Yes. Spinal manipulation reduces mechanical neck pain and helps specific headache types, especially cervicogenic headaches, which start in the neck. Randomized trials also show fewer migraine days for some patients. It is not the right treatment for every headache, so a careful exam comes first at our Lansing, Holt, and Jackson offices.
Patients rarely come in asking which category their headache fits. They come in the way mrkeesie14 (Lansing) described: “I’d wake up some days and my neck would be stiff and I’d have neck pain and headaches from the stiffness… For years I tried treating it with heating pads and massagers and even a TENS unit.” A first adjustment finally changed that, though the review also describes a hesitancy that came from watching a parent’s experience with a different chiropractor.
The pattern repeats across the 486 patient reviews published on this site: 19 describe neck pain, 13 describe headaches, and the two complaints often arrive together. Stiff neck in the morning, headache by the afternoon, and a drawer full of things that did not work.
This article explains why neck pain and headaches travel together, what the research shows about spinal manipulation for each headache type, and when a headache needs chiropractic and when it may need medical care.
Why Your Neck Hurts in the First Place
Most neck pain is mechanical. That means it comes from the joints, muscles, and discs of the neck rather than from disease, and it is extremely common: neck pain is the fourth leading cause of disability worldwide, and close to half of adults deal with it in a given year.[1]
The usual suspects are not mysterious. A head held forward over a laptop loads the joints at the base of the skull hour after hour. A phone read in bed does the same thing. Add a pillow that puts your neck at the wrong angle for eight hours, an old whiplash injury, or the stress that parks itself in the shoulders, and the joints stop moving the way they should. Desk work and working from home come up again and again in the neck pain reviews at our three offices.
A restricted joint rarely announces itself by name. It shows up as stiffness when you check your blind spot, a sore spot at the top of the shoulder blade, or a neck that takes until lunch to loosen up. Left alone, it also shows up somewhere patients do not expect: the head.
When the Headache Starts in Your Neck
Not all headaches are the same problem, and the difference decides the treatment. The headache types that matter here:
- Cervicogenic headache: head pain that starts in the joints and muscles of the upper neck. The upper neck shares nerve wiring with the head, so an irritated joint at the top of the spine refers pain upward. These headaches usually sit on one side, begin at the base of the skull, and flare with neck movement or long hours in one position.[2]
- Tension-type headache: the most common headache there is. It feels like a band of pressure on both sides, and tight neck and scalp muscles are part of the picture for many people.
- Migraine: a neurological condition, not a neck problem. Throbbing pain, nausea, and sensitivity to light set it apart. The neck can still be involved, since many migraine sufferers carry neck pain too, but the migraine itself starts in the brain. Even so, spinal manipulation may help relieve migraine symptoms for some patients, which the evidence below explains.
- Cluster headache: far less common, but worth naming. These bring severe, one-sided pain around the eye that arrives in bouts over days or weeks. Cluster headache is a neurological condition managed medically, not a neck problem, so it is not what spinal manipulation targets.
Chiropractic clinical guidelines sort the evidence along exactly these lines: spinal manipulation is recommended for cervicogenic headache and migraine management, with joint mobilization and exercise among the options for tension-type headache.[3] Part of the first exam at our offices is figuring out which type, or which combination, you actually have.
For tension-type headache in particular, the work is often soft-tissue manipulation rather than a joint adjustment: hands-on release of the tight neck and scalp muscles that refer pain into the head. Easing those muscles can take the edge off the band-like pressure that defines these headaches, which is why our plans frequently pair adjustments with in-house massage therapy.
What the Evidence Shows for Spinal Manipulation
For neck pain itself, a 2015 Cochrane review found that multiple sessions of cervical manipulation produce better pain relief and improved function compared with some medications, at both short and intermediate follow-up, with results similar to mobilization.[4] Cochrane reviews are the strictest summaries in medicine, and this one covered 51 trials.
For cervicogenic headache, the evidence includes a dose-response trial: 256 adults randomized to different numbers of spinal manipulation visits over six weeks. More visits produced more relief, and patients receiving manipulation had meaningfully fewer headache days than those receiving light massage at every dose tested.[5] That trial is why we talk about a course of care rather than a single fix.
For migraine, a 2019 meta-analysis in the journal Headache pooled six randomized trials and found spinal manipulation reduced both migraine days and pain intensity.[6] The honest limits: the effect is a reduction in frequency and intensity, not a cure. We tell migraine patients to expect improvement over weeks and to keep their neurologist if they have one.
“Struggled with migraines my whole life and chiropractic adjustments and massages have been the only thing that has helped me!” - Lauren C. (Jackson)
One review is one person’s account, which is exactly why we pair it with the trials above. Her experience matches what the research predicts for the patients who respond: fewer bad days, not zero.
When Chiropractic Is Not the Right Call
Some headaches need a medical doctor or an emergency room before anyone touches your neck. Get medical care first if any of these apply:
- A thunderclap headache - the worst headache of your life, arriving in seconds. Go to the ER.
- A headache with fever and a stiff neck.
- A headache that follows a blow to the head.
- Any headache with confusion, vision loss, trouble speaking, or weakness in an arm or leg.
- Neck pain with fever, unexplained weight loss, or numbness and weakness running into the hands.
We screen for all of this at the first exam, and we refer out when the exam points past us.
Patients also ask about the safety of neck adjustments, usually because of something they read about strokes. The largest study on the question, covering more than 100 million person-years in Ontario, found no increased stroke risk after chiropractic care compared with visits to a family doctor. The association that does exist appears because people in the early stage of a stroke seek care for neck pain and headache from both professions alike.[7] The most common side effect is the boring one: mild soreness that typically fades within 24 hours.
What Treatment Looks Like at Our Three Offices
Care starts with an exam, not a table. The doctor takes your history, checks how each joint in your neck moves, tests strength and reflexes, and sorts your headache into the types above. You can read a step-by-step walkthrough on our what to expect page. X-rays happen when the exam gives a clinical reason.
Treatment is an adjustment to the restricted joints, and the technique scales to the patient: gentle, low-force methods are available, which matters if the idea of a neck adjustment makes you tense up. Massage therapy is in-house at our offices for the muscle side of the problem, the same pairing we describe on our headaches and migraines page.
Because Dr. David Severance and Dr. Moriah Severance are naturopathic doctors as well as chiropractors, the plan reaches past the table. An adjustment frees the joint, but if your monitor sits six inches too low, the joint locks up again by Friday. Expect homework:
- A screen raised to eye level.
- A pillow check.
- Movement breaks with a timer.
- One or two specific exercises.
Timeline honesty matters here. Relief is sometimes immediate, and mrkeesie14’s review tracks the more common arc: “In the past 2 months I haven’t had a single day where I needed to take motrin for my neck or lay in bed with a heating pad and massager.” Two months, not one visit. You can read more accounts on our neck pain testimonials page.
If you are mid-flare right now, call the nearest office and say so.
“A wk of migraines of pain and crying and you guys got me in the same day.” - Jonda W. (Holt)
Same-day visits are often available at all three locations. Call, text, or send a message through our contact form, and we will call you back.
Frequently Asked Questions
Can a chiropractor help with tension headaches?
Often, yes. Tension-type headaches usually involve tight muscles and restricted joints in the neck, and chiropractic clinical guidelines support spinal manipulation and joint mobilization for them. Expect improvement over a series of visits, plus home advice on posture and stress, since those usually drive the tension.
What is a cervicogenic headache?
A cervicogenic headache is head pain that starts in the joints and muscles of the upper neck. It is usually felt on one side, begins at the base of the skull, and gets worse with neck movement or long hours in one position. This is the headache type that responds best to chiropractic care.
How many visits before I feel a difference?
Many patients notice a change within the first few visits, and the research supports a course of care over several weeks. In a 2018 randomized trial, headache relief increased with the number of spinal manipulation visits across six weeks of care. The doctor gives you a specific timeline at your first visit and updates it based on how you respond.
Is it safe to have your neck adjusted?
Serious complications are rare. A 2008 study in Spine covering more than 100 million person-years found no increased stroke risk from chiropractic care compared with visits to a family doctor. The most common side effect is mild soreness that typically fades within 24 hours, and we use gentler techniques for patients who need them.
Should I see a chiropractor or a medical doctor first for headaches?
It depends on the headache. A sudden severe headache, a headache with fever and a stiff neck, or one that follows a head injury needs a medical doctor or the emergency room first. For recurring headaches tied to neck pain, posture, or muscle tension, a chiropractic exam is a reasonable first step, and we refer out if the exam points to something else.
References
- Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clinic Proceedings. 2015;90(2):284-299. PubMed ↩
- Blanpied PR, Gross AR, Elliott JM, et al. Neck pain: revision 2017. Clinical practice guidelines linked to the International Classification of Functioning, Disability and Health. Journal of Orthopaedic & Sports Physical Therapy. 2017;47(7):A1-A83. PubMed ↩
- Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of Manipulative and Physiological Therapeutics. 2011;34(5):274-289. PubMed ↩
- Gross A, Langevin P, Burnie SJ, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database of Systematic Reviews. 2015;(9):CD004249. PubMed ↩
- Haas M, Bronfort G, Evans R, et al. Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. The Spine Journal. 2018;18(10):1741-1754. PubMed ↩
- Rist PM, Hernandez A, Bernstein C, et al. The impact of spinal manipulation on migraine pain and disability: a systematic review and meta-analysis. Headache. 2019;59(4):532-542. PubMed ↩
- Cassidy JD, Boyle E, Côté P, et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine. 2008;33(4 Suppl):S176-S183. PubMed ↩
