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Which Headache Are You Having
Headaches that respond well to hands on care are usually cervicogenic, meaning they originate in the neck, or tension type, where tight neck and shoulder muscles drive the pain. Migraine is a different condition and is handled differently. Sorting out which one you have is the first thing worth doing, because it determines whether treatment here is the right answer at all.
Most people arrive having tried the same things: painkillers, more water, less screen time, an eye test. Those help some headaches and do nothing for others, and the reason is that the word headache covers several unrelated problems that happen to share a symptom.
The Neck Link
Headaches That Start in the Neck
The upper cervical spine and the base of the skull share nerve pathways with the head and face. When those joints stiffen, or the muscles around them stay switched on for weeks, pain refers upward. It typically presents as an ache starting at the base of the skull and spreading over one side of the head, sometimes settling behind the eye.
The pattern is recognisable. It tends to be worse at the end of a working day, worse after long driving or desk sessions, and often accompanied by a stiff neck or a shoulder that will not settle. It is usually one sided and the same side each time. Turning the head may reproduce it.
This is the category that responds best to what happens here, because the driver is mechanical and reachable.
Tension
Tension Type Headaches
These feel like a band of pressure around the head rather than a sharp one sided pain, and they are the most common headache there is. Sustained muscle tension through the neck, jaw, and shoulders is a major contributor, which is why they cluster around stressful weeks, poor sleep, and long hours at a screen.
Jaw clenching drives a good number of them. If yours come with jaw tightness or clicking, the jaw itself may be part of the problem and treating the neck alone will only get you so far.
The Distinction
Migraine Is Different
Migraine is a neurological condition, not a mechanical one. It involves changes in how the brain processes sensory input, and it often arrives with nausea, light and sound sensitivity, and sometimes visual aura beforehand. Chiropractic care does not cure migraine, and anyone who tells you otherwise is overselling.
What is true is that neck dysfunction is a common trigger and a common travelling companion. Plenty of people with migraine also have a genuinely irritable neck, and treating that can reduce how often attacks are set off. Some people find attacks become less frequent or less severe. Others notice no difference.
The commitment here is simple. If a few weeks of care are not changing anything, we will say so rather than keep booking you in. Migraine is best managed alongside a physician, and the two approaches sit together comfortably.
Treatment
How These Get Treated
The first visit is mostly assessment. How the neck moves, which segments are restricted, which muscles are tender and whether pressing them reproduces your headache, and what your week actually looks like in terms of desk setup, sleep, and training.
From there, treatment usually combines soft tissue work on the suboccipital, upper trapezius, and scalene muscles, often using Active Release Technique, with joint work to restore movement in the upper neck. Where the tissue is dense and chronically tight, myofascial release or muscle scraping may be added.
Then the part that decides whether it lasts: exercise and position changes so the neck stops being loaded the same way forty hours a week. Treatment without that tends to work until you go back to your desk.
Right Now
What Helps Before Your Visit
- Heat on the neck and shoulders for about ten minutes, then move it gently. For a headache that has been building over days, heat generally beats ice. More on choosing between them.
- Get the screen to eye height. Looking down at a laptop for hours loads exactly the structures that refer pain into the head.
- Break up long sitting. Standing and moving the neck through its full range every half hour does more than any single stretch.
- Watch the jaw. If you catch yourself clenching, that is a lead worth mentioning at your visit.
- Keep a short log. When they hit, how long they last, what preceded them. A week of that makes the pattern far easier to identify.
Know the Limits
When It Is Not a Routine Headache
Some headaches need a doctor immediately rather than any of the above. Seek urgent medical attention for:
- A sudden, severe headache that peaks within seconds, often described as the worst of your life.
- Headache with fever, a stiff neck, or a rash.
- Headache with confusion, slurred speech, weakness, or vision loss.
- Headache following a head injury, particularly with vomiting or drowsiness.
- A headache pattern that has clearly changed, or one that is new and persistent over the age of fifty.
None of those are what this page is about, and none of them should wait for a chiropractic appointment.
Questions
Frequently Asked Questions
For many headaches, yes. The ones that respond best are cervicogenic headaches, which start in the neck and refer pain into the head, and tension type headaches, where tight neck and shoulder muscles are a major driver. Both are common and both are mechanical, which is what hands on care is suited to. The honest caveat is that not every headache is mechanical, so the first visit is spent working out which kind you have.
This needs a careful answer. True migraine is a neurological condition and chiropractic care does not cure it. What it can do is address the neck contribution, which is real for a lot of migraine sufferers, and reduce one of the common triggers. Some people find attacks become less frequent or less severe. Others find no change, and we will tell you if that looks likely rather than keep booking visits. Migraine is usually best managed alongside a physician, not instead of one.
Headaches that are worse at the end of a working day, that come with neck or shoulder tightness, that sit on one side, or that follow a period of poor sleep or heavy desk work. Those patterns point at a mechanical driver. Headaches that arrive with visual aura, nausea, and light sensitivity are more likely migraine and are handled differently.
It is a fair question to ask and worth answering properly. Serious complications from neck treatment are very rare. There has been long running debate about a possible link with arterial injury, and the current view is that much of that association reflects people already experiencing a dissection seeking care for the neck pain it causes. We screen for risk factors before treating, and manipulation is not the only tool available. Soft tissue work, joint mobilisation, and exercise are all effective and lower force, so if you would rather not have your neck adjusted, say so and we will work another way.
You should have a reasonable idea within a handful of visits. If your headaches have a mechanical driver, the frequency or intensity usually starts shifting early. If nothing has changed after a few weeks of consistent care, that is useful information too, and it means the driver is something else and you need a different answer.
It depends on the pattern. Neck related and tension type headaches are squarely mechanical and a good fit here. Frequent migraine, headaches that are changing in character, or anything with neurological symptoms should involve a physician or neurologist, and the two approaches work perfectly well together. If what you describe belongs with them rather than here, we will say so at the first visit.
Sources
References
- Cleveland Clinic. Headaches.
- National Institute of Neurological Disorders and Stroke (NIH). Headache.
- American Migraine Foundation. Tension type headache.
This page is for education and does not replace an individual evaluation by a licensed provider.