As a chiropractor with over 30 years of experience, one of the most common things I see in the clinic is patients who've been managing headaches for years without ever addressing the real cause. Many of those headaches aren't coming from the head at all — they're coming from the neck.
I've had patients who've taken paracetamol or ibuprofen daily for years. Patients who've been told they have tension headaches or migraines and have simply accepted them as part of life. Patients who have never once had their cervical spine properly assessed.
When I assess these patients and find the dysfunction in their upper neck that's been generating those headaches — and then treat it — the results are often dramatic. Not because I've done something miraculous, but because the cause was there all along, waiting to be found.
What is a cervicogenic headache?
A cervicogenic headache is a headache that originates from the cervical spine — the neck. The upper cervical joints (particularly C1-2 and C2-3), the muscles of the suboccipital region, and the surrounding nerves all have the ability to refer pain into the head.
When these structures are irritated, inflamed, restricted or dysfunctional, they can generate pain signals that are felt in the skull, behind the eyes, at the temples, or across the top of the head — despite the fact that there is nothing wrong with the brain or blood vessels or any other intracranial structure.
The headache is entirely real. The pain is entirely real. But its source is in the neck, not the head. This distinction matters enormously — because treating the head does nothing to address the neck, and the headaches will keep coming back.
How do I know if my headache is coming from my neck?
No symptom alone is definitively diagnostic, but there are patterns that strongly suggest cervicogenic involvement. When I'm taking a headache history, I'm listening for a cluster of features that point toward the neck as the source.
Signs your headache may be cervicogenic
- Pain at the base of your skull — the suboccipital region. This is where the upper cervical structures are, and it's often where cervicogenic headaches are most intensely felt.
- One-sided or predominantly one-sided headache — cervicogenic headaches often present on one side, following the referral pattern of a specific cervical joint or nerve root.
- Worsens after prolonged sitting, screen use or driving — sustained neck flexion or forward head posture loads the upper cervical structures and tends to bring on or worsen cervicogenic headaches.
- Accompanied by neck stiffness or reduced movement — restricted cervical range of motion, particularly rotation or extension, is a common associated finding.
- Pressing on the neck reproduces or changes the headache — manual pressure over the upper cervical joints or suboccipital muscles produces the headache or changes its quality. This is a particularly important clinical sign.
- Flare-ups after desk work, driving or looking down for extended periods — a clear postural trigger pattern that implicates the cervical spine.
What I do about it at Momentum
When a patient presents with headaches, I perform a thorough assessment of the cervical spine before drawing any conclusions. This includes assessment of cervical range of motion, joint assessment for restriction and tenderness, postural analysis, and neurological screening where indicated.
If I identify cervical dysfunction that is likely contributing to the headaches, treatment typically combines:
- Cervical adjustments — targeted manipulation of the upper cervical joints to restore normal movement and reduce the mechanical irritation that is generating the referred pain
- Soft tissue therapy — manual release of the suboccipital muscles, the upper trapezius, the levator scapulae and other muscles that are often tight and tender in cervicogenic headache patients
- Postural correction — identifying and addressing the postural habits — particularly screen use and desk posture — that are loading the upper cervical structures and perpetuating the headaches
- Laser therapy — for patients with persistent muscular tension or chronic presentations, low-level laser therapy can be incorporated to help reduce inflammation and support soft tissue recovery
Most patients with cervicogenic headaches respond well to the right treatment in most cases, and many notice meaningful improvement from the first session. The key is getting an accurate diagnosis first — which requires a proper assessment.
A word on posture and screens
There is a well-established relationship between forward head posture — the position most of us adopt when sitting at screens, looking at phones or driving — and cervical spine loading.
For every centimetre your head moves forward from its neutral position over your shoulders, the effective load on your cervical spine roughly doubles. In a neutral position, the average adult head weighs approximately 5–6 kg. With just 5 cm of forward head posture, that effective load increases to around 18 kg. With 7–8 cm of forward displacement — which is not uncommon in habitual screen users — the cervical structures are bearing the equivalent of 27 kg or more for hours at a time.
Over weeks, months and years, this sustained overload leads to cervical joint restriction, muscle fatigue and dysfunction, altered joint mechanics and, in many patients, the very upper cervical dysfunction that generates cervicogenic headaches.
This is why postural correction is not an optional add-on to headache treatment — it is often as important as the hands-on component. If we treat the neck without addressing the postural habits that caused the dysfunction, the headaches will return.
Don't just manage the pain — find the cause
If you've been taking pain medication for headaches without addressing the physical cause, you're treating the symptom and leaving the source untouched. Medication has its place, but it doesn't restore joint mechanics, release muscle tension or correct postural dysfunction. It manages the output of a problem without touching the problem itself.
A thorough chiropractic assessment can tell you within a single appointment whether your neck is contributing to your headaches. If it is, we can do something about it — directly, non-invasively, and typically with results that are apparent within a handful of sessions.
If your headaches have a different primary cause, I'll tell you that too, and refer you accordingly. The goal is always to find the real cause, not to fit every headache into a chiropractic treatment model.
If you've been putting up with recurring headaches — or managing them with medication without lasting improvement — it's worth having your neck properly assessed. It may change everything.
