Most people who walk into Martens Chiropractic with a headache have already tried the obvious things. Ibuprofen. More water. A dark room. Sometimes new glasses. What few have had is someone press on the top three joints of the neck to see whether that reproduces the headache they came in with. The test takes a minute and often changes the conversation.
Can a problem in your neck really cause head pain?
Yes, and the anatomy is well established. Sensory nerves from the upper three levels of the neck (C1, C2, and C3) converge on the same brainstem relay as the trigeminal nerve, which carries sensation from the face and much of the head. Researchers call that junction the trigeminocervical complex. Because the brain cannot reliably sort out which signal came from where, an irritated joint, disc, or muscle at the top of the neck gets felt behind the eye, at the temple, or across the forehead.
What is a cervicogenic headache?
A cervicogenic headache is head pain caused by a disorder of the cervical spine and its bones, discs, or soft tissues. That definition comes from the International Classification of Headache Disorders, third edition (ICHD-3), the diagnostic reference published by the International Headache Society.
The pattern is recognizable once you know it:
- Pain starts at the base of the skull and spreads forward, rarely the reverse.
- It stays on one side, usually the same side each time, and rotation toward that side is restricted.
- Neck movement, or holding one position too long, sets it off.
- Nausea is uncommon, and light sensitivity, if present, is mild.
Published prevalence estimates run from under one percent of the general population to over four percent, with higher rates among people reporting frequent, severe headaches.
How do I tell it apart from a migraine?
Migraine attacks typically last 4 to 72 hours untreated, throb, worsen with ordinary activity, and bring nausea or sensitivity to light and sound. About a third of patients get aura, the visual or sensory disturbance that arrives ahead of the pain.
Here is the wrinkle: neck pain shows up in migraine constantly. A 2010 study by Calhoun and colleagues in Headache found 75 percent of migraine patients reported neck pain with their attacks, making it more common than nausea. A sore neck does not settle the question. Plenty of people have both a migraine disorder and a neck joint lighting the fuse.
What does Martens Chiropractic check during a headache exam?
The exam answers one question first: does the neck reproduce this headache? That takes a history of where the pain begins, what positions trigger it, and how long episodes last, then hands-on assessment of the upper cervical joints, looking for familiar pain rather than plain tenderness.
One useful measure is the cervical flexion-rotation test, which isolates rotation at the C1 to C2 segment. Healthy adults reach roughly 44 degrees each side. Results at or below about 32 degrees point toward upper cervical involvement and have been studied specifically in cervicogenic headache.
Screening for what does not belong in a chiropractic office matters just as much. The SNNOOP10 red flag list used in headache medicine covers sudden “worst headache of my life” onset, fever with neck stiffness, new headaches after 50, neurological changes, and headache after trauma. Any of those means a referral, not an adjustment.
How long before you know whether care is working?
Ask for a defined trial rather than an open-ended commitment. A sensible plan runs four to six weeks with a formal reassessment around the fourth to sixth visit, comparing headache frequency, intensity, and duration against a written baseline.
Practice guidelines for chiropractic headache management, including those from Bryans and colleagues in the Journal of Manipulative and Physiological Therapeutics, support spinal manipulation for cervicogenic headache and episodic migraine. If nothing has moved by the reassessment, the plan should.
What can I do between visits?
Track it before you try to fix it. A two week log with date, start time, duration, intensity from 1 to 10, and what you were doing beforehand beats memory every time.
Watch how often you reach for pain relievers. Under ICHD-3 criteria, simple analgesics on 15 or more days a month, or triptans, opioids, and combination products on 10 or more days a month, sustained past three months, can produce medication overuse headache. Rebound pain looks identical to the original problem.
Then check the mechanics. Screen height at eye level, a pillow that keeps the neck neutral instead of propped, and a break from static posture every 30 minutes each do more than they sound like they should.
Getting a real answer about your headaches
Headaches that start in the neck respond to care aimed at the neck, and they return when the source goes unexamined. If your pain begins at the base of your skull, favors one side, or flares after a long stretch at a desk, a cervical exam is a reasonable next step. Schedule an evaluation with Martens Chiropractic and bring your headache log.