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 nerve injury or disorder. From the nerve source of head and facial pain, cervicogenic headache is a high cervical spondylosis. Analysis of the nerve signals of cephalofacial pain can come from local nerve endings irritation, which manifests as localized soreness and swelling pain with localized pressure pain. The posterior cervical spinal nerve branches into the occipital lesser nerve to innervate the skin of the neck behind the occiput, the posterior branch of the cervical 2 spinal nerve is the greater occipital nerve to manage sensation in the frontal area of the head, and the cervical 3 spinal nerve is divided into the greater/lesser auricular nerve to distribute behind the ear. When the nerve roots or nerve branches are stimulated, the pain may appear as pulling pain or epileptic-like radiating pain; when the sympathetic nerve is abnormal, burning-like, pinprick-like, throbbing-like or hypersensitivity-like pain occurs; when the central nerve cells are abnormal, there is persistent pain with skin numbness and sometimes explosive swelling-like pain, but there is no pressure pain or abnormality in the local tissue where the pain is felt. The trigeminal nucleus is a secondary neuron that extends from the pontine brain to the level of cervical 4. There is a traffic connection 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 nerve, the glossopharyngeal nerve, the facial nerve and the vagus nerve. Since the concept of cervicogenic headache was first introduced in 1983, epidemiological studies have shown that its incidence in the population has been increasing year by year, and many cervicogenic headaches have been diagnosed as “vascular headache” or “neurovascular headache”, and he proposed the diagnostic criteria for cervicogenic headache in 1990. He proposed diagnostic criteria for cervicogenic headache in 1990. (5) headache attacks can be triggered by pressure on structures innervated by the supraorbital nerve and high cervical nerve C1-3; (6) neck stiffness and limited active or passive movement, which may be accompanied by ipsilateral shoulder and upper extremity pain; (7) other related symptoms or signs, such as nausea, vomiting, photophobia, blurred vision, lacrimation, phonophobia, vertigo, etc. In China, it has been recently reported that most cervicogenic headaches are bilateral headaches, with temporal region being more common, mainly distending pain or pulling pain, and most of them are accompanied by nausea, dizziness, tinnitus, etc., 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. Cervical spine X-rays and MRI photographs are mostly positive findings. The rate of positive diagnostic cervical nerve blocks is high. Osteomalacia, cervical flexion retroflexion, and muscle spasm or contracture in degenerative cervical spine pathology are one of the important causes of posterior headache containing cephalalgia. Because the cervical vertebral hyperplastic or deformed bone or hardened deformed soft tissue such as bone spur or disc protrusion can mechanically jam the cervical spinal nerve causing local hypoxic edema, the exuded sterile inflammatory material stimulates the nerve to send abnormal signals causing pain. In addition, when primary afferent nerve fibers from two different parts of the body make synaptic connections 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 the nociceptive impulses generated by cervical neuropathy affecting 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 nucleus of the trigeminal spinal tract sensed as facial pain.Eperson et al. reported in 1997 that 100 patients with MRI-confirmed cervical disc (C3 In 1997, Eperson et al. reported that in 100 patients with headaches caused by MRI-confirmed herniated cervical discs (C3 -C7), the headaches disappeared in 94% of the patients after 22 months of follow-up by microscopic cervical discectomy. Our department has also had dozens of patients with intractable head and facial pain induced by discography and cured by radiofrequency treatment. Therefore, patients with headache should be alert to and pay attention to cervical spondylosis, and pay attention to whether patients have common manifestations of type VI cervical spondylosis such as neck and pillow soreness, hand numbness, tinnitus or dizziness in the treatment of cervicogenic headache. Infrared thermography in the auxiliary examination of cervical spondylosis shows abnormally high temperature behind the cervical occipital area, disturbance of the whole body temperature or abnormally low temperature in the arm. The frontal, lateral, hyperextension, hyperflexion and open position of cervical spine X-ray often reveals straightening of cervical curvature, retroflexion, asymmetry of the annular pivot joint or bone spur, etc. The MRI of cervical spine shows darkening, bulging or protrusion of intervertebral disc, and the CT of cervical spine shows protrusion or calcification of intervertebral disc and calcification of posterior longitudinal ligament, etc. The treatment of cervicogenic headache follows the principle of cervical spine disease treatment from outside to inside and from simple to complex. First of all, patients should be educated to stop the bad work or life habits that damage the cervical spine, to use strengthening cervical muscle exercise, and to choose a suitable pillow to support traction. Those with myofascial adhesions or contractures apply physical therapy or puncture release of adhesions, including ozone, silver needle or radiofrequency thermocoagulation targeted to remove the cause of cervical nerve entrapment such as posterior branch of nerve or occipital neuralgia. Cervical sympathetic nerve block or pulsed radiofrequency is very effective for cervical spondylosis of vertebral artery type or sympathetic type, and improving the blood supply to the head and neck can help treat symptoms such as dizziness, neck pain, insomnia or palpitations. If the headache is reduced by more than 50% after the block, the source of the nerve irritation should be carefully investigated. Headache caused by cervical disc herniation can be treated by cervical discography, and when the headache is induced or replicated, radiofrequency or plasma radiofrequency treatment of the intervertebral disc fiber ring target is feasible. When multiple methods fail to relieve the headache, placement of an occipital nerve stimulator or spinal cord stimulator is an excellent analgesic method to shield the peripheral nerves or even the nucleus of the trigeminal spinal tract from abnormal impulses. Summary: Pay attention to finding and eliminating the site and source of nerve abnormalities in the treatment of headache patients, with particular attention to cervical spondylosis. Its treatment ranges from simple to complex from external to internal, with peripheral myofascial release, pulsed radiofrequency for stuck nerves, cervical sympathetic nerve block adjustment, and cervical discography and radiofrequency, all of which can be very helpful in relieving the pain of patients with cervicogenic headache.