The concept of cervicogenic headache was introduced by Sjaastad in 1983, and in 1990, the International Headache Society (IHS) promulgated the classification criteria for cervicogenic headache, and in 1995, Bogduk pointed out that cervical degeneration and muscle spasm were the direct causes. It is believed that it can also be referred to as posterior cervical nerve branch origin headache. It is also referred to as high neurogenic cervical spondylosis. Cervicogenic headache has been widely accepted in clinical practice. Definition of cervicogenic headache 1. Dull pain or soreness in the occipital, top, temporal, frontal or orbital regions of the head or both of these regions. 2.The headache is accompanied by upper neck pain, neck pressure, neck stiffness, or pain in the upper neck and limited movement when moving. 3.More often there is a history of head and neck injury. Mechanism of cervicogenic headache 1.Cervicogenic headache can arise from the muscle tissue and nerve roots in the neck, especially when the anterior root is compressed or inflammatory attack can cause reflex cervical muscle spasm. 2. Chronic spasm of persistent muscles causes tissue ischemia, metabolite aggregation, metabolic end products causing myofasciitis and pain, and can directly stimulate the nerve trunks and nerve endings penetrating in the soft tissue to produce pain. 3, prolonged head-down work, muscle contraction to maintain a certain work posture, so that the muscle blood supply is reduced, followed by muscle spasm, while the ligaments, myofascial injury occurred. 4.Long time of mental or physical work is the most likely to cause nerve-muscle tension in the neck among all parts of the body, which is also a common anatomical cause of cervicogenic headache in adolescents. Clinical manifestations of cervicogenic headache The age of onset of patients is mostly between 20-60 years old, and the age of onset tends to be younger. It is more common in females. In the early stage, it is mostly discomfort in the occipital area, behind the ear, and the lower part of the ear, but later it turns into stuffiness or soreness, and gradually pain appears, and the pain area may extend to the forehead, D, top, and neck. As the disease progresses, the pain gradually worsens, persists, shortens the remission period, and worsens episodically. It has a high incidence among ambulatory workers and often leads to decreased work efficiency, loss of concentration and memory, depression, irritability, irritability, fatigue, and a significant decrease in the quality of life and work. There is significant pressure pain in the lateral cervical spine below the ear and posteriorly under the mastoid process. Those with longer disease duration have pressure points at the back of the neck, D, top, and occipital regions. Some patients have diminished tactile and pinprick sensation, or decreased sensation of smell, taste and tongue and cheek on the affected side, or positive pressure top test and head rest test, or no obvious signs. X-ray examination may show degenerative changes of the cervical spine, or narrowing of the cervical intervertebral foramen, hyperplasia of the anterior and posterior edges of the vertebral body, widening and thickening of the spinous process, and calcification of the supraspinous ligament. CT mostly has no special changes, and a few can see cervical disc herniation, which is not necessarily related to the pain site and pain degree. Diagnosis of cervicogenic headache in clinical practice 1.The upper cervical paravertebral, posterior subpapillary, and head pressure points are important bases for the diagnosis of cervicogenic headache. 2.History of trauma to the head and neck 3.The extent of pain conforms to the distribution pattern 4.Symptoms of nerve root irritation 5.Imaging characteristics: It is not difficult to diagnose patients with advanced stage, but early stage patients often do not easily see abnormal manifestations. Treatment of cervicogenic headache 1.Rest 2.Traction intermittent cervical traction, continuous cervical traction, etc. 3.Medicinal treatment: use traditional Chinese medicine such as cervical pain granules, root pain pellets, Zhengtian pill and Ge Chuan headache soup for internal use; use capsaicin ointment and warm pain relief patch for external use. 4.Manipulation therapy: tendon and chiropractic therapy, point therapy, gua sha therapy, etc. 5.Physical therapy infrared irradiation, ultrasonic therapy, microwave therapy, nano moxibustion paste transcutaneous bioelectric stimulation therapy, transcutaneous electrical stimulation therapy 6.Cervical nerve block and injection therapy 7.Sleeping pillow therapy pillow height, softness, shape, content, etc. have a direct impact on the cervical spine during sleep, choose a suitable pillow in line with the physiology of the cervical spine to treat cervicogenic headache can receive twice the result with half the effort.