What Is the Trigeminocervical Nucleus?
The trigeminocervical nucleus (TCN) is a key part of the nervous system that acts like a “pain processing hub” in the upper part of the spinal cord and brainstem.
It’s where pain signals from the face (via the trigeminal nerve) and pain signals from the neck (via the upper cervical nerves, C1–C3) meet and mix.
Why Does This Matter?
Because of this shared nerve pathway, problems in the upper neck can be felt as pain in the head or face— and vice versa.
This explains why:
Neck problems can trigger headaches (especially cervicogenic headaches)
Migraines can be felt in the neck and shoulders
Treating neck dysfunction can relieve headache symptoms
How It Works
The trigeminal nerve carries sensations from the:
Forehead
Eyes
Temples
Jaw and face
The upper cervical spinal nerves (C1–C3) carry signals from:
Neck muscles and joints
Back of the head
Upper shoulders
These nerves all connect into the trigeminocervical nucleus.
When this area becomes irritable, it can:
Amplify pain signals
Misinterpret neck signals as headache
Trigger or worsen migraines, cervicogenic headaches, or tension-type headaches
Why This Matters in Physiotherapy
Understanding the trigeminocervical nucleus helps explain why treating the neck can relieve some types of headaches — even if the pain is felt in the head or face.
Physiotherapists trained in headache management (e.g., Watson Headache® Approach) often assess and treat the upper cervical spine to reduce sensitisation in the TCN.
By:
Mobilising stiff joints (C1–C3)
Reducing muscle tension
Improving posture and movement
Educating the patient
...we can calm the nervous system, reduce pain referral, and decrease the frequency and intensity of headaches.
Key Takeaway
The trigeminocervical nucleus is the brainstem hub where neck and head pain signals meet. When this area becomes overly sensitive, it can cause or worsen headaches — especially if there’s dysfunction in the neck.
By understanding and treating this nerve pathway, headache relief becomes possible — without relying solely on medication. To find out what we can do to quiet this system, head over to the page on down regulation here.
If you have any questions regarding your headache, or are interested in seeing if we can help you, please give us a call at (02) 8411 2050. Here at Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We have expertise in musculoskeletal physiotherapy and are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.