Introduction
Headache, or head pain, is a very familiar ailment. About 40%1 of people have, currently do, or will suffer from headaches at some point in their life. It is a commonality, however, doesn’t make it normal, per se. Every headache has its source or cause and, contrary to common belief, the head itself is not such a frequent location of it.
Unfortunately, most are quick to grab the bottle of Ibuprofen or Advil to take care of the problem. This is all fine and dandy in the beginning and consequences will likely not be felt but long-term use of these drugs can cause serious issues. Not to mention, these medications only alleviate the pain without resolving the issue itself.
I will rarely encounter someone suffering from headaches with absolutely no neck problems. I normally hear something like “Every time my neck starts hurting I get a headache.” or “My neck is so tensed; I feel like the headache comes from this tension.” or even “I feel the pain starting in my neck and it radiates to my head.”
Even though many have an itch that their neck causes (or at least factors into) their headache, they don’t have a clear understanding of the reasoning behind this link.
This article will explore the 3 most common headaches caused by a (or multiple) neck problem(s).
These three headaches are:
- Tension headaches
- Migraines
- Cervicogenic headaches
Article Outline
- Tension headaches: defined, symptoms and cause(s)
- Migraines: defined, symptoms and cause(s)
- Cervicogenic headaches: defined, symptoms and cause(s)
- The role of the neck: bones, muscles, joints, nerves and blood vessels
- Headache assessment: a special attention on the neck
- Treatment and management of headaches with a focus on craniocervical junction alignment
- Will you recover?
- Tension headache treatment near me, migraine treatment near me and cervicogenic headache treatment near me
Tension Headaches
[A tension headache is a] “bilateral headache marked by mild to moderate pain of variable duration that typically is accompanied by contraction of the neck and scalp muscles.”2
As the name implies, tension headaches arise from muscular tension. The sub-occipital, trapezius, temporalis and sternocleidomastoid muscles are the most frequent culprits.3 All these muscles find their attachments at different points of the neck spine.
As indicated before, symptoms of tension headaches are bilateral pain (on both sides) of the head; mainly across the forehead from temple to temple. These will often feel like a tight headband. They are generally accompanied by neck pain at the base of the skull where the suboccipital and trapezius muscles attach.
Muscular tension can develop for many different reasons:
- Too much time spent looking down at books or devices and/or;
- Accident or injury leading to neck instability (CCI or other cervical instability) and/or;
- Spinal misalignment of the neck
Migraines
[A migraine is] “a condition marked by recurring moderate to severe headache with throbbing pain that usually lasts from four hours to three days, typically begins on one side of the head but may spread to both sides, is often accompanied by nausea, vomiting, and sensitivity to light or sound, and is sometimes preceded by an aura and is often followed by fatigue.”4
Here I have to add that this is a very general definition of migraine. Migraines are very complicated primary headaches and their symptoms can vary a lot.
Migraines typically happen in 4 phases:
- Prodrome

The prodrome phase can happen hours to days before a migraine. Change in mood, feeling thirsty, neck pain, fatigue and digestive issues are all prevalent symptoms.
- Aura

The aura phase of migraine precedes (most often) the head pain phase and is usually associated with visual disturbances.
- Headache

The migraine headache is unilateral, meaning only on one side, most of the time.
- Postdrome

The postdrome phase follows the headache phase and is associated with symptoms such as: neck ache/stiffness, fatigue and brain fog
Also important to note is the fact that some will experience aura and some not.
What we currently know and understand about migraines are the following:
- Migraine is a neurovascular condition, meaning, nerves and blood vessels play a role in the problem5
- Migraine is a change in the state of the brain and its components
- The trigeminal nerve plays a major role in migraine
- The issue is not simply related to blood vessels inside the head
Migraine sufferers all know very well what can trigger (cause) a migraine. Below is a list of the ones I hear most often:
- Something happens to the neck (a bad night of sleep, an accident, looking a certain way for too long, etc.)
- Certain foods
- Lack of sleep
- Exercise
- Hormones
Cervicogenic headaches
Cervicogenic headaches is a broad umbrella term that includes all headaches coming from a neck problem. And as I am sure you can imagine by now, they are frequent.
Many different structures (anatomy) of the neck can be culprits, whether it is muscles, joints, nerves, ligaments or blood vessels.
“A cervicogenic headache is head pain that originates in your neck. The pain can radiate from an injury or condition that affects your cervical spine, like an injury, arthritis or a slipped disk.”6
Just like a migraine, the pain is typically unilateral. Neck pain is just about always associated with the headache but in some instances, it isn’t. The headache can be localized to a specific portion of the head or it can radiate from the neck up.
A few different causes are possible:
- Blood clots (rather rare)
- Disc lesion (herniation, bulge, extrusion, protrusion)
- Joint irritation
- Nerve irritation
- Ligament damage resulting in muscle trigger points
The role of the neck: bones, muscles, joints, nerves and blood vessels
The neck is a very complex area of the body, anatomically speaking. There are tons of nerves and blood vessels very close to vertebrae, there are lots of ligaments holding it into as good of an alignment as possible, many muscles attach to vertebrae to move and stabilize them and finally each of these vertebrae have so many joints.
All in all, this is to say that there are many possibilities and areas where things can go wrong.
The neck is also an interesting area because it is, quite literally, a stick holding a bowling ball (your head). In addition, the neck is very mobile as compared with other areas of the spine and human skeleton. All this mobility comes at a price, and that is: stability. The neck is prone to instability — which is another big reason why it is so often affected and becomes the source of many issues.
The weakest part of the neck is called the craniocervical junction (don’t worry, I won’t test you on that!). This is the junction between the skull and the Atlas (the first vertebra of the neck). This area is easily misaligned and is the most likely to affect nerves (the trigeminal being one of them) and blood vessels; create joint irritation and abnormal muscle tensions.
Headache assessment: a special attention on the neck
Since the craniocervical junction is the weakest link and the area most susceptible to cause headaches, that is always our starting point in assessing a patient suffering from headaches.
We look for:
- Abnormal muscle tension and trigger point pain referral patterns
- Signs of joint dysfunction based on orthopedic tests and X-ray images
- Signs of nerve irritation based on pain patterns and thermography
- Signs of disc lesions (discs cannot be seen on X-ray because they are a “soft” tissue but signs of lesions can be observed)
- Signs of ligament damage and instability based on X-ray findings
- Indication of blood vessel involvement based on history and presentation of the headache pattern
In our clinic, we perform:
- A detailed review of your health history to nail down as best as possible the kind of headache you are dealing with
- A complete physical examination including orthopedic and range of motion tests to evaluate joint, nerve and muscle involvement
- A careful evaluation of the neck and upper shoulder muscles
- A thermographic evaluation of the spine
- A unique craniocervical junction X-ray series
Treatment and management of headaches with a focus on craniocervical junction alignment
Once our assessment is completed and we have confirmed, analyzed and calculated:
- The presence of a craniocervical junction misalignment;
- The effects of such a misalignment on the joints, muscles, ligaments and nerves of the neck;
- The unique misalignment of the individual;
- The specific adjustment needed to correct such misalignment, gently and specifically
We proceed with the first craniocervical junction alignment procedure. The completion is the procedure can take between 3-5 hours, depending on the complexity of the case. Following the alignment procedure, two X-rays are repeated to confirm the achievement of the craniocervical alignment. No need to wait 6 months for improvement in the alignment.
Tests are also repeated to confirm immediate improvement in nerve and muscle functions.
Will I recover?
Most suffering from tension or cervicogenic types of headaches can expect a full recovery; meaning the headaches will disappear without coming back. However, there is a bit of a caveat.
Even though the craniocervical junction alignment procedure is highly stable, someone may lose their alignment, at some point, based on daily activities. Headaches may (or may not) reappear at this point and another alignment procedure may be required.
Migraines, on the other hand, are more complex and the recovery is less predictable. About 90% of our patients see an improvement in migraine frequency and/or duration after a craniocervical alignment procedure. This improvement may take a few weeks to a few months. Continued care to verify the alignment and correct it if necessary is paramount to these patients so that their migraines keep decreasing in frequency and duration. Some will even experience complete resolution as long as they maintain their alignment.
Tension headache treatment near me, migraine treatment near me and cervicogenic headache treatment near me
Atlas Spine and Wellness Care has experts in the assessment and care of tension headaches, cervicogenic headaches and migraines. Our upper cervical chiropractors are highly skilled in the gentle correction of the craniocervical junction misalignment and soft tissue therapy.
Until you’ve tried upper cervical chiropractic, you haven’t tried everything! Book a free consultation today and get better faster.
- World Health Organization, 2024, World Health Organization, Retrieved August 30, 2024, from https://www.who.int/news-room/fact-sheets/detail/headache-disorders
- Merriam-Webster. (n.d.). Tension headache. In Merriam-Webster.com dictionary. Retrieved September 2, 2024, from https://www.merriam-webster.com/dictionary/tension%20headache
- Fernández-de-Las-Peñas, C., Cook, C., Cleland, J. A., & Florencio, L. L. (2023). The cervical spine in tension type headache. Musculoskeletal science & practice, 66, 102780. https://doi.org/10.1016/j.msksp.2023.102780
- Merriam-Webster. (n.d.). Migraine. In Merriam-Webster.com dictionary. Retrieved September 2, 2024, from https://www.merriam-webster.com/dictionary/migraine
- Goadsby, P. J., Holland, P. R., Martins-Oliveira, M., Hoffmann, J., Schankin, C., & Akerman, S. (2017). Pathophysiology of Migraine: A Disorder of Sensory Processing. Physiological reviews, 97(2), 553–622. https://doi.org/10.1152/physrev.00034.2015
- Cleveland Clinic, 2024, Cleveland Clinic, Retrieved September 2, 2024, from https://my.clevelandclinic.org/health/diseases/cervicogenic-headache
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