Headache & Migraine Assessment and Treatment

What Type of Headache Do I Have?

Headache is a symptom rather than a single condition, and different types of headache can sometimes produce similar symptoms.

Common types include:

• Migraine
• Tension-type headache
• Cervicogenic (neck-related) headache
• Cluster headache
• Headaches associated with illness, medication or other medical conditions

Understanding the pattern of your symptoms is important because treatment that may help one type of headache may not be appropriate for another.

At Isis Chiropractic Centres, our assessment focuses on identifying whether musculoskeletal factors may be contributing to your headaches and recognising when medical investigation or treatment is more appropriate.

What Is a Cervicogenic Headache?

A cervicogenic headache is a headache caused by a disorder involving structures in the neck.

Pain may begin in the neck or around the base of the skull and spread towards the side or front of the head. Some people also experience neck stiffness, tenderness or reduced movement.

Symptoms may sometimes be aggravated by certain neck movements or by maintaining particular positions for prolonged periods.

Because cervicogenic headache, migraine and tension-type headache can share some features, it is important not to assume that a headache is coming from the neck simply because neck pain is also present.

Clinical assessment helps determine whether the neck is likely to be contributing to the headache and whether musculoskeletal treatment may be appropriate.

Find out more about neck pain and treatment →

What Is Migraine?

Migraine is a neurological condition that can cause recurrent attacks of headache together with other symptoms.

Symptoms vary between people and may include:

• Moderate or severe headache
• Throbbing or pulsating pain
• Pain that is more prominent on one side of the head, although both sides may be affected
• Nausea or vomiting
• Sensitivity to light or sound
• Symptoms made worse by normal physical activity
• Visual, sensory or other neurological symptoms known as aura in some people

Not everyone with migraine experiences all these symptoms, and some people experience migraine aura without a significant headache.

Neck pain and stiffness can also occur during a migraine attack. This does not necessarily mean that a problem in the neck is causing the migraine.

Migraine management may involve advice about lifestyle factors and headache patterns, as well as medication to treat or prevent attacks when appropriate. Medical assessment can help establish the diagnosis and suitable treatment options.

What Can Trigger a Migraine?

Migraine attacks may occur without an obvious trigger, and triggers vary considerably between individuals.

Some people notice an association with factors such as:

• Changes in sleep
• Stress or relaxation after stress
• Missed meals
• Dehydration
• Alcohol
• Hormonal changes
• Bright lights, strong smells or other sensory stimuli

A trigger is not necessarily the underlying cause of migraine, and trying to avoid every possible trigger can become unnecessarily restrictive.

Keeping a headache diary can help identify patterns, including headache frequency, duration, associated symptoms, medication use and possible triggers.

This information can be valuable when discussing recurring headaches with your GP or another healthcare professional.

What Is a Tension-Type Headache?

Tension-type headache commonly causes pressure or tightness around the head and may feel like a band around the forehead or skull.

The pain is often mild to moderate and is generally less likely than migraine to be associated with nausea or significant worsening during normal physical activity.

Neck and shoulder discomfort can occur alongside tension-type headaches, although this does not necessarily mean that the neck is the main cause.

Treatment depends on the frequency, severity and individual characteristics of the headaches. Advice about activity, sleep, stress management and appropriate medical treatment may be helpful.

What Is a Cluster Headache?

Cluster headache is a less common but particularly severe type of headache.

It typically causes intense pain around one eye or on one side of the head, often accompanied by symptoms such as a watering or red eye, nasal congestion, eyelid changes or marked restlessness.

Attacks may occur repeatedly over a period of weeks or months.

Cluster headache is not a routine musculoskeletal condition and requires appropriate medical diagnosis and treatment.

If your symptoms suggest cluster headache, we would recommend medical assessment rather than attempting to manage it as a neck-related headache.

How Do We Assess Recurring Headaches?

We Listen to the Pattern of Your Headaches

We will ask when your headaches started, how often they occur, how long they last, where you feel the pain and whether you experience symptoms such as nausea, visual disturbance, dizziness, neck pain, numbness or weakness.

We also ask about previous headaches, medical history, medication use and how symptoms affect your everyday life.

We Examine Your Neck and Movement

Where appropriate, we assess the movement and function of your neck and surrounding muscles and joints to determine whether musculoskeletal factors appear to be contributing to your symptoms.

We Check Your Nervous System When Appropriate

Depending on your symptoms, your examination may include neurological tests such as muscle strength, reflexes, sensation, coordination or other appropriate assessments.

We also consider warning signs that may suggest a neurological, vascular or other medical cause requiring further investigation.

We Explain What We Find

We will explain whether your symptoms appear consistent with a musculoskeletal or neck-related headache and whether chiropractic treatment may be appropriate.

If your history or examination suggests that your headache requires medical assessment, investigation or treatment by another healthcare professional, we will explain this and advise you on the next step.

Can Neck Problems Cause Headaches?

Yes. Problems involving structures in the upper part of the neck can sometimes contribute to headache symptoms.

This is particularly relevant to cervicogenic headache, where pain originating from the neck is perceived in the head.

However, having neck pain and headache at the same time does not automatically mean that one is causing the other.

Migraine, for example, can itself be accompanied by neck discomfort.

Assessment therefore helps determine whether the neck appears to be contributing rather than assuming that every headache associated with neck pain has the same cause.

Can Chiropractic Care Help With Headaches?

Chiropractic care may be appropriate for some people with headaches associated with neck pain or musculoskeletal problems, particularly where examination suggests that the neck is contributing to symptoms.

At Isis Chiropractic Centres, treatment is based on the individual assessment rather than the headache diagnosis alone.

Where appropriate, management may include:

• Advice about movement, activity and self-management
• Joint mobilisation or manipulation where suitable following assessment and informed discussion
• Soft-tissue techniques for associated neck and muscle discomfort
• Exercises to improve neck movement, strength and physical capacity
• Rehabilitation and strategies for managing recurring symptoms
• Referral for medical assessment or treatment where indicated

Manual treatment is only one possible part of management. Exercise, rehabilitation and self-management advice may also be important.

Evidence for manual therapy varies according to the headache type and treatment used. It should not be assumed that treatment effective for some neck-related headaches will also prevent or treat migraine.

Migraine is a neurological condition, not simply a neck problem. Chiropractic treatment is not a substitute for evidence-based medical management of migraine.

If your symptoms are more appropriately managed through medical care or another healthcare pathway, we will explain this and recommend the appropriate next step.

Find out more about chiropractic treatment at Isis.

Is Chiropractic Treatment Safe for Headache Patients?

As with any healthcare treatment, potential benefits, risks and alternatives need to be considered for each individual patient.

Before recommending treatment, we take a medical history and conduct an appropriate examination to assess whether chiropractic care is suitable and whether there are reasons why a particular technique should not be used.

New, unusual or changing headache symptoms require particular attention because some serious neurological or vascular conditions can initially present with head or neck pain.

Neck manipulation is not appropriate for every patient. Although serious complications are uncommon, potentially serious adverse events have been reported in association with cervical manipulation, including injuries involving cervical arteries. The precise risk and causal relationship are difficult to establish reliably.

Treatment does not always involve manipulation of the neck. Depending on your symptoms and preferences, care may include mobilisation, soft-tissue treatment, exercise, rehabilitation and advice.

We discuss relevant benefits, risks and alternatives before treatment so that you can make an informed decision about your care.

Do I Need an X-Ray or MRI for Headaches?

Most people with recurring headaches do not automatically require an X-ray or MRI.

The need for imaging depends on the headache pattern, medical history, examination findings and whether there are features suggesting a serious underlying condition.

An X-ray can provide information about bones and joints but does not diagnose migraine or most other primary headache disorders.

Routine neck X-rays are not recommended simply because someone experiences headaches.

Where symptoms suggest a neurological or other medical cause, we will advise on appropriate medical assessment and investigation. MRI or other imaging may be considered by the relevant medical service when clinically indicated.

Can Exercise Help With Neck-Related Headaches?

Exercise can form part of the management of some people with cervicogenic or neck-related headaches, particularly where neck movement, strength or physical capacity appears relevant.

Depending on the assessment, this may involve:

• Gentle neck mobility exercises
• Progressive strengthening of neck and shoulder muscles
• Exercises for the upper back and shoulder-blade muscles
• Gradual return to normal physical activity
• Advice about varying prolonged positions and managing activity

The most appropriate exercises depend on your symptoms and examination findings rather than on the headache label alone.

Advice about sleep, movement, activity and other lifestyle factors may also form part of a broader management programme.

Find out more about exercise, movement and rehabilitation.

When Should a Headache Be Assessed Urgently?

Most headaches are not caused by a serious medical condition. However, certain symptoms can indicate a medical emergency.

Call 999 for symptoms such as:

• A sudden, extremely severe headache that reaches maximum intensity within seconds or minutes
• Headache with sudden weakness, facial drooping, difficulty speaking or other symptoms suggesting a stroke
• Headache with sudden loss of consciousness, a seizure or marked confusion

Seek immediate emergency medical assessment for:

• A new severe headache following significant head or neck trauma
• Headache with fever, marked neck stiffness, a rash or feeling seriously unwell
• A new severe headache with significant visual disturbance or neurological symptoms

Other headaches that warrant prompt medical assessment include:

• A new or substantially changed headache during pregnancy or shortly after childbirth
• A new headache in someone over 50, particularly with scalp tenderness, jaw pain when chewing or visual symptoms
• A new or progressive headache in someone with a history of cancer, immunosuppression or other significant medical illness
• A persistent headache that is becoming more frequent, severe or different from the usual pattern
• Headaches associated with frequent use of pain-relieving medication

Some of these circumstances require same-day assessment, especially where visual symptoms or other warning signs are present.

Do not wait for a routine chiropractic appointment if you develop emergency warning signs.

Headaches, Neck Pain and Dizziness

Headache can sometimes occur alongside neck pain or dizziness, but these symptoms have many possible causes.

Migraine, for example, can be associated with dizziness, while some people with cervicogenic headaches also experience neck stiffness or discomfort.

Because these symptoms overlap, dizziness does not by itself establish that the neck is responsible.

Assessment helps determine whether your symptoms appear suitable for musculoskeletal care or whether further medical evaluation is appropriate.

Other Problems Associated With Headaches

You may also find these pages useful:

• Neck Pain
• Migraines
• Migraine Variants

Headache and Migraine Assessment Near You

Isis Chiropractic Centres provides assessment and treatment for appropriate musculoskeletal and neck-related headache problems at our clinics in Milton Keynes, Northampton and Aylesbury.

Our clinicians aim to identify whether neck-related factors may be contributing to your headaches and recognise when another type of treatment or medical referral is more suitable.

Headache Assessment in Milton Keynes

Our Milton Keynes clinic has been providing chiropractic care locally since 1994.

We assess neck-related musculoskeletal problems that may contribute to certain headaches, with appropriate physical examination, exercise and rehabilitation where indicated.

The clinic has on-site X-ray facilities for situations where imaging is clinically appropriate, rehabilitation facilities and free parking.

Headache assessment in Milton Keynes →

Headache Assessment in Northampton

Our Northampton clinic has been providing chiropractic care locally since 1989.

We assess musculoskeletal and neck-related problems associated with certain types of headache, offering appropriate treatment, advice and rehabilitation where indicated.

The clinic also has on-site X-ray facilities for clinically indicated investigations and free parking.

Headache assessment in Northampton →

Headache Assessment in Aylesbury

Isis Chiropractic Centres was established in Aylesbury in 1986.

Our Aylesbury clinic provides assessment and treatment for appropriate musculoskeletal and neck-related conditions that may contribute to headaches.

Management may include manual treatment, exercise and advice where appropriate, with referral for medical assessment when indicated.

The clinic offers on-site X-ray facilities for clinically indicated investigations and free patient parking.

Headache assessment in Aylesbury →

Frequently Asked Questions About Headaches

Can neck pain cause headaches?

Yes. Some headaches can be associated with structures in the neck. These are commonly referred to as cervicogenic headaches. However, headaches have many possible causes, so assessment is important.

Can a chiropractor help with headaches?

Chiropractic care may help some people with headaches associated with neck pain or musculoskeletal problems. Whether treatment is suitable depends on the type of headache, medical history and examination findings.

Is migraine caused by the neck?

Migraine is a neurological condition and is not simply caused by a problem in the neck. Neck discomfort can occur during migraine, while some people may also have a separate musculoskeletal problem contributing to their symptoms.

What is the difference between migraine and a cervicogenic headache?

Migraine is a neurological condition that can include headache, nausea and sensitivity to light or sound. A cervicogenic headache originates from a disorder involving the neck. Because symptoms can overlap, diagnosis should take account of the full history and examination.

Do I need a scan for recurring headaches?

Not usually. Most recurring headaches do not automatically require imaging. Further investigation may be recommended when symptoms, examination findings or medical history suggest that it is appropriate.

Does chiropractic treatment always involve manipulation of the neck?

No. Treatment depends on your symptoms, examination findings and preferences. It may include mobilisation, soft-tissue techniques, exercise, rehabilitation and advice, as well as manipulation where clinically appropriate following informed discussion.

Should I see my GP about headaches?

Medical assessment may be appropriate for new, unusual, severe or changing headaches, headaches associated with neurological symptoms, or where the diagnosis is uncertain.

We will also recommend medical assessment if anything in your consultation or examination gives us cause for concern.

Can frequent painkiller use make headaches worse?

Yes. Frequent use of certain medicines for headache relief can contribute to medication-overuse headache in some people.

If you regularly need medication for headaches, discuss this with your GP or pharmacist rather than repeatedly increasing the dose or frequency yourself.

Start by Understanding Your Headaches

You do not need to know whether your headaches are migraine, tension-type, cervicogenic or associated with your neck before contacting us.

That is what the assessment is for.

Our clinicians in Milton Keynes, Northampton and Aylesbury can assess relevant musculoskeletal factors, explain what they find and discuss appropriate treatment, rehabilitation or medical referral where needed.