Headache Tips From a Clarksville TN Chiropractic Office
Most people experience headaches, and most headaches are not dangerous. A small number are, and the features that separate the two are worth knowing before anything else on this page.
Read this part first: the features that need urgent assessment
Seek emergency medical care for:
- A headache of sudden, severe onset, reaching maximum intensity within about five minutes
- Headache with fever, or with a stiff neck, or with a rash. Any one of these is enough, and they often do not appear together
- Headache with new neurological symptoms: weakness, numbness, difficulty speaking, confusion, loss of coordination, or visual loss
- Headache after a head injury, particularly with drowsiness or repeated vomiting
- A painful red eye with blurred vision or halos seen around lights
- In anyone over fifty, a new headache with scalp tenderness, pain in the jaw when chewing, or any change in vision. Visual loss from this cause can be permanent, and it is treatable if caught early.
- Severe neck pain, or a new and unexplained headache, or both, especially alongside visual disturbance, unsteadiness or slurred speech. Either symptom alone can be the first sign. That combination can indicate a tear in an artery in the neck, and it needs immediate medical investigation rather than manual treatment. It does not always announce itself at once: in reported cases the neurological signs followed the first headache or neck pain by a median of several hours to several days, so a day or two of "just" severe neck pain and headache does not rule it out.
Arrange prompt medical review for:
- A headache that is new in a person over fifty
- A headache that has changed its usual pattern, or is progressively worsening
- A headache consistently worse on coughing, straining or exertion
- A headache that changes markedly with posture, clearly worse either standing up or lying down
- Headache with vomiting that has no other explanation
- Headache in someone who is pregnant or has recently given birth, is immunosuppressed, or has a history of cancer
- Headache on most days of the month in someone taking pain relief for it regularly, which can be caused by the pain relief itself
This list is not exhaustive, the timings on it are approximate, and it is not a test to pass before seeking help. If something about your headache worries you, that is reason enough.
Primary and secondary headache
Headaches are grouped into those that are the condition itself and those that are a symptom of something else. The large majority of headaches people experience are of the first kind: tension-type headache and migraine account for most of them. That is why the emergency features above are worth stating explicitly rather than relying on reassurance about how common benign headache is.
Our page on the different types of headaches covers the categories in more detail.
Cervicogenic headache
Cervicogenic headache is the presentation most relevant to a chiropractic examination. It is headache referred from a structure in the neck, most often the upper cervical joints, and the referral mechanism is anatomical: sensory fibres from the upper cervical nerve roots converge with fibres from the trigeminal nerve, which supplies the face and much of the head. The nervous system does not reliably distinguish the source, so a problem at the top of the neck can be felt in the head.
It is typically one-sided and stays on the same side, often begins in the neck or at the base of the skull and spreads forward, and is commonly provoked by neck movement or by sustained neck positions. Reduced movement in the upper neck is part of how the condition is defined rather than a frequency anyone has measured.
Migraine, by contrast, is typically not locked to one side, and comes with nausea, or with sensitivity to light and sound, or with more than one of those. The classification that defines cervicogenic headache warns explicitly that these features are not unique to it, and that nausea and light sensitivity occur in cervicogenic headache as well. So they shift the odds rather than settling the question. The distinction is genuinely difficult, and the two can occur in the same person.
Sustained position and muscle tension
Holding the head and neck in one position for extended periods loads the cervical extensors continuously, and a head carried forward of the trunk increases that load for as long as the position is held. Tenderness in the muscles around the skull is a recognised feature of tension-type headache, and reduced neck extensor strength has been reported alongside it. That evidence is weak and it cannot say which came first, so sustained posture is worth describing as an association rather than as an established cause.
In surveys of people with migraine, the most commonly reported triggers include stress, hormonal changes, missed meals, weather, disrupted sleep, certain smells, bright light, alcohol, and neck pain. Trigger patterns vary a great deal between individuals, which is why headache diaries are commonly used to identify them.
What an examination looks for
A chiropractic examination for headache is directed at that question. It looks at cervical range of motion, particularly in the upper segments, at whether neck movement or sustained positioning reproduces the headache, at the muscles of the neck and shoulder girdle, and at neurological signs that would point away from a musculoskeletal source.
We will take your history, examine you, and tell you what we find, including when what we find is not something we treat. If we are not able to help you with your problem or are unable to reduce your pain levels, we will make sure to give you a recommendation to another experienced provider.
Headache that is not coming from the neck is not something a chiropractic examination is the right tool for, and saying so is part of the examination rather than a failure of it.
If you are dealing with headaches in Clarksville TN, call our team at Source Chiropractic. If anything in the urgent list above applies, that is a call to an emergency department and not to us.
Follow the evidence
Research, with context.
Published sources behind the discussion. Read the findings alongside the limits; a study is not a diagnosis or a promise of a result.
A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache
200 people with cervicogenic headache, assigned to manipulation, specific exercise, both, or a control group.
What it foundManipulative therapy and exercise each reduced headache frequency and intensity, with benefits reported at 12 months.
What it cannot tell usParticipants were not blinded, and the combined approach was not significantly superior. These findings concern cervicogenic headache, not migraine in general.
Publication details & citation
Jull et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002. DOI: 10.1097/00007632-200209010-00004.
Read the publication recordChiropractic spinal manipulative therapy for migraine: a three-armed, single-blinded, placebo, randomized controlled trial
104 people with migraine, assigned spinal manipulation, sham treatment or usual pharmacological management.
What it foundMigraine days decreased in all groups, with no significant between-group difference in the primary outcome. The authors considered the observed manipulation effect probably a placebo response.
What it cannot tell usThe trial was small. Secondary outcomes do not overturn the primary result, and a treatment trial of this size cannot establish the frequency of rare serious harms.
Publication details & citation
Chaibi et al. Chiropractic spinal manipulative therapy for migraine: a three-armed, single-blinded, placebo, randomized controlled trial. European Journal of Neurology. 2017. DOI: 10.1111/ene.13166.
Read the publication record
Read our editorial policy for how sources and clinical review are identified.