Which kind of headache?
Three kinds of headache bring most people to us.
- Neck-related (cervicogenic) headaches start at the base of the skull or on one side of the neck and spread forward. They are often worse after long periods at a desk or on a phone, and the neck is usually stiff and tender.
- Tension-type headaches feel like a tight band around the head. Neck and shoulder tension, stress and poor sleep are common contributors.
- Migraine is a neurological condition, often with nausea, sensitivity to light or sound, and sometimes visual disturbance. Chiropractic care does not treat migraine itself, but neck stiffness and tension are common alongside migraine, and we can assess and treat those.
Your assessment is designed to tell these apart, and to make sure nothing more serious is behind the headaches. If we think you need your GP, we will say so and help you get there.
What happens at your first appointment
Your first appointment takes about 30 to 40 minutes. It includes:
- Your history. Where the headaches sit, how often they come, how long they last, what triggers them, what you have tried and what has helped.
- A physical examination. Movement and tenderness of the neck and upper back, the muscles at the base of the skull, and neurological screening when needed.
- Posture analysis. Digital posture analysis for adults, including head position, which is often part of the neck-related picture.
- An explanation. Which kind of headache we think you have, what we can help with, and what we recommend.
- Your first treatment, when clinically appropriate.
We do not X-ray for headaches. If the history suggests imaging or a medical review is needed, we refer you to your GP first.
How we help
For neck-related and tension-type headaches, treatment may include:
- Gentle adjustment or mobilisation of the upper neck and upper back, using low-force techniques where appropriate.
- Soft tissue work for the muscles at the base of the skull, the neck and the tops of the shoulders.
- Exercises for the deep neck muscles and upper back, and advice on screen height, phone use and sleeping position.
- A simple headache diary, so you and your chiropractor can see whether the pattern is changing.
If you have migraine, we work alongside your GP or neurologist rather than instead of them. Decisions about migraine medication stay with your doctor; our part is the neck and shoulders.
When to get headaches looked at
Occasional headaches that settle with rest, water and a break from the screen are normal. Headaches that come most weeks, that are changing in pattern, or that always start in the neck are worth an assessment. Frequent painkiller use for headaches is also a reason to get help, because it can itself cause headaches.
- A sudden, severe headache that reaches full intensity within seconds or minutes (the worst headache of your life).
- Fever, a stiff neck, a rash, confusion or drowsiness.
- A headache after a head injury, especially with vomiting or drowsiness.
- Weakness, numbness, difficulty speaking, loss of vision or a drooping face.
- A new type of headache if you are over 50, pregnant, or have a history of cancer or a weakened immune system.
What the research says
The research on manual therapy for headaches is strongest for headaches that begin in the neck, and more limited for migraine.
Research has found that chiropractic spinal manipulation can reduce the number of headache days in people with headaches originating from the neck, called cervicogenic headaches. A trial involving 256 adults found that the group receiving 18 manipulation sessions over six weeks experienced approximately three fewer headache days per four weeks than the light-massage control group at the main follow-ups.
Haas, M., Bronfort, G., Evans, R., Schulz, C., Vavrek, D., Takaki, L., Hanson, L., Leininger, B., & Neradilek, M. B. (2018). Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: A dual-center randomized controlled trial. The Spine Journal, 18(10), 1741-1754. doi.org/10.1016/j.spinee.2018.02.019More on the research we rely on.
ACC and headaches after an injury
Headaches that began after a car accident, a fall or a knock to the head may be covered by ACC as part of a neck or head injury. Any suspected concussion needs a medical assessment first. Once that has happened, we can lodge a claim for the neck injury at your first appointment or see you under an existing one.