What it usually is

Most of the headaches I see are the everyday kind, not the scary kind. Some start in the neck and wrap up the back of the head, which we call a cervicogenic headache. Some are tension-type headaches, the tight band that shows up after a long day at a screen. And a lot of them have a sidekick: bad sleep, stress, or a pillow that should have been retired years ago.

What it often feels like

A dull ache or pressure, often at the base of the skull, sometimes creeping up behind one eye. Or, if it is a headache or a stiff painful neck that's got you visiting your chiropractor, it may be your pillow that is the culprit.

What we look at

First I listen, because your story tells me more than any test. Then we check how your neck and upper back move, which muscles are cranky, and whether the nerves and reflexes are behaving. We also talk about sleep, screens, stress and your pillow, because a headache rarely has just one cause. Most importantly, I am checking that your headache is one I should be treating at all.

What usually helps

For neck-related headaches the usual tools are adjusting, soft tissue work and exercise for the neck and shoulders. We look at posture, not because there is one perfect way to sit, but because your neck likes to change positions. And we talk about understanding pain, stress and sleep, because a tired, stressed brain turns the volume up.

What you can do at home

Get up and move your neck every half hour or so when you are at a desk. My number one tip for sleep hygiene is: plug your phone in downstairs, far away from where you sleep. If you are a stomach sleeper with your head cranked to one side all night, I'm looking at you. Try a few minutes of paying attention to your breathing when you feel the band tightening.

When it's not a chiro problem

A sudden, severe or unusual headache needs a medical doctor or emergency care first. Go to emergency (or call 911) for the worst headache of your life, a headache that hits like a thunderclap, or one that comes with fever and a stiff neck, confusion, weakness, numbness, trouble speaking, or changes in your vision. A headache after a hit to the head needs a medical check first too. See your medical doctor soon for a new headache after age 50, a headache that keeps getting worse, or a headache pattern that has changed.

Headaches