03 / Understand the area
Upper neck
The upper neck helps you turn and nod your head. Pain here can overlap with symptoms around the skull.
An educational guide that covers the left and right sides alike. Where it hurts is a useful clue, but only a clue.
A useful starting point
What this area can tell you.
A stiff feeling below the skull doesn't tell you which joint or muscle is involved, or if that spot is even the one to treat. That's why we look at how comfortably your neck moves and ask about your headache history. Strength and sensation matter too, as does any recent fall, collision or new illness. If you get headaches along with the neck pain, it helps to describe them as two patterns: when each one starts, which lasts longer, and if either is coming more often.
Notice the pattern
Three questions to bring with you.
You don't need to know what it is before you come in. These are details that help when you tell us what you're feeling.
- Is turning to one side more limited than nodding or looking up?
- Do the neck pain and headache start together, or does one show up without the other?
- Have you had a recent fall or collision, or any new change in balance, sensation or strength?
When to get help sooner
New neck pain with a severe unusual headache, double vision, fainting, difficulty speaking or weakness needs emergency assessment. Significant trauma or fever with a stiff neck also needs urgent medical care.
Follow the connection
Possible explanations. Better questions.
These guides cover conditions and patterns that may overlap with this area. Think of them as a place to start our conversation: no body map can tell you which one, if any, you have.
Neck pain
Stiffness, referred pain and nerve symptoms, and the questions our exam sets out to answer.
Read the guide Condition guideHeadaches & migraines
The common headache patterns, what we look for at an exam, and the symptoms that need urgent care.
Read the guide Condition guideWhiplash
What to watch for after a crash or any sudden jolt to the neck, and how recovery is checked.
Read the guideWhat the studies found, and where they stop
How the research fits this area.
The neck trial studied nonspecific neck pain lasting 2 to 12 weeks, and the headache trial only included people with a cervicogenic diagnosis. Neither shows that pain in the upper neck, with nothing else to go on, points to what should be treated.
How we select and explain sources ↗Follow the evidence
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial
272 adults with nonspecific neck pain lasting 2 to 12 weeks.
What it foundManipulation performed better than medication at several follow-ups, but there was no important pain difference between manipulation and home exercise with advice.
What it can't tell usTreatment was unblinded. The study doesn't cover every cause of neck pain, instability after trauma, or an unexplained neurological problem.
Publication details & citation
Bronfort et al. Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Annals of Internal Medicine. 2012. DOI: 10.7326/0003-4819-156-1-201201030-00002.
Read the publication recordA randomized controlled trial of exercise and manipulative therapy for cervicogenic headache
200 people with cervicogenic headache, assigned to manipulation, specific exercise, both, or a control group.
What it foundManipulative therapy and exercise each reduced headache frequency and intensity, with benefits reported at 12 months.
What it can't tell usParticipants weren't blinded, and the combined approach wasn't significantly superior. The findings are about headache that starts in the neck (cervicogenic headache), not migraine in general.
Publication details & citation
Jull et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002. DOI: 10.1097/00007632-200209010-00004.
Read the publication record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.
Your next step
Bring your questions.
We’ll start there.
Your answers to those three questions are where we start. We go over your history and symptoms, examine you, and explain what we found before we recommend anything. If it turns out to be something another doctor should look at, we'll tell you.
Anatomy: BodyParts3D, © DBCLS, CC BY 4.0. Model & rendering credits. Return to the full body explorer.