Headaches: When the Neck Is Involved, and When It Isn't

Almost everybody gets headaches. That’s part of what makes them hard to take seriously, and part of what makes them hard to sort out.

At Simi Spine & Wellness we hear some version of the same sentence every week: “I get these headaches, and I think they might be coming from my neck.”

Sometimes that’s exactly right. Sometimes it isn’t. The whole job is knowing which.

I’m Dr. Shawn DeCloedt. I want to be straight with you about what a chiropractor can help with when it comes to headaches, what we can’t, and which headaches should never wait for an appointment with anyone but a medical doctor.

Not Every Headache Is the Same Problem

“Headache” is a description of where it hurts. It doesn’t tell you why.

There are many types, with different causes and different treatments. For what we do, three matter most:

• Headaches that originate in the neck
• Tension-type headaches
• Migraines

They can overlap, and one person can have more than one. But they are not the same thing, and what helps one doesn’t necessarily help another.

Headaches That Start in the Neck

The clinical name is cervicogenic headache. It means the pain is felt in the head but the source is in the neck.

The pattern tends to look like this:

• Usually one-sided, and it stays on that side
• Often starts at the base of the skull and spreads toward the forehead or behind the eye
• Gets worse with certain neck positions, or after holding your head still for a long time
• Comes with neck stiffness or a reduced ability to turn your head
• Pressing on certain spots in the upper neck can reproduce it

If that sounds familiar, the neck is worth examining. This is the type of headache where evaluating and treating the neck makes the most sense, and it’s closely tied to the everyday neck pain so many people carry around.

Tension-Type Headaches

This is the most common headache there is.

People describe it as a band around the head, pressure at the temples, or a dull ache across the forehead or the back of the skull. It’s usually on both sides. It’s unpleasant but it typically doesn’t stop you from functioning.

Tight muscles in the neck, shoulders, and jaw often come along with it, and long days in one position don’t help. So can poor sleep, skipped meals, and stress.

Working on the muscles and joints of the neck and upper back is reasonable for some people with this pattern. So is changing the daily habits that feed it, which is often the bigger part.

What About Migraines?

Migraine is a neurological condition. It is not a neck problem and it is not a bad tension headache.

A migraine is usually a throbbing pain, often on one side, that gets worse with activity. It commonly comes with nausea and sensitivity to light or sound. Some people see flashing lights or zigzag lines beforehand.

If that describes your headaches, you should be under the care of a medical provider. There are effective medical treatments, and a proper diagnosis matters.

Where we sometimes fit in: many people with migraines also have neck pain and muscle tension. Addressing that can be worthwhile. But I’m not going to tell you an adjustment treats migraine, because that isn’t an honest claim.

Headaches That Need a Doctor, Not a Chiropractor

This is the most important section of this article. Please read it even if you skip the rest.

Call 911 or go to an emergency room for:

• A sudden, severe headache that reaches full intensity within about a minute
• The worst headache of your life
• A headache with weakness, numbness, confusion, trouble speaking, drooping of the face, or loss of vision
• A headache with a fever and a stiff neck
• A headache after a significant blow to the head
• A headache with a seizure or a loss of consciousness

See a medical provider promptly for:

• A new kind of headache if you are over 50
• Headaches that are steadily getting worse over days or weeks
• A headache that wakes you from sleep or is worse when you lie down
• A headache that comes on with coughing, straining, or exertion
• A new headache during pregnancy or shortly after
• A new headache if you have a history of cancer or a weakened immune system
• Neck pain and headache together that started suddenly and feel unlike anything you’ve had before

None of those are chiropractic problems. If you come to us with one, we will send you where you need to go.

What Tends to Set Headaches Off

For the common types, the same handful of things show up again and again:

• Long stretches at a screen without moving
• Sleeping too little, too much, or on a pillow that leaves your neck bent
• Not drinking enough water
• Skipping meals
• Too much caffeine, or suddenly cutting it out
• Clenching or grinding your teeth
• Stress, and the shoulder tension that goes with it
• Taking pain relievers many days a week, which can cause headaches of its own

That last one surprises people. If you’re taking something for headaches more than two or three days a week, tell your doctor. It may be part of the cycle.

Keep a Simple Headache Log

Before you see anyone, this is the most useful thing you can do.

For two weeks, write down:

• When the headache started and how long it lasted
• Where you felt it
• What you were doing beforehand
• How you slept the night before
• What you ate and drank
• What you took for it, and whether it helped

Patterns show up quickly on paper that you would never notice otherwise. Bring it with you. It makes the evaluation far more useful, whether that’s here or at your doctor’s office.

How We Evaluate a Headache

We start by listening. How the headaches began, what they feel like, what makes them better or worse, and whether anything on the warning list above applies.

Then we examine how your neck and upper back move, check the muscles and joints at the base of the skull, and run a basic neurological screen.

What we’re looking for is whether the neck is plausibly involved. If it is, we’ll tell you what we found and what we’d suggest. If it isn’t, or if something doesn’t add up, we’ll tell you that and point you toward the right provider.

What Care Might Include

When the neck and surrounding muscles are part of the picture, care may involve:

• Chiropractic adjustments or gentler mobilization, depending on what you’re comfortable with
• Massage therapy for the muscles of the neck, shoulders, and base of the skull
• Assisted stretching and mobility work
• Instrument-assisted soft tissue techniques
• Corrective exercise for the neck and upper back, so the change holds

Not everyone gets all of those, and nobody should. If you’d rather not have your neck adjusted, say so. There are other ways to work.

We expect to see some change within the first few visits. If we don’t, we stop and re-evaluate rather than keep repeating what isn’t working.

Headaches After an Accident or a Hit to the Head

A headache that begins after a collision, a fall, or a blow to the head is its own category.

If there’s any chance of a concussion, meaning confusion, memory gaps, nausea, dizziness, or you were knocked out even briefly, get medical evaluation first. That comes before anything we do.

Once that’s been ruled out, neck injury is a common source of headaches after an auto accident, and symptoms often show up days later rather than at the scene. That’s what our whiplash evaluation is for.

Headache Treatment in Simi Valley

If you’ve been getting headaches along with a stiff, sore neck, and nothing on the warning list applies to you, come in and let’s take a look.

We’ll go through your history, examine your neck, and give you a straight answer about whether we think we can help.

And if we think you need a different kind of provider, we’ll tell you that too.

This article is intended for general educational purposes and does not replace individualized medical advice, diagnosis, or treatment. Treatment recommendations are made after an appropriate evaluation.