1. Accounts for about 15% of headaches.
  2. May or may not be of traumatic origin.
  3. Medications may have only a marginal effect.

Symptoms: (see Cervical Facet Pain Maps)

  1. Unilateral headache, (rarely bilateral).
  2. Headache spreads from neck upwards (C3 or C2 distribution).
  3. Headache is non-throbbing.
  4. May be fluctuating or continuous.
  5. Patient may have dizziness, ipsilateral blurred vision, photophobia, phonophobia.


  1. May have abnormalities on cervical MRI scan.
  2. Provocation by pressing over occipital nerves.
  3. Provocation with neck movement.
  4. Decreased range of motion of the neck.
  5. Precision nerve blocks of the facet nerves and possibly nerve roots.
  6. Precision injections of the Atlanto-axial or Atlanto-occipital joints


  1. Precision facet nerve blocks.
  2. Nerve root blocks
  3. Radiofrequency rhizotomies of the facet nerves.
  4. Radiofrequency treatment of the dorsal root ganglion.
  5. Precision injection of the Atlanto-axial and Atlanto-occipital joints

Cervical Facet Pain Map

Cervical Facet Pain Map 2

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