A Pain in the Neck (and Head)

Headaches are the third most common reason that people seek chiropractic care (after back & neck pain), but most people who present with headaches also experience neck pain. Is there a relationship between the two?

Women with headache

The majority of migraine patients experience a “tightness”, “stiffness” or “throbbing” in their neck during migraine episodes, almost always on the same side as the headache. The other common type of headache is a “tension headache”, and tension in various muscles of the head and jaw can also create pain into the neck. A more direct relationship is the headache known as a cervicogenic headaches, which literally means that the headaches is produced by the neck. 

So why in the world would we get head pain if the problem is in the neck? And why do we get neck pain if the problem is actually in the head?

Sometimes it is as simple as both areas being irritated by the same movements or habits, but the main mechanism is less glamorous than we’d like to think…

Our Brain Gets Confused.

No, really.

To be fair, this is not the fault of our brains entirely but more a confusion in the messaging system. It turns out that the nerves carrying the information from the upper neck and those carrying information from the head/face converge at a certain point in the pathway before the information gets sent to the brain. 

In other words, the information coming from a variety of structures all get muddled up into one place and the brain doesn’t actually know where the original message came from. In this way, information coming from structures in the neck (joints, muscles etc.) can be interpreted as a sensation coming from the head and vice versa.


Each of the muscles in our body have typical referral patterns (examples above) where the pain is felt at a place that is not where the actual muscle is. For example, the muscles that you can pinch between the neck and your shoulder often refers pain up the neck to the temple. This can be another way in which a muscle in the neck can create pain that is felt in the head, and treatment of the actual muscle can relieve this pain.

What this really means for addressing neck pain and/or headaches is that the two need to be assessed and treated together.

In terms of tips for you at home & work, the main focus is avoiding overloading the involved structures which could include a combination of the following:

  • DECREASING TIME SPENT SITTING: You will notice that it is much easier to stand in a “good” posture (without slouching) than it is to sit in the same way, so it is important to take regular breaks from sitting or alternate between using a sitting desk and a standing desk
  • GIVE YOUR MUSCLES A BREAK: A good posture is more about variety, so try not to have your neck in the same position for long periods, such as gripping a phone between your ear and shoulder, or looking down at your desk for long periods. The muscles also work less hard if your head is “stacked” in a natural position on top of the rest of your spine, so try and have your head in a natural, relaxed upright position with minimal muscle activity
  • ADDRESSING HABITS: Additional habits such as clenching or grinding your teeth, tensing your shoulder area or repetitive movements of your neck, shoulders and arms can all contribute to overworking of the muscles in the surrounding areas so try and limit these where possible. You could try sticky notes to remind you, short meditations spread out through your day to practice consciously relaxing the muscles or some activity in the day where you’re doing something completely different 

As I often remind people, you wouldn’t go for a workout and train the same muscles over and over for hours, yet this is sometimes what we are doing at work! We end up in the same posture for hours at a time and work the same muscles with little to no breaks.

Let’s be nice to our bodies and give them breaks with a healthy variety of movements 🙂 

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