muscle tension, stress, and tightness around the head, neck, shoulders, or jaw. Cervicogenic headaches originate from dysfunction within the neck itself.

Can neck pain cause tension headaches?

Yes. Tight muscles in the neck, shoulders, and upper back can contribute to tension headaches, especially when combined with stress, poor posture, or prolonged computer use.

Can neck pain cause cervicogenic headaches?

Yes. Cervicogenic headaches originate from the neck and are often associated with stiffness, restricted movement, joint irritation, or previous neck injury.

How do I know if my headache is coming from my neck?

Signs that your headache may be coming from your neck include pain at the base of the skull, neck stiffness, limited neck movement, headaches that worsen with neck motion, or headaches that occur after prolonged sitting or computer work.

Can physical therapy help tension headaches?

Yes. If muscle tension, posture, neck stiffness, or movement problems are contributing to your tension headaches, physical therapy may help reduce symptoms and prevent recurrence.

Can physical therapy help cervicogenic headaches?

Yes. Because cervicogenic headaches originate from the neck, physical therapy can be especially helpful by improving neck mobility, reducing muscle tension, strengthening supporting muscles, and addressing posture or movement limitations.

Find Out What Type of Headache You May Have

Tension headaches and cervicogenic headaches can feel similar, but they often have different underlying causes.

If you are dealing with recurring headaches, neck pain, or stiffness, a physical therapy evaluation can help identify what is contributing to your symptoms and what treatment approach may be most effective.

At Gordon Physical Therapy, we help people throughout Spokane Valley, WA find lasting relief from neck pain and headaches through personalized, hands-on care.

Learn more about our Neck Pain & Headaches Treatment Program or request an appointment today:
https://physicaltherapyspokane.com/neck-pain-headaches-treatment/