🧠 Can Brain Stimulation Help Treat Neck-Related Headaches?

Dr. Suraj Malhan, DO, MS
Headache & Facial Pain Neurologist

For patients and clinicians battling cervicogenic headache (CGH)—a type of headache rooted in cervical spine dysfunction—treatment often feels like trial and error. Traditional approaches like physical therapy, medications, and nerve blocks help some, but not all. Now, a new study published in Headache (2025) is pointing us in a novel direction: targeting the brain itself using transcranial direct current stimulation (tDCS).

💡 What is tDCS?

Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique that delivers a low-level electrical current through electrodes placed on the scalp. This current modulates neuronal excitability—either enhancing or dampening the activity of specific brain regions.

In this study, the primary target was the primary motor cortex (M1)—a region associated not just with movement, but with modulation of pain perception via descending inhibitory pathways. By enhancing excitability in M1, tDCS may reduce central sensitization—a key player in chronic pain and headache disorders like CGH.

📅 What Was the Treatment Protocol?

The study by Jobin et al. implemented a 6-week protocol with the following setup:

• 20-minute sessions for 6 weeks

• Active tDCS at 2 mA was delivered with electrodes over C3 and C4 (motor cortices)

• Stimulation occurred concurrently with supervised exercise therapy (ET)—including cervical mobilization, postural training, and motor control exercises

Patients were also encouraged to continue daily home exercises.

🔍 What Did the Study Find?

• ✅ Safe & Well-Tolerated: No serious side effects, and >90% adherence

• ✅ Effective: Participants receiving active tDCS + ET experienced:

• Reduced headache pain intensity

• Fewer headache days

• Improved neck pain scores

• These effects were sustained up to 12 weeks after the final session

• ❌ No significant impact on mood or quality of life (suggesting the effect is symptom-specific)

Importantly, sham tDCS + ET did not produce the same results—suggesting a real therapeutic effect from the brain stimulation.

🧠 Why This Matters

For patients, this opens the door to a non-invasive, drug-free option for cervicogenic headache—especially when standard treatments fall short.

For clinicians, it emphasizes the role of the central nervous system in CGH and supports the use of multimodal neuromodulatory strategies. tDCS may enhance the impact of movement-based therapy by “priming” the brain to respond more effectively to input.

This study supports a biopsychosocial approach: combining physical rehab, neural modulation, and behavioral interventions to address the complex nature of CGH.

📌 Bottom Line

This pilot study is early-phase but highly promising. Larger trials are needed, but tDCS could become a key tool in the management of refractory cervicogenic headache—especially in specialized headache centers that already integrate procedural and physical therapy.

As a headache specialist passionate about integrating neuroscience, OMT, and rehab strategies into CGH care, I see this as a potential step forward in reshaping how we treat these complex patients.

🔗 Read the full article:
Jobin et al., Headache, 2025.