There are over 150 types of headache. Most fall into a few categories: tension headaches, migraines, cervicogenic headaches (originating in the neck), and cluster headaches. Each has different causes and different treatment. The mistake most people make is treating all of them the same way — usually with over-the-counter medications that don't address the underlying problem.
Tension headaches
Most common type. Pressure or tightness around the head, often described as a 'band' around the forehead. Usually bilateral. No nausea or visual changes. Triggered by stress, poor posture, eye strain, dehydration, sleep problems.
Tension headaches are mechanical — caused by tight muscles in the neck and upper back referring pain into the head. They respond well to chiropractic care, soft tissue therapy, and lifestyle changes (better sleep, hydration, posture, stress management).
Cervicogenic headaches
Pain that starts in the neck and spreads up into the head — usually the back of the head, behind the eyes, or one-sided. Often comes with neck stiffness, reduced range of motion, and tenderness at the base of the skull.
Cervicogenic headaches are caused by joint dysfunction and muscle problems in the upper cervical spine. They're some of the most consistently treatable headaches — proper care addresses the source directly.
Migraines
Throbbing, often one-sided, sometimes preceded by visual or sensory aura. Often comes with nausea, light sensitivity, sound sensitivity. Can last hours to days.
Migraines have a complex neurological component, but the cervical spine often plays a triggering role. Many migraine patients have significant relief with combined chiropractic care and lifestyle modification — not always elimination, but reduced frequency and intensity. Severe migraines may also need medical management; we coordinate with your other providers.
How Dr. Ngo evaluates headaches
First, we figure out which type you have. History — when do they happen, what do they feel like, what triggers them, what relieves them. Physical exam of the cervical spine, palpation of muscles known to refer pain to the head, neurological screen.
Red flags — sudden severe 'thunderclap' headaches, headaches with fever or stiff neck, new headaches after age 50, headaches with neurological symptoms — get referred for medical evaluation immediately.
For everything else, we treat what we find.
Treatment
Cervical adjustments to restore proper joint mobility in the upper neck. Soft tissue work on the suboccipital muscles, upper trapezius, and other muscles known to refer pain into the head. Specific exercises for cervical stabilization. Posture and ergonomic correction.
Lifestyle modifications matter — most headache patients have triggers (sleep deprivation, dehydration, stress, certain foods) that contribute. We help you identify and address them.
Most tension and cervicogenic headache patients see significant improvement within 2-4 weeks. Migraine response varies — some patients have dramatic improvement, others modest. We'll know within a month whether the approach is working.
Frequently asked questions
How do I know if my headache is coming from my neck?
Common signs: pain starts at the base of the skull or in the neck and spreads upward. Headache is one-sided and on the same side as neck stiffness. Reduced cervical range of motion. Specific neck movements trigger or worsen the headache. Tenderness when pressing on the upper neck. We can confirm with a physical exam.
Can chiropractic care help migraines?
Often yes, though responses vary. Many migraine patients have a significant cervical component, and addressing it reduces frequency and intensity. It's not a guaranteed cure — migraines are complex — but for patients with a cervicogenic trigger, the difference can be substantial.
How often should I come in for headaches?
Initially, 2-3 times per week for 2-3 weeks while we get on top of the issue. Then we taper based on how you're responding. Chronic headache patients sometimes benefit from periodic maintenance care after the initial phase.
Will I have to take medication forever?
Goal is to reduce or eliminate the need for daily medication by addressing the cause of your headaches. Some patients still benefit from medication for occasional severe migraines, but the daily-painkiller pattern often becomes unnecessary once the underlying cervical issues are resolved.
Can stress cause headaches?
Yes — and stress headaches are real. Stress causes muscle tension, especially in the neck and shoulders, which refers pain into the head. Treating the muscular and joint dysfunction helps. Addressing the stress itself helps more. Both are usually needed.