In 2010, Professor Yu of the Department of Neurology at Beijing 301 Hospital, with funding from WHO, surveyed more than 5,000 unrelated adults aged 18-65 in China and found that the annual prevalence of primary headache was 23.8%, including migraine 9.3% and tension headache 10.8% , of which 23-47% need to see a doctor, causing an annual economic loss of 667.9 billion yuan (104 billion yuan in direct loss and 563.9 billion yuan in indirect loss), accounting for 2.22% of GPD, suggesting that headache reduces the quality of life of patients and needs the attention of the whole society. Headache symptoms are classified as secondary headache and primary headache. Secondary headaches such as localized diseases nasal and ophthalmic diseases or tumors in the mind or epilepsy, while primary headaches refer to those with unclear triggering causes, including migraine, cluster and tension headaches. Ninety percent of patients with primary headache are tension headache, which mainly manifests as contraction of head muscles, full head pressure or tight-turning dull pain, and 70% of patients with occipital neck pain. Other primary headaches are neuropathic headaches such as trigeminal neuralgia, occipital neuralgia, and pterygopalatine neuralgia. Pain is a signal from sensory nerve injury or disorder. From the nerve source of head and facial pain, the abnormal sensory nerve signals of head and facial pain should be firstly checked whether the local nerve endings are irritated, and the pain is manifested as localized soreness and swelling pain with localized pressure pain, and local lesions such as history of myofascial trauma, localized adhesion stiffening or striated contracture can be found. The nerves in the head and occipital shoulder all come from the spinal nerves or posterior branches of the higher cervical spine. The branch of the cervical 1 spinal nerve is the small occipital nerve that innervates the skin of the neck behind the occiput, the posterior branch of the cervical 2 spinal nerve is the large occipital nerve that manages sensation in the frontal area of the head, and the cervical 3 spinal nerve is divided into the large/ small auricular nerve that is distributed behind the ear. When the nerve root or nerve branch is stimulated it manifests as pulling pain or epileptic-like radiating pain. The spinal nerve emanates from the spinal canal, and nerve irritation or entrapment pain can occur through the intervertebral discs, posterior longitudinal ligaments, small bony joints, or myofascial problems. Nociception in the facial-temporal region is primarily managed by the trigeminal nerve, which is a secondary neuron extending from the pontine brain to the level of cervical 4. There is traffic or convergence between the nerve roots in the upper cervical region and the nucleus pulposus of the trigeminal nucleus in the cervical medulla and even the paramedian, glossopharyngeal, facial and vagus nerves. Perispinal lesions such as cervical disc herniation or calcification of the posterior longitudinal ligament or osteophytes can cause cephalalgia, which is characterized by persistent pain with explosive swelling-like pain, occasionally with skin numbness, i.e., central pain. There are also burning, pins-and-needles, throbbing or hypersensitivity-like pain in the head and face when the cervical sympathetic nerve is stimulated, accompanied by dizziness, tinnitus or runny nose and other symptoms of plant nervous disorder. Since Sjaasta et al. first proposed the concept of cervicogenic headache in 1983, epidemiological studies have shown that its incidence in the population has been increasing year by year, and it is recognized that many cervicogenic headaches are diagnosed as “vascular headache” or “neurovascular headache”. “In 2006, the International Headache Society defined the characteristics of cervicogenic headache in its headache classification criteria as: (1) unilateral headache; (2) pain that first occurs in the neck and then spreads to the frontal, temporal and orbital areas on the side of the lesion; (3) pain that first occurs in the neck and then spreads to the frontal, temporal and orbital areas on the side of the lesion. (3) pain is dull, often deep, non-pulsating, and heavy in the frontotemporal region; (4) intermittent attacks, lasting from a few hours to a few days at a time, with later attacks continuing; (5) headache can be triggered by neck movement, poor posture, and pressure on structures innervated by the supraorbital nerve and high cervical nerve C1-3; (6) neck stiffness, limited active or passive movement, and may be accompanied by ipsilateral shoulder and (7) other related symptoms or signs, such as nausea, vomiting, photophobia, blurred vision, lacrimation, phonophobia, vertigo, etc. A recent article in China reported that most cervicogenic headaches are bilateral headaches, mostly temporal, mainly distending or pulling pain, and most of them are accompanied by nausea, dizziness, tinnitus and other symptoms, while the headache location, nature and whether it is unilateral or not are not the main factors. Among its signs, the main ones are limitation of cervical spine movement, positive head press test, cervical 2 transverse process pressure pain even radiating to the head, and pressure pain at the outlet of the greater occipital nerve. Most of the cervical spine X-ray and MRI photographs are positive findings, and the rate of positive cervical nerve diagnostic blocks is high. Degenerative lesions of the cervical spine with osteophytes, cervical flexion retroflexion, and muscle spasm or contracture are one of the important causes of posterior headache containing cephalalgia. The hyperplastic or deformed bones or hardened deformed soft tissues such as bone spurs or herniated intervertebral discs of the cervical spine can mechanically jam the cervical spinal nerve causing local hypoxic edema, and the exuded sterile inflammatory material stimulates the cervical sensory nerve to send abnormal signals causing headache. In addition, when primary afferent nerve fibers from two different parts of the body synapse with the same secondary neuron in the spinal cord, the nociceptive impulses produced by a neuropathy in one part may be mistaken for afferents from primary nerve fibers in the other part of the body, a phenomenon called neural convergence. Therefore, in addition to nociceptive impulses from cervical neuropathy that can affect head and occipital pain, when signals from nerves in lesions of the trapezius, sternocleidomastoid, cervical joints, cervical discs, or posterior longitudinal ligaments stimulate the cervical medulla spina, resulting in transmission from the trigeminal spinal nucleus to the cerebral cortex and perceived as facial pain. In 1997, Eperson et al. reported that in 100 patients with headache caused by MRI confirmed cervical disc (C3 -C7) herniation, the headache disappeared in 94% of the patients after 22 months of follow-up by microscopic cervical discectomy. Therefore, patients with headache should be alerted to cervical spondylosis, and attention should be paid to whether the patient has one of the common manifestations of type VI cervical spondylosis such as neck and pillow pain, hand numbness, tinnitus, or dizziness during treatment. Infrared thermography in the auxiliary examination often shows abnormally high temperature behind the cervical occipital area, disorder of the whole body temperature or abnormally low temperature in the arm, etc. Cervical spine X-ray in forward, lateral, hyperextension, hyperflexion, oblique and open position often reveals straightening of cervical curvature, retroflexion, cervical spine spur, instability or intervertebral foramen deformation, asymmetry of the annular pivot joint, etc. Cervical spine MRI presents darkening, bulging or protrusion of the diseased intervertebral disc, cervical spine CT sees disc protrusion or calcification, calcification of the posterior longitudinal ligament, etc. Since 2008, our department has also had dozens of patients with intractable head and face pain induced in discography and cured by radiofrequency treatment. We have tried to treat primary headache or neurovascular headache from cervical spondylosis and have helped many patients with intractable headache to achieve radical results. Pain physicians treating cervical spondylosis need to use a combination of measures, following the principle of working from the outside to the inside, from the simple to the complex. The adherent hardened cervical fascia is first punctured and released to remove the cause of posterior cervical nerve branch or occipital nerve entrapment pain, and then cervical sympathetic nerve block or pulsed radiofrequency is used to improve the blood supply to the cervical nerve roots, vertebral artery or brain, as well as to regulate disturbances in plant nerve function and metabolism to relieve symptoms such as dizziness, tinnitus, neck pain, insomnia or palpitations. If necessary, a block of the occipital nerve or posterior branch of the cervical spinal nerve or posterior cervical trigger point or pulsed radiofrequency is performed. When the headache is reduced by more than 50% after the nerve block, the diagnosis of cervicogenic headache can be established, and the physician will continue to look for the source of stimulation or compression of that sensory nerve. In practice, we have found that many patients with intractable head and facial pain induce or replicate head and facial pain during lesioned cervical discography, and the headache is cured by performing intervertebral disc annulus targeting radiofrequency or plasma radiofrequency. In patients with definite vertebral headache who cannot be relieved by multiple methods, percutaneous puncture of the cervical epidural cavity and placement of spinal cord stimulation electrodes to shield peripheral stimulation to the thalamus has been tried for analgesia. In addition, educating patients to stop bad work or living habits that damage the cervical spine, using regular work, cervical muscle isometric exercise, metacarpal pillow support traction cervical spine and various physical therapy are very important work and should also be included in the routine treatment plan of cervical spondylosis. Summary: In the treatment of headache patients, attention is paid to finding the site and source of sensory nerve abnormalities, and there is a close anatomical and pathophysiological link between cervical spine lesions and headache. Cervicogenic headache treatment from peripheral myofascial release, pulsed radiofrequency of the entrapment nerve, cervical sympathetic nerve block adjustment, cervical discography with radiofrequency, and implantation of a spinal nerve stimulator or morphine pump are among the many measures that can provide an alternative treatment for patients with cervicogenic headache.