Headaches That Start in Your Neck: Why Pain Pills Never Fix Them
If you take pain relievers for headaches and the headaches keep coming back, you are not doing anything wrong. In many cases the pill is working exactly as designed. It dulls the pain signal. What it does not do is touch the thing producing the signal, and when that thing is your neck, the headache is back as soon as the medication wears off.
After more than 40 years of treating headaches, I can tell you that neck-related headaches are some of the most overlooked patients who walk into my office. They have usually been told it is sinuses or migraines. Some of them are right. A surprising number are not.
Can a Headache Really Start in the Neck?
Yes. It is called a cervicogenic headache. "Cervical" refers to the neck, and "genic" means it originates there. The pain is felt in your head, but the source is the joints, muscles, and nerves of the upper neck.
Here is why that happens. The nerves that carry sensation from the top three joints of your neck connect into the same pathway in your brainstem that carries pain from your face, forehead, and the area around your eyes. Your brain cannot always tell which one is sending the signal. So an irritated joint at the base of your skull can show up as pain behind your eye or across your temple.
How to Tell If Your Headaches Come From Your Neck
You cannot diagnose yourself, but these patterns are worth paying attention to:
The pain starts at the base of the skull or in the upper neck and moves forward
It is usually on one side, and it tends to be the same side every time
Pain behind one eye, or at the temple or forehead, without the nausea and light sensitivity that come with a migraine
Turning your head, looking up, or holding one position for a long time brings it on or makes it worse
Your neck feels stiff, or you cannot turn as far as you used to, especially to one side
Pressing on certain spots at the base of your skull reproduces the pain
Pain medication takes the edge off for a few hours, then it returns
If three or four of those sound like you, there is a good chance your neck is involved. For a side-by-side look at how neck headaches differ from tension-type headaches and migraines, read my guide on what kind of headache you actually have.
Why Pain Pills Do Not Fix It
Pain relievers work on the pain signal or the inflammation around it. They do not restore motion to a stiff joint, release a tight muscle, or take pressure off an irritated nerve. If a stiff upper neck is producing your headaches, it will still be stiff tomorrow.
There is also a second problem. Taking pain relievers frequently can cause headaches of its own. Doctors call it medication-overuse headache, and it creates a loop: the headache comes, you take something, it wears off, and the headache returns, sometimes stronger. If you are reaching for pain medication on most days of the week, tell your doctor. Do not stop any prescribed medication without talking to the physician who prescribed it.
What Causes Neck-Related Headaches
Old injuries. A car accident, a fall, or a sports injury from years ago can leave an upper neck problem that quietly produces headaches long after you stopped thinking about the original event. Whiplash is a common source. See my post on whiplash after a car accident and the one on headaches after a car accident.
Forward head posture. Every inch your head sits forward of your shoulders adds load to the joints and muscles at the base of your skull. Hours at a desk or on a phone add up. These tech neck exercises are a good place to start.
Joint restriction. The small joints in the upper neck can lose normal motion, and the muscles around them tighten to protect the area.
Disc and nerve problems. Lower in the neck, a disc problem or an irritated nerve can refer pain upward.
Jaw dysfunction. The jaw and the upper neck share muscles and nerves, so TMJ problems and neck headaches often show up together.
How I Find Out Where Your Headaches Are Coming From
Diagnosis comes first. I start with your history: where the pain is, how often it comes, how long it lasts, what triggers it, and what comes with it. Then I examine your neck, posture, and range of motion, test the joints and muscles, and perform a neurological screening. When the findings call for it, I take high-frequency digital x-rays on site.
The goal is to answer one question: does your pain change when I load, move, or press on the structures in your neck? If it does, your neck is a real part of the problem, and we can treat it. If it does not, I will tell you that, and I will tell you who you should see instead.
What Treatment Looks Like
Treatment is based on what the exam shows, not on a standard package. Depending on your findings, your care may include:
Hands-on chiropractic adjustments to restore motion to the upper neck joints
Low-force chiropractic with the Activator Method, for patients who prefer a gentler approach
Soft tissue work for the muscles that tighten around a stiff joint
Cervical traction when a disc or nerve component is involved
Cold laser therapy and therapeutic ultrasound to calm irritated tissue
Posture and work-setup changes, so the headaches do not keep coming back
Cervicogenic headache is the type where I see chiropractic make the biggest difference, because when the neck is the source, treating the neck is treating the cause. How quickly you improve depends on the cause, how long you have had the headaches, and how your body responds. I reassess as we go, and I do not sell prepaid packages or long-term plans.
My goal is to get you better as quickly as possible, then get you out of my office.
What You Can Do in the Meantime
Break up long stretches at a desk or on a phone every 30 minutes or so
Raise your screen to eye level so you are not looking down
Avoid cradling your phone between your ear and shoulder
Check your pillow: your neck should stay level with your spine, not tilted up or down
Note when your headaches come and what you were doing before them. Patterns show up quickly
When a Headache Needs Emergency Care
Most headaches are not dangerous, but some need a hospital, not a chiropractor. Go to the emergency room right away if you have:
A sudden, severe headache unlike any you have had before
A headache with fever, a stiff neck, or confusion
Vision changes, weakness, trouble speaking, or facial drooping
Sudden severe neck pain together with a headache, dizziness, or trouble with balance
A headache after a blow to the head
Find Out Where Your Headaches Are Coming From
If you have been treating the same headaches for months or years, the most useful step is finding out where they start. I will review your history, examine your neck, take x-rays if they are needed, and explain what I find in plain language. You will leave knowing whether your headaches have a neck component, whether I can help, and what a realistic plan looks like. The consultation and exam are free, with no obligation.
For the full picture of how we evaluate and treat headaches, see our headache chiropractor page. If your headaches come with neck pain, our neck pain page covers that side of it.
To schedule, call (864) 271-0001 or book online. Early morning hours are available, and we see patients from Greenville, Greer, Taylors, Simpsonville, and Travelers Rest. Our staff handles insurance filing.
Dr. Jeff W. Brown, D.C.
Brown Chiropractic Center, Greenville, SC
