Chiropractor in Clarksville TN Talks About Headaches
Most headaches aren't dangerous, even the ones that wreck your concentration, cancel your plans or send you to a dark room for the afternoon. A small number are. So before we get to triggers, posture and what a chiropractor's exam can tell you, here are the warning signs we'd want everyone who gets headaches to know.
Headache warning signs that need urgent care
Get emergency medical care right away for any of these. Don't wait to see a chiropractor first:
- 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.
These call for a prompt visit to a medical doctor:
- 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, and the timings on them are approximate. They also aren't a test you have to pass before getting help. If something about your headache worries you, that's reason enough to have it checked.
What commonly triggers headaches?
When people with migraine are surveyed, the triggers they report most often include stress, hormonal changes, missed meals, weather, disrupted sleep, certain smells, bright light, alcohol, and neck pain. Triggers vary a lot from one person to the next. That's why headache diaries are commonly used to pin down a person's own triggers, instead of working from a general list like this one.
One item on a lot of trigger lists needs a second look: blood pressure. Ordinary high blood pressure isn't a common cause of headache, and reading a headache as a sign of blood pressure trouble is more likely to mislead you than to help. A headache that's genuinely new and severe alongside very high blood pressure is a different matter: it belongs with the warning signs at the top of this page, not in a list of triggers.
Can posture and neck tension cause headaches?
The short answer is that the two have been reported together, but the evidence is weak and can't show which causes which. Holding your head and neck in one position for a long time keeps the neck extensor muscles, the ones along the back of your neck, working the whole time, and carrying your head forward of your trunk adds to that load for as long as you hold the position. Tenderness in the muscles around the skull is a recognized feature of tension-type headache, and weaker neck extensors have been reported alongside it. That evidence is weak and can't tell us which came first, so we describe sustained posture as an association with headache, not an established cause.
The practical measures that follow from it are low risk: changing position every half hour or so, moving the neck gently through its range after you've been still for a while, and noticing jaw clenching, which a lot of people do without realizing it.
Headaches after exercise: get them checked before you change your workout
A common piece of advice for headaches after a workout is to cut back and switch to a different exercise. We don't give that advice, because it points the wrong way.
A headache that comes on consistently with exertion, coughing or straining is on the prompt medical review list above. Exertional headache is usually benign. It's also one of the recognized ways a secondary cause can show up, so the right move is to get it checked by a doctor, not to quietly train around it. Scaling back the activity removes the trigger, and with it the signal. That's exactly what you don't want if something is being missed.
Once a doctor has checked an exertional headache and found no cause, it's reasonable to talk about adjusting your warm-up, hydration and intensity.
What a chiropractic exam can tell you about your headaches
A chiropractic exam for headaches looks at one specific question: is your neck contributing to the pattern? It checks how the upper neck joints move and if they're tender, looks at your posture and the loads you hold through the day, and tests whether the headache can be brought on or eased through the neck. Headache that's referred from the neck is called cervicogenic headache. Our page of headache tips explains it and how it's told apart from migraine, and our guide to the different types of headaches covers the others.
If your headaches don't fit a neck-related pattern, or anything from the lists above is present, we'll tell you so and refer you for a medical evaluation instead of starting a course of care.
What are the risks, and what else treats headaches?
Here's a realistic look at the risk. Hands-on treatment of the neck isn't risk-free. The effects reported most often are short-lived: neck soreness, a headache or tiredness after treatment. Serious events, including injury to the arteries in the neck, are reported rarely. It's genuinely unsettled whether manipulation causes those injuries, or coincides with an artery problem that was already underway and was the reason the person came in with neck pain in the first place. The largest population study of the question found an association between chiropractic visits and this kind of stroke in people under 45. It found a comparable association with visits to primary care doctors, and that's the main reason researchers take reverse causation seriously. The same authors say plainly that they haven't ruled out neck manipulation as a potential cause of some of these events.
And rarely reported isn't the same as rare. This country has no systematic reporting system for adverse events after manual therapy, so the published counts describe the cases that were written up, not everything that happened, and the true rate isn't known. If an exam points to an artery problem, manual treatment of the neck is off the table, and we'll refer you for medical care immediately.
The other options, and what each is good for. Which one fits depends on the headache:
- Medical assessment and prescribed treatment. For migraine and cluster headache, this is the route to the treatments with the strongest evidence, including drugs taken at the start of an attack and drugs taken daily to cut how often attacks happen. Neither is something a chiropractor provides, us included.
- Treating an identified secondary cause. If a headache turns out to be driven by medication overuse, a jaw problem, uncorrected vision, or anything on the urgent list above, treating that cause is the answer, and manual therapy is beside the point.
- Physical therapy and exercise programs. These overlap with what a chiropractic exam looks at and add supervised progression, which suits a persistent neck-related pattern.
- Doing less, on purpose. For occasional tension-type headache, sleep, hydration and a break from the position that set it off resolve a great many episodes without anyone treating anything.
If your headaches are frequent, severe or changing, start with a medical assessment. If it's the neck question you want answered, call Source Chiropractic's Clarksville office to set up an exam, and we'll tell you what we find, including when it's not something we treat.
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.