Joel L. Buckner, D.C., C.C.I.C., C.C.E.P.
387 Haywood Lane
Nashville, TN 37211


Many headaches, including ones frequently diagnosed as tension or cervicogenic headaches (headaches from the neck area) can have mechanical causes (joint and muscle dysfunction and/or degeneration). These can be due to injury or develop gradually.

Several possibilities exist in the neck to cause headaches.

  1. Muscular- neck muscles such as the trapezius, sterno-cleido-mastoid, sub-occipital, etc. can develop areas of tension or irritation, often called trigger points, that refer pain to the head. We use myofascial release techniques to treat these types of headaches. Most respond well with their headaches stopping or improving significantly. A small percentage that don't improve in a reasonable time (usually 2-4 weeks) are referred for medical treatment with medication or injections.
  2. Neck Joints-There are facet joints between the vertebra that also may refer pain to the head when injured, stiff, and/or irritated. These are treated with manual mobilization or manipulation methods. A very small percentage may need to be referred for joint injections or medication.
  3. Occipital nerves- There are 3 pairs of nerves that come out of the upper neck and over the head. If they are injured, irritated, or entrapped, headaches can occur and are often felt behind the eyes as well as in the head. Myofascial release methods are almost always successful in treating these types of headaches.

Careful examination is used to determine if these may be causing a person's headaches and to rule out other causes. If a person is experiencing a very severe or the worst headache in their life, head/neck pain with dizzyness, nausea, blurry vision, difficulty speaking, or arm or leg weakness, we recommend going to the ER first for evaluation.

Another fairly common cause of headaches is analgesic rebound headache from over medication. If you are using pain relieving medication frequently this may be cause or exacerbating headaches due to other problems.

Duke University endorses Chiropractic Care for Headaches

A large study was conducted in 2001 by Duke University's Evidence-Based Practice Center for Clinical Health Policy Research

A goal was set to identify and summarize from controlled trials, the efficacy of behavioral and physical treatments for tension-type and cervicogenic headaches.

Different studies from everything from traditional medical intervention, to acupuncture, chiropractic, massage, relaxation techniques and biofeedback were looked at.

Amongst many of the conclusions, the study summarized that: "If effective and available, non-drug treatments may be the first choice for most patients and may also be well suited for the significant minority of patients who: (a) have poor tolerance of pharmacological treatments; (b) have medical contraindications for pharmacological treatments; (c) experience insufficient relief from, or are unresponsive to, pharmacological treatment; (d) wish to become pregnant (or are nursing); (e) have a history of long-term, frequent, or excessive use of analgesic or abortive medications that can aggravate headache problems; or (f) simply prefer to avoid medication use".

Conclusions With Regard to Chiropractic:

  • Cervical manipulation was associated with significant improvements in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.
  • Adverse effects are uncommon with manipulation, and this may be one of it's appeals over drug treatment.
  • Manipulation is effective in patients with cervicogenic headaches...

McCrory DC, Penzien DB, Hasselblad V, Gray RN. Evidence Report: Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache. Duke University Evidence-based Practice Center for Clinical Health Policy Research. - 2001