Condition
Headaches + Migraines
If your neck is involved, we can usually tell within one visit.
4 in 5
headache sufferers have neck pain alongside their headaches
Cervicogenic and tension-type headaches respond well to treating the neck. True migraine is a neurological condition — we can help some aspects and we will say so honestly.
What it feels like
- Pain starting at the base of the skull and spreading forward
- One-sided head pain that does not switch sides between episodes
- Headache triggered or worsened by neck movement or sustained posture
- Reduced neck rotation on the same side as the headache
- Pain behind one eye or across the temple
- Nausea, light or sound sensitivity in migraine specifically
What tends to cause it
- Upper cervical joint dysfunction referring pain into the head
- Trigger points in the suboccipitals, upper trapezius, and sternocleidomastoid
- Sustained postural loading, particularly at a desk
- Jaw clenching and TMJ dysfunction
- Migraine, a primary neurological condition with its own mechanisms
- Medication overuse headache, which is more common than most people realise
Around eight in ten people with recurring headaches also have neck pain. That association is strong, and it is easy to over-interpret — but it does mean the neck deserves examination in nearly every headache case, and it frequently does not get one.
The convergence that explains everything
The upper three cervical nerve roots and the trigeminal nerve — which serves your face, forehead, and much of your head — feed into a shared processing region in the brainstem called the trigeminocervical nucleus.
Signals arriving from a joint at C2 and signals arriving from your temple pass through the same relay. The brain does not reliably distinguish them. So irritation at the top of the neck can be experienced, entirely genuinely, as pain behind the eye.
This is not a theory about subluxations. It is basic neuroanatomy, and it is why treating a joint at the base of the skull can eliminate pain someone has been feeling in their forehead for years.
Sorting your headache type
Cervicogenic — one-sided, always the same side, starts at the back of the head and spreads forward, worse with neck movement, restricted neck rotation on the painful side. Highly responsive to neck treatment.
Tension-type — both sides, band-like pressure, mild to moderate, no nausea, no significant light sensitivity. Responds well to soft tissue work and load management.
Migraine — typically one-sided but can switch, throbbing, moderate to severe, nausea, light and sound sensitivity, sometimes preceded by aura, worsened by routine activity. This is neurological. We can help with the cervical component and triggers, and your physician or neurologist manages the condition itself.
Medication overuse — daily or near-daily, present on waking, brief relief from medication then return. Needs a supervised medication holiday, not manual therapy.
What we will not claim
We are not going to tell you that headaches are caused by spinal misalignment interfering with nerve flow to your brain. That explanation is not supported and it is embarrassing to the profession.
What we will tell you is that a large proportion of recurring headaches have a treatable cervical component, that this component is routinely overlooked, and that finding out whether yours does takes about one visit.
How we treat it here
Classify the headache first
Cervicogenic, tension-type, migraine, and medication overuse headaches have different mechanisms and different treatments. We take a proper headache history — location, quality, triggers, duration, associated symptoms — before deciding whether we are the right provider at all.
Test the upper cervical spine
The cervical flexion-rotation test is quick and informative. Restricted rotation with a headache on the same side points strongly toward C1–C2 involvement, which is very treatable.
Treat joints and tissue together
Adjustment or mobilisation of the restricted upper cervical segments, plus soft tissue and needling for the suboccipitals and upper trapezius. These two together consistently outperform either alone.
Address the load
Deep neck flexor endurance, workstation changes, and where relevant, jaw and clenching habits. Headaches driven by sustained load return unless the load changes.
Headaches
Questions we get about this.
Can chiropractic help migraines?
Partly, and we want to be precise here. Migraine is a primary neurological disorder involving cortical and trigeminovascular mechanisms — it is not caused by your neck being out of alignment, and any clinic telling you otherwise is overreaching. What is true is that cervical dysfunction is a common migraine trigger and a common comorbidity, and that treating the neck reduces attack frequency for some migraine patients. There is reasonable evidence for manual therapy as an adjunct. We work alongside your neurologist, not instead of them.
What is a cervicogenic headache?
A headache whose actual source is the cervical spine. The upper three cervical nerve roots converge with the trigeminal nerve in the brainstem, and your nervous system cannot always distinguish which is sending the signal — so neck input gets experienced as head pain. These are typically one-sided, do not switch sides, start at the back of the head, and worsen with neck movement. They respond very well to treating the neck, often quickly.
How many visits before I know if this is working?
For cervicogenic and tension-type headaches, most people notice a change in frequency or intensity within four to six visits. If nothing has shifted by then, the neck is probably not the driver and we will tell you so rather than keep going.
Could my painkillers be causing this?
Possibly. Medication overuse headache develops from regular use of acute headache medication — generally more than 10 to 15 days a month depending on the drug — and it is frequently missed. It presents as a daily or near-daily headache that improves briefly with medication and returns. If your history fits, we will raise it and refer you back to your physician, because the withdrawal needs supervising.
New patient special — $59 New Patient Visit
Get your headaches properly examined.
One visit, a real diagnosis, and a plan with a visit count and an end date. If it turns out we are not the right provider, we will say so and point you to who is.
Columbus, OH · Same-week appointments · Most insurance accepted