Dr. Reed Jarvis, DC | Owner & Chiropractor, The Resilience Lab | Louisville, TN
Most people reach for a painkiller when a headache hits. It takes the edge off, at least temporarily. But if your headaches keep coming back, masking the pain isn't solving the problem. For a significant portion of people dealing with chronic or recurring headaches, the source isn't in the head at all. It's in the neck.
Understanding that distinction changes everything about how you approach treatment.
Two types of headaches that respond well to chiropractic care
Not every headache has a musculoskeletal origin. Migraines, cluster headaches, and headaches caused by systemic conditions require different management. But two of the most common headache types, tension-type headaches and cervicogenic headaches, are directly related to dysfunction in the cervical spine and surrounding musculature. These are exactly the presentations where chiropractic care has strong clinical evidence behind it.
Tension-type headaches are the most common headache disorder, affecting roughly 26% of adults worldwide. They present as a pressing or tightening sensation around the head, often described as a band of pressure, and are associated with muscle tension and referred pain from the neck and upper back.
Cervicogenic headaches are secondary headaches that originate from a disorder of the cervical spine, specifically from the upper cervical vertebrae, facet joints, and surrounding soft tissue. The pain begins in the neck and is referred upward into the head. Unlike a migraine that starts in the brain, a cervicogenic headache is a musculoskeletal problem with a musculoskeletal solution.
Why the neck is involved
The upper cervical spine, particularly the C1, C2, and C3 segments, has a direct neurological connection to the trigeminal nucleus, the same nerve center that processes pain signals from the face and head. When structures in the upper cervical spine become irritated, restricted, or dysfunctional, they can generate pain signals that the brain interprets as coming from the head. This is referred pain from the cervical spine, and it is one of the primary mechanisms behind cervicogenic and tension-type headaches.
Joint restriction in the upper cervical spine, trigger points in the suboccipital, upper trapezius, and sternocleidomastoid muscles, and poor cervical posture all contribute to this pattern. Forward head posture increases the mechanical load on the upper cervical joints and compresses the suboccipital muscles, creating exactly the conditions that drive headaches from the neck up.
What the evidence says
A 2026 clinical practice guideline on chiropractic management of cervicogenic and tension-type headaches concluded that chiropractors can appropriately care for individuals with both conditions using a variety of nonpharmacological interventions. Spinal manipulative therapy has been shown in multiple studies to reduce headache frequency, intensity, and duration in people with cervicogenic and tension-type presentations.
Soft tissue techniques including myofascial release have also been shown in a 2024 systematic review to be effective for tension-type and cervicogenic headache. Joint mobilization reduces stiffness and restriction in the upper cervical joints that drive referred head pain. And targeted rehabilitation to address deep cervical flexor weakness and postural endurance extends the results beyond the treatment room.
How we approach headaches in our office
Headaches that come through our door get a thorough assessment before any treatment begins. Not all headaches are the same and not all headaches are appropriate for chiropractic management. Red flags like severe sudden-onset headache, neurological symptoms, vision changes, or headache following head trauma require immediate evaluation and referral.
For cervicogenic and tension-type headaches, the assessment focuses on upper cervical joint mobility, trigger point patterns in the surrounding musculature, postural load, and reproduction of familiar head pain with cervical provocation. If we can reproduce the headache with cervical testing and reduce it with treatment, that tells us exactly where the problem is coming from.
Treatment combines chiropractic adjustments targeting the upper cervical and thoracic spine, dry needling into the suboccipital, upper trapezius, and cervical musculature, soft tissue work through the posterior chain of the neck, and postural rehab to address the underlying drivers. The combination addresses both the acute pain pattern and the structural reasons it keeps coming back.
What patients typically experience
People dealing with chronic tension headaches or cervicogenic headaches often notice a significant reduction in both frequency and intensity within a few visits. Some experience relief in the session itself when upper cervical adjustments reduce the joint restriction generating the referred pain. For others the improvement is more gradual as the underlying tissue changes and postural patterns shift.
The goal is not just fewer headaches in the short term. It's addressing the cervical dysfunction, trigger point patterns, and postural load that are generating them so the headaches don't keep coming back.
