Most headache advice assumes the problem is in your head. Often it is. But a meaningful share of persistent headaches are referred from the neck, and those behave differently enough that the distinction is worth making before deciding what to do.
The headache that starts at the base of the skull
A cervicogenic headache originates in the cervical spine and refers forward. The pattern is usually recognisable: it begins at the base of the skull, often stays on one side, and travels up and behind the eye. It tends to be provoked by holding a position or moving the neck, rather than arriving unannounced.
People who have them frequently describe stiffness alongside the headache, and often notice both are worse on days spent at a desk.
How that differs from migraine
Migraine is a neurological condition. It commonly brings nausea, sensitivity to light and sound, and sometimes visual disturbance before the pain begins, and it does not usually track with neck position in the way a cervicogenic headache does.
That matters because the two need different answers. Migraine is managed with your physician, and nothing on this page changes that. What chiropractic care can look at is whether a neck component is present alongside it — which is a narrower and more answerable question than treating migraine itself.
The two can coexist. Having migraine does not rule out also having a neck-driven headache, and treating the second does not claim to treat the first.
How the difference gets identified
Largely through history. Where the pain starts, what brings it on, whether it changes with neck movement, whether there is nausea or light sensitivity, and whether it follows a pattern across the week. Those answers separate the two more reliably than the intensity of the pain does.
An examination then checks cervical movement, joint function and the muscles at the base of the skull, looking for whether the neck reproduces or contributes to the headache.
What care addresses
Where the neck is involved, care focuses there. Upper cervical care from Dr. Jenn is used for precision cases at the top of the cervical spine. Alongside that, care typically involves soft tissue work for the muscles at the base of the skull and attention to the sustained positions that keep provoking it.
Where a headache follows a head impact, the picture is different again — we covered that in post-concussion syndrome and chiropractic, including the point that a concussion is a brain injury and needs medical evaluation first.
When a headache needs urgent medical attention
Some headaches are not a chiropractic question at all. Seek urgent medical assessment for a sudden severe headache unlike any you have had before, a headache accompanied by fever and a stiff neck, one that follows a head injury, or one alongside confusion, vision loss or weakness.
Where to start
If your headaches have a pattern — same side, same starting point, worse on desk days — that pattern is information, and it is worth bringing to an examination rather than managing indefinitely. More detail lives on our headaches and migraines page.
Tired of managing around them? Schedule your visit online or call (203) 226-1047.
Common questions
What is a cervicogenic headache?
A headache whose source is the neck rather than the head. It typically starts at the base of the skull and refers forward, often on one side, and tends to be provoked by neck position or movement.
Can chiropractic care cure migraine?
No. Migraine is a neurological condition managed with your physician. What chiropractic care can address is a neck component where one is present, which is a different question from treating migraine itself.
Who provides upper cervical care for headaches?
Dr. Jenn, who works with upper cervical patients for precision cases.
When does a headache need urgent medical attention?
A sudden severe headache unlike any you have had before, a headache with fever and a stiff neck, or one following a head injury needs urgent medical assessment rather than a chiropractic appointment.