Why Do I Keep Getting Headaches?
Recurring headaches rarely have a single cause — neck and jaw function, muscle tension, sleep, stress and hydration often combine. Here is how they are assessed.
Overview
Recurring headaches usually do not have one single cause. More often they are the result of several factors combining: the joints and muscles of the neck, jaw function, posture and screen time, sleep quality, stress, hydration and missed meals. Migraine adds neurological and genetic factors that are not caused by the neck or jaw, although neck and jaw symptoms frequently accompany it.
It helps to know which pattern you have, because the approach differs. Tension-type headache typically feels like a band of pressure or tightness on both sides. Cervicogenic headache starts in the neck, is often one-sided, and is typically reproduced or worsened by neck movement, sustained posture or pressure at the base of the skull. Migraine is usually throbbing, often one-sided, and comes with sensitivity to light or sound, nausea, or a need to lie down; some people have visual or sensory changes before it starts. Mixed patterns are common, and only an assessment can sort out how much of your headache is musculoskeletal.
What a chiropractor can offer is assessment and conservative management of the musculoskeletal contributors — the neck, upper back and jaw — along with education about sleep, hydration, screen breaks and activity. Chiropractic care does not address the neurological mechanisms of migraine, and it is not a substitute for medical assessment of a headache disorder. Where medical management is appropriate, care is co-managed with your physician.
Some headaches need urgent medical attention rather than an appointment with a chiropractor: a sudden severe headache that peaks within seconds to minutes, headache with fever and neck stiffness, headache after a head injury, headache with weakness, numbness, confusion, or speech or vision changes, or a new headache pattern starting after age 50. Also speak with your physician or pharmacist if you are using pain relievers or migraine medication frequently, since frequent use can itself keep headaches going.
Common Causes
- Neck joint dysfunction in the cervical spine
- Tension or trigger points in the neck, shoulder and scalp muscles
- Jaw clenching or grinding, which loads the muscles at the side of the head
- Sustained posture — desk work, laptop and phone use
- Sleep disruption, insufficient sleep or irregular sleep timing
- Stress and sustained muscle tension
- Dehydration and skipped meals
- Hormonal changes, discussed with your physician
- Frequent use of pain relievers (medication overuse headache)
- Migraine, which has neurological and genetic contributors
Symptoms
- Pressure, tightness or a band-like feeling around the head
- One-sided pain that starts in the neck or base of the skull
- Pain worsened by neck movement, sustained posture or pressure at the back of the head
- Throbbing pain with light or sound sensitivity (migraine pattern)
- Nausea or a need to lie down during an episode
- Associated neck stiffness or limited neck rotation
- Headache frequency that is increasing or changing in character
Our Approach
Assessment starts with your headache pattern: how often, where it starts, how long it lasts, what triggers it, what you take for it, and how it affects sleep and work. A headache diary over a few weeks is often the most useful thing you can bring. Dr. Entezami then examines the cervical and thoracic spine, the jaw, the neck and shoulder muscles, and your posture, with a neurological screen where it is indicated. Where findings sit outside the musculoskeletal picture — or where red flags are present — referral to your physician or a neurologist is arranged rather than treated here. Conservative management may include manual therapy of the cervical and thoracic spine, contemporary medical acupuncture, soft tissue and trigger point therapy, and practical coaching on workstation setup, screen breaks, sleep, hydration and activity pacing. The appropriate approach depends on the individual assessment; for many people this care reduces the frequency or intensity of some headaches, while for others its role is limited. Results and treatment needs vary.
Treatments Used
- Headache Pattern & Trigger Assessment (Headache Diary)
- Cervical & Thoracic Spine Assessment
- Cervical Spinal Manual Therapy
- Contemporary Medical Acupuncture
- Soft Tissue & Trigger Point Therapy
- Low Level Laser Therapy
- Posture, Workstation & Screen-Break Coaching
- Sleep, Hydration & Activity Pacing Education
- Referral & Co-management with Your Physician
Common Questions
Can a chiropractor help with migraines?
The evidence is mixed, and no conservative treatment reliably stops migraine. What chiropractic assessment can do is identify and manage musculoskeletal contributors such as neck joint dysfunction or jaw clenching, which may help some people with headache frequency or intensity. Care here is not a treatment for the neurological mechanisms of migraine and does not replace medical management. If you have migraine, ongoing care with your physician is important, and chiropractic care is best used alongside it rather than instead of it.
How can I tell if my headache is coming from my neck?
Features that point toward a neck contribution include pain that starts at the base of the skull or in the neck and spreads to one side of the head, pain reproduced or worsened by neck movement or sustained posture, reduced neck rotation, and associated neck stiffness. These clues are suggestive rather than conclusive — distinguishing a cervicogenic headache from a tension-type or migraine pattern is a clinical judgement made during an assessment.
When should I see a doctor instead of a chiropractor?
See a physician promptly for a sudden severe headache that peaks within seconds to minutes, headache with fever and neck stiffness, headache after a head injury, headache with weakness, numbness, confusion, speech or vision changes, a new headache pattern after age 50, or a headache pattern that is clearly worsening. Ongoing migraine management and frequent pain-reliever use also belong with your physician or pharmacist.
Do I need an MRI or other imaging for headaches?
Routine imaging is not usually needed for common headache patterns when the history and examination are typical. Imaging is considered when there are concerning features, an atypical pattern, or neurological findings. If imaging is appropriate it is ordered by your physician or a specialist, and Dr. Entezami will refer you rather than manage that part of your care here.
How often would I need treatment?
There is no universal schedule, and anyone who gives you a fixed number of visits in advance for headaches is guessing. The plan follows your assessment and your response — often a short course of care to see whether the musculoskeletal contributors respond, alongside self-management you continue between visits. The appropriate approach depends on the individual assessment, and results and treatment needs vary.