Headaches, Arlington Texas
Headaches: Telling A Neck Headache From A Migraine
The short answer
Some headaches are produced by the top three joints of the neck and are felt at the back of the head, behind an eye, or across one temple. Those are called cervicogenic headaches and they are the ones this clinic is aimed at. Migraine is a different mechanism, and treating a neck does not treat a migraine. The examination exists to work out which one you have before anything is done about it, and plenty of people turn out to have some of both.
The Mechanism
A Joint At The Base Of The Skull, Felt Behind Your Eye
Pain in the front of the head arriving from the back of the neck is anatomy, not a theory.
The sensory nerves from the top three segments of the neck feed into the same relay in the brainstem as the nerve supplying the face and the front of the head. Signals arriving there from a stiff or irritated upper neck joint get read as coming from somewhere they did not come from. That is why a headache can sit behind an eye while the source is a joint two inches below the skull, and it is why pressing on the neck can reproduce the whole thing.
A neck headache usually has a pattern. It tends to stay on one side, it often starts at the base of the skull and travels forward, it is frequently worse after a long stretch at a desk or a bad night on the wrong pillow, and neck movement changes it. Migraine behaves differently: light and sound become intolerable, nausea is common, and an attack tends to run its own course whatever the neck is doing.
- Which side it sits on, and whether it ever swaps sides
- Where it starts, and where it travels to
- Whether neck movement or a sustained posture changes it
- Whether pressure over the upper neck joints reproduces your headache
- What comes with it, and how long an episode lasts
What The Research Says
Useful, And The Honest Size Of The Effect
Chiropractic and Manual Therapies, 2022 (Bini, Hohenschurz-Schmidt, Masullo, Pitt and Draper-Rodi): a systematic review and meta-analysis of twenty randomised trials covering 1,439 patients with cervicogenic headache. Pooling six sham-controlled manual therapy trials showed moderate to large short term effects on headache frequency and intensity. A stricter re-analysis limited to the trials at low risk of bias showed small effects favouring manual therapy on headache intensity, frequency and disability at both short and long term, with moderate quality evidence for spinal manipulation compared with sham.
What this means in plain terms: the effect is real and it is modest. The larger numbers come from the weaker trials, and the authors say so themselves. Treatment is worth trying for a headache that behaves like a neck headache. It is not a reason to keep going for months while nothing changes.
Exercise sits alongside the hands-on work in almost every one of those trials, usually deep neck flexor and shoulder blade work. That is the part that holds the change once it has been made, so it gets loaded and progressed in front of someone here rather than handed over on a sheet.
The Plan
A Timeframe, And What Would Change It
If four to six weeks of the right treatment has not moved a headache, the answer is a different question, not more of the same treatment.
Dr. Monet is certified in applied kinesiology, and manual muscle testing is used here as one part of an examination rather than as a test standing on its own. On a headache that matters, because the deep neck muscles and the muscles holding the shoulder blade are usually somewhere in the picture, and testing them under load says more than asking whether they feel sore.
Migraine is not treated here and will not be described as though it were. Where the examination finds a neck contribution alongside a genuine migraine pattern, the neck part is still worth treating and the migraine still belongs with your physician. You get told that at the first visit rather than after the sixth.
Read This First
Headaches That Need A Hospital, Not An Appointment
If You Notice Any of These Warning Signs, Please Seek Emergency Room Care Right Away.
- The worst headache of your life, or one that hit full intensity within a minute or two
- Headache with a fever and a stiff neck, or with a rash
- Headache with weakness, numbness, slurred speech, double vision or loss of vision
- Headache with clumsiness in the hands, or feeling unsteady on your feet
- A headache that is getting worse day by day, or is worse lying down or first thing in the morning
- A first new headache after the age of 50, or a new headache with a history of cancer
- A headache that began after a fall, a collision or any blow to the head
There is no imaging in this building. If your examination points at something that needs a scan, you get referred rather than treated anyway. Call 817-800-7136 and describe it, and you will be told plainly where to go.
Common Questions
Headaches, Asked And Answered
How do I know if my headache is coming from my neck?
The usual signs are that it stays on one side, starts at the base of the skull and travels forward, changes with neck position or a long stretch at a desk, and can be reproduced by pressure over the upper neck joints. The examination checks each of those rather than taking the diagnosis on trust.
Can chiropractic treat migraine?
Migraine is a different mechanism and it is not treated here. What happens often enough to be worth saying is that people have both. Where the examination finds a neck contribution, treating the neck is reasonable, and the migraine still belongs with your physician.
How many visits before I know whether it is working?
Four to six weeks of the right treatment is a fair test for most people. If the frequency or the intensity has not moved by then, the honest response is to reconsider the diagnosis rather than book more of the same.
Is neck treatment safe if I get headaches?
The trials in the 2022 review reported adverse effects that were mild and short lived, usually some soreness afterwards. The examination also exists to find the situations where treatment is not appropriate, and those get referred out instead.
Do I need a scan first?
Usually not. There is no imaging in this building, so if your examination points at something needing an X ray or an MRI you get referred for one. A scan is for answering a specific question, not for looking around.
Do you take insurance for this?
Insurance and paying directly both work. Call 817-800-7136 and ask before you book, and you will be told how it works in your case. Appointments only, so there is no option to turn up and be seen on the spot.
Sources
Where The Numbers On This Page Come From
- The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis. Bini P, Hohenschurz-Schmidt D, Masullo V, Pitt D, Draper-Rodi J. Chiropractic and Manual Therapies 2022;30:49. Twenty randomised trials, 1,439 patients. Source of the moderate to large short term pooled effects, the smaller effects in the low risk of bias sensitivity analysis, and the moderate quality rating for spinal manipulation against sham.
Get The Headache Examined Properly
Call and describe where it starts and what sets it off, or book online and pick a time.
3825 W Green Oaks Blvd, Suite 710, Arlington, TX 76016. Appointments only.