Headache Tips From a Clarksville TN Chiropractic Office
Most people get headaches, and most of them aren't dangerous. A small number are. So this page starts with the signs that separate the two, because they matter more than anything else on it.
Which headache symptoms need emergency or urgent medical attention?
Get emergency medical care for any of these:
- 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.
See a medical doctor promptly for any of these:
- 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
These lists don't cover everything, the timings in them are approximate, and they aren't a test you have to pass before getting help. If something about your headache worries you, that's reason enough.
Primary and secondary headaches: what's the difference?
Doctors sort headaches into two groups. A primary headache is the problem itself. A secondary headache is a symptom of something else going on. Most of the headaches people get are the primary kind, and tension-type headache and migraine account for most of those. Knowing that doesn't help much if yours is one of the few that's dangerous.
Our guide to the different types of headaches goes through the categories in more detail.
What is a cervicogenic headache?
A cervicogenic headache is a headache that comes from the neck, and it's the kind a chiropractic exam is most concerned with. The pain starts in a structure in the neck, most often the upper cervical joints at the top of the spine, and you feel it in your head. There's a plain anatomical reason for that. Sensory nerve fibers from the upper cervical nerve roots meet fibers from the trigeminal nerve, which supplies the face and much of the head, and the nervous system can't reliably tell which one a signal came from. So a problem at the top of your neck can feel like a problem in your head.
It's typically on one side of the head and it stays on that side. It often starts in the neck or at the base of the skull and spreads forward, and it's commonly brought on by moving the neck or by holding the neck in one position for a long time. Reduced movement in the upper neck is one of the features used to define the condition, not a figure for how often it turns up.
Migraine typically isn't locked to one side, and it comes with nausea, or sensitivity to light and sound, or more than one of those. The classification that defines cervicogenic headache warns explicitly that its features aren't unique to it, and notes that nausea and light sensitivity turn up in cervicogenic headache as well. So those signs tip the odds one way or the other without settling the question. Telling the two apart is genuinely hard, and the same person can have both.
Can posture and muscle tension cause headaches?
When you hold your head and neck in one position for a long time, the muscles at the back of the neck (the cervical extensors) are working the whole time. With the head carried forward of the body, they work harder, for as long as the position lasts. Tender muscles around the skull are a recognized feature of tension-type headache, and researchers have reported weaker neck extensor muscles alongside it. That evidence is weak, and it can't say which came first. So we describe sustained posture as linked to these headaches. It hasn't been shown to cause them.
When people with migraine are surveyed about their triggers, the ones reported most often include stress, hormonal changes, missed meals, weather, disrupted sleep, certain smells, bright light, alcohol, and neck pain. Triggers vary a great deal from one person to the next, which is why headache diaries are so commonly used to pin them down.
What does a chiropractic exam for headaches look for?
A chiropractic exam for headache is aimed at one question: is this coming from the neck? It looks at how the neck moves, especially the upper segments at the top of the spine. It checks if moving the neck, or holding it in one position, brings the headache on. It looks at the muscles of the neck and shoulders, too, and for neurological signs that would point away from the muscles and joints as the source.
We'll take your history, examine you, and tell you what we find, including when it's 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.
Not every headache comes from the neck, and a chiropractic exam isn't the right tool for one that doesn't. If what we find points to something other than a muscle-and-joint problem, we'll tell you and refer you for the right medical evaluation.
If anything on the emergency list above applies, that's a call for an emergency room, not for us. Please don't wait for an appointment with us. If something on the second list applies, see a medical doctor first. Otherwise, if your headaches tend to start at the base of your skull, or show up after long hours at a desk or behind the wheel, call our Clarksville office and one of our doctors will check whether your neck is part of it before anyone talks about treatment.
Follow the evidence
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
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 can't tell usParticipants weren't blinded, and the combined approach wasn't significantly superior. The findings are about headache that starts in the neck (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 can't tell usIt was a small trial. Its secondary outcomes don't overturn the main result, and a trial this size is too small to show how often rare serious harms happen.
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
Our editorial policy explains how to read these sources and what our clinical-review labels mean.