Some back and neck pain needs a doctor today, not a chiropractor. Some back and neck pain is not a case for a chiropractor and needs a doctor the same day. Go to an emergency room, not to us, if you have numbness in the groin or inner thighs, if you have lost control of your bladder or bowels, if a leg is becoming weak rather than just painful, if the pain followed a serious fall or a car crash, if you have a fever with back pain, if you have unexplained weight loss alongside it, if you have a history of cancer, or if a headache came on suddenly and is the worst you have ever had. We would rather you rang your doctor and never rang us at all.
A headache that starts at the base of the skull, spreads up one side of the head and settles behind an eye, that is nearly always on the same side, that gets worse after a long day at a screen and that is accompanied by a stiff neck, is a fairly recognisable pattern. Headaches with that shape are frequently generated by the upper neck — the joints and muscles at the top of it share nerve pathways with the structures that produce head pain — and they tend to respond well to treating the neck.
Tension-type headache, the ordinary band-around-the-head variety, also often has a substantial neck and muscular component, and hands-on treatment plus the boring work on desk setup, breaks and deep neck strength tends to reduce how often it turns up. These two groups are what we can genuinely help with, and between them they account for a lot of the headaches that walk in here.
Migraine is a different thing. It is a neurological condition with its own mechanisms, its own triggers and its own effective medical treatments, and we do not claim to treat it. What we sometimes can do is help with a stiff, painful neck that is coexisting with your migraines, and some people find their attacks become less frequent when the neck is less irritable. That is a reasonable thing to try alongside your doctor's care. It is not a substitute for it, and we will not present it as one.
Which headaches we can help with
Four patterns. The first two are our territory; the third belongs with your doctor; the fourth belongs in an emergency room.
Headache coming from the neck
Typically one-sided and always the same side, starting at the base of the skull and spreading forwards, with a stiff neck and reduced neck rotation, provoked by sustained postures and sometimes by pressing on particular spots in the upper neck. This pattern responds well to hands-on neck treatment combined with the exercise and workstation work, and it is the one we are most useful for.
Tension-type headache
A band of pressure around the head, both sides, dull rather than throbbing, worse late in the day and worse in stressful weeks. Often accompanied by tight, tender muscle across the shoulders and up into the base of the skull. Hands-on work helps in the short term; the durable gains come from breaks, sleep, deep neck strength and how the working day is arranged.
Migraine
Often one-sided and throbbing, frequently with nausea, light or sound sensitivity, sometimes with visual aura beforehand, and typically disabling in a way that tension headache is not. This is a neurological condition that belongs with your doctor, and there are good medical treatments for it. We do not treat migraine and we will say so plainly.
The ones that need an emergency room
A headache that came on suddenly and is the worst you have ever had, a headache with fever and a stiff neck, with a rash, after a head injury, with confusion, weakness, difficulty speaking or visual loss, or a new headache pattern in someone over fifty. None of these is a case for a chiropractor. Go to an emergency room.
What treatment involves
For the two patterns we can genuinely help with.
Assess the upper neck properly
The joints in the top three segments of the neck are the ones most implicated in headaches generated there, and examining how each of them moves — and whether pressing on particular structures reproduces your familiar headache — is a large part of deciding whether this is a neck problem at all. If it does not reproduce, we say so rather than treating hopefully.
Treat the joints and the muscle
Mobilisation or adjustment of the stiff segments, and soft-tissue work through the muscles at the base of the skull and across the top of the shoulders. For a lot of headache patients the muscle work is where most of the relief comes from. All of this can be done without high-velocity manipulation if that is what you prefer.
Deep neck strength
The small muscles at the front of the neck that hold the head up quietly all day are usually weak and poor at endurance in people with long-running headaches. Training them takes about four minutes a day, is exceptionally dull, and has better evidence behind it than most headache gadgets sold online. It goes on almost every programme.
The rest of the day
Screen height, break frequency, how much water and how much sleep, how the neck spends the commute, and how many hours a week the head is held forward and down. Treating a neck weekly while it spends fifty hours in the position that provoked it is not a plan. A workstation assessment is on the fees page.
What we will not claim
Headache is a field with a great deal of overselling in it. Here is where we stop.
That we treat migraine
We do not. Migraine is neurological, it has effective medical treatments, and it belongs with your doctor. If you have a stiff neck alongside your migraines we may be able to help with that, and some people find attacks become less frequent when the neck is calmer. That is a reasonable thing to try alongside medical care and it is not a replacement for it.
That adjustment cures headaches
Nothing cures a tendency to headache. Treatment aimed at the neck can reduce how often headaches of the right kind occur and how bad they are, and combined with strength work and better working habits that is often a substantial improvement. It is not a cure, we will not describe it as one, and if nothing has changed in four visits we will say so.
That we can stop your medication
We do not give advice about your medication, we do not tell anybody to reduce or stop anything they have been prescribed, and we are not qualified to. That conversation is between you and the doctor who prescribed it. If your headaches improve, tell them, and let them make that call.
That imaging is needed
Most headaches do not need a scan, and scanning them routinely mostly finds incidental things that cause worry without changing anything. Imaging matters when the pattern or the examination suggests something specific — and in that situation the right move is a same-week referral to your doctor, which is what we do.
Headache Care in western Queens
Headaches that come from the neck respond well to neck treatment. Migraine is a neurological condition and belongs with your doctor. Telling the two apart is most of the first appointment.
Every course of care here starts the same way: a full hour, a proper history, an examination, and then a plain statement of what we think is going on and how confident we are about it. You are told what we propose, roughly how many visits it ought to take and what should have changed by when — and we agree a date to stop and look at whether it worked. If the honest answer at any point is that this needs somebody else, you get that instead, and we write to them the same week.
Chiropractic care is not a substitute for medical diagnosis. Chiropractic care is not a substitute for medical diagnosis, and nothing on this website is medical advice for your particular problem. We are not physicians: we do not prescribe medication, we do not perform surgery, and we do not treat disease. What we do is examine how your spine and joints move, work on them by hand, and give you something to do between visits. If your problem turns out to be outside that, we say so and refer you — which happens often enough that you should expect it as a normal outcome rather than a failure.
What chiropractic does not treat. We treat musculoskeletal problems: the spine, the joints, the muscles and the nerves that are irritated by them. We do not claim that adjusting a spine treats asthma, allergies, ear infections, colic, digestive disease, high blood pressure, infertility, immune function or any other internal illness. Chiropractors who make those claims are making them without good evidence, and you should be wary of anybody who does. If somebody has told you that spinal care will fix a condition on that list, we will tell you honestly that it will not.
Questions
Headache Care — the questions we are asked most
Can chiropractic cure my migraines?
No. Migraine is a neurological condition, it belongs with your doctor, and there are good medical treatments for it that we are not a substitute for. What we can sometimes do is treat a stiff, irritable neck alongside your migraines, and some people find that their attacks become less frequent when the neck is calmer. We will not present that as treating your migraine, and we will not ask you to change any medication.
How do I know if my headache is coming from my neck?
The typical pattern is one-sided and always the same side, starting at the base of the skull and spreading forward, with a stiff neck, reduced rotation, and provocation by sustained postures. The most useful test is whether pressing on particular structures in the upper neck reproduces your familiar headache — if it does, that is a strong pointer. That examination is what the first appointment is for.
How many visits before I know if this is working?
Four to six, and we agree that as a review date at the first appointment rather than leaving it open. For neck-related headache the useful measure is frequency and duration over a fortnight rather than how your head feels on the day you happen to be in the clinic, so we usually ask people to keep a simple diary. If nothing has moved by the review, we change the plan or refer you.
Should I be worried about a headache that wakes me at night?
It is worth mentioning to your doctor, yes. A headache that consistently wakes you, one that is worse when you lie down or cough, a new headache pattern in someone over fifty, or one that is steadily getting worse week by week are all patterns that deserve medical assessment rather than a course of neck treatment. We would refer you rather than treat you, and we would do it that week.
Can you treat my headaches without touching my neck forcefully?
Yes. Mobilisation, soft-tissue work at the base of the skull, instrument-assisted technique and exercise all treat neck-related headache perfectly well without any high-velocity manipulation. Say so at the start of the appointment and it goes in your notes. A good proportion of our headache patients are treated this way by preference, and it is not a lesser option.
Do my headaches mean something is wrong with my spine?
Almost certainly not in the way that phrase suggests. Neck-related headache comes from joints and muscles that are stiff, overworked and irritable — not from anything being out of place, degenerating dangerously or pressing on your brain. Imaging of the neck in headache patients mostly finds ordinary age-related change that is equally common in people who never get headaches at all.
Related
Often seen alongside this
Spine & Nerve Pain
Chiropractic Adjustment
The technique the whole trade is named after: a short, shallow, quick movement through a stiff joint. It takes a fraction of a second, it is usually a relief rather than a pain, and it is not the only thing we do.
Read more
Spine & Nerve Pain
Lower Back Pain
The single most common reason anybody rings this clinic. Most of it is a joint and the muscle around it, most of it improves inside a few weeks, and most of it does not need a scan.
Read more
Spine & Nerve Pain
Neck Pain
A neck that will not turn, a shoulder that aches with it, and a headache creeping up the back of the skull. Treatable — and treatable without high-velocity manipulation if that is what you would prefer.
Read moreA fee agreed before the visit, not after it
Book an appointment
Pick a chiropractor and an hour from the calendar — it shows only the times each of them genuinely has free. A first visit is a full hour and costs $95 for the examination on its own, or $145 if we treat you at the same appointment. You decide which after the examination, not before.