Does this sound like you?
Common signs
- Pressing or tightening pain on both sides of the head rather than one
- A band-like tightness around the forehead, temples or the back of the head
- Mild to moderate pain that is dull rather than throbbing
- Pain that does not get worse when you walk up stairs or move about
- No nausea or vomiting with it
- Tenderness in the muscles at the base of the skull, the neck and the shoulders
- Headaches that build through the working day and ease at the weekend
- Difficulty concentrating, and a sense of pressure rather than sharp pain
This list describes the condition in general. It is not a diagnosis. Only an in-person assessment can tell you what is causing your symptoms.
What contributes to it
Why it happens
- Sustained loading of the neck and shoulder muscles
- Muscles held at a low level of contraction for hours become tender and refer pain into the head. A screen set too low, a laptop used without a stand, long stretches on a phone and driving in traffic all ask the muscles at the base of the skull to work continuously without ever fully letting go.
- Restricted movement in the upper neck
- When a segment of the upper neck stops moving well, the muscles around it work harder to compensate and stay loaded. This is a frequent finding in people whose headaches begin at the back of the skull, though it is not the whole story on its own.
- Stress, sleep and jaw clenching
- Poor sleep, an unsupportive pillow and low-grade clenching keep the muscles around the skull and jaw under tension overnight, so the area never gets a genuine rest period. These rarely explain a headache entirely, but they very often sit alongside whatever else is going on.
- Painkillers taken too often
- This one surprises people. Taking headache medication on more days than not can, over months, make headaches more frequent rather than less. It is a recognised pattern with its own name, medication-overuse headache. We are not the right people to adjust your medication, but if the pattern fits, it is worth raising with your doctor or pharmacist rather than leaving unexamined.
How we help
Our approach
Working out which headache this actually is
Your first visit is largely history taking: where the pain sits, what it feels like, what brings it on, what it arrives with, and what you have already tried. Tension headache, migraine and headache coming from the neck can overlap, and plenty of people have more than one at a time. Arriving at a headache diagnosis is a job for your doctor. What we are establishing is whether there is a mechanical contribution worth addressing.
Examining the neck and upper back
That is followed by the rest of the Gonstead six-step assessment: visualisation, nervoscope instrumentation, palpation with a full-motion assessment of the neck and upper back, and X-ray analysis where indicated. Your chiropractor is looking for restricted segments and for the tender, overworked muscle that so often accompanies them.
What care involves where the neck is contributing
Where the assessment points to restricted segments, the adjustment is specific to them and delivered by hand, and your chiropractor will explain what they found first. Where the surrounding muscle is a significant part of it, our physiotherapy side may add manual therapy or dry needling for the tender points at the base of the skull and across the shoulders, alongside a programme to build endurance in the deep neck muscles. We are aiming at better movement and less sustained load on that tissue. What that changes about the headaches themselves varies from person to person.
The part that happens outside the clinic
Desk and screen height, how often you get up, your pillow, and how much caffeine and water go through a working day all feed into this. You will usually be asked to keep a simple record of when the headaches happen and what came before them, because headache patterns are very hard to judge from memory and it is often the most useful thing a patient brings to a second visit.
When to seek urgent care
See a doctor first if you have any of these
These need a medical assessment before you begin chiropractic care. If any apply to you, contact a doctor or go to the nearest emergency department.
- A sudden, severe headache that reaches full intensity within seconds or minutes
- The worst headache of your life, or one clearly unlike any you have had before
- Headache with fever, neck stiffness, or a rash
- Headache with weakness, numbness, confusion, difficulty speaking, or loss of vision
- Any headache following a blow to the head, a fall, or a road accident
- A new headache beginning after the age of 50, or one steadily worsening over days and weeks
- Headache that is worse on lying down, coughing or straining, or that wakes you from sleep
- Headache alongside a history of cancer, a compromised immune system, or unexplained weight loss
Frequently asked questions
What patients ask us
How is a tension headache different from a migraine?
A tension headache is usually felt on both sides as a steady pressing tightness, is mild to moderate, and does not get worse when you move about. A migraine is more often one sided and throbbing, tends to be worse with activity, and commonly brings nausea or sensitivity to light and sound. That is the textbook split, and real life is messier, since some people get both. Migraine is a neurological condition and its medical management belongs with a doctor.
Can a tight neck really cause a headache?
Muscles and joints in the neck and upper back can refer pain into the head, and that is well recognised. Whether it is what is driving your headaches specifically is a question for the examination rather than something to assume. Some features point that way, such as pain starting at the base of the skull, tenderness in those muscles, and headaches that track your working day, but none of them is conclusive on its own.
Will chiropractic stop my headaches?
We cannot tell you that, and you should be wary of anyone who does. Where restricted neck segments and overloaded muscle are contributing, restoring movement and reducing that load often changes how much head pain people get. It depends on the presentation, and some people notice little difference. Your chiropractor will tell you honestly what they expect and what they do not.
I take painkillers most days. Is that a problem?
It is worth looking at. Headache medication taken on more days than not can, over months, feed a cycle where headaches become more frequent. It has a recognised name, medication-overuse headache. Changing or stopping medication is not our decision to make and should not be done abruptly on our say-so. Bring a list of what you take and how often to your first visit, and raise the pattern with the doctor or pharmacist who supplies it.
What should I bring to a first visit?
A list of any medication you take, including anything over the counter, and if you can manage it, a rough record of the last few weeks: when the headaches came, how long they lasted, and what you were doing beforehand. If you have had imaging or seen a doctor about the headaches, bring the report.