Could your headache be coming from your neck? Researchers seem to think so! | Dr. Alex Ritza | Downtown Toronto Chiropractor near Yonge and Bloor |
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Could your headache be coming from your neck? Researchers seem to think so!

Could your headache be coming from your neck? Researchers seem to think so!

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It is relatively common knowledge that when a male (more commonly) or female (less commonly) experiences a heart attack, pain is often felt into the jaw, arm, pectoral region or hand. The problem or injury is to the heart, but pain is felt in an area where there is absolutely no problem. Did you know that similar phenomenon involving the neck might be the cause of your headaches?

How many of us experience and suffer from headaches on a far too often basis. They can be debilitating at worst, and annoying at best. They can stop us from doing what we need to do, and living life to the fullest.

So much is unknown about the risk factors, causes, and physiology of headaches, but we do know that the neck and its cervical spine can be a major cause of headaches in the general population (between 2-17%), and in up to 50% of motor vehicle accident victims. While it is counter intuitive, some headaches, known as “cervicogenic headaches” (headaches generated from the cervical spine) are believed to be a direct result of painful muscles and joints in the neck. “But how does a problem in the neck result in a person feeling pain in the face and head? How is that possible?”, you ask, well here is how. And the science is fascinating!

Some neuroanatomy

This picture shows the convergence of the three noted nerve pathways that come together in the brainstem before going up into the brain

Nerves that carry sensation, and pain information from the muscles, ligaments, and joints of the upper three neck (cervical) vertebrae (C1-C2-C3) make a few interesting connections with other nerves in the spinal cord before reaching the brain to tell it what they feel. Namely, the first three cervical nerves from the spine connect with a part of the brainstem called the trigeminocervical nucleus (read – part of the brainstem) that also receives sensory input from the fifth cranial nerve that supplies sensation to the orbits, forehead and temples, and the cervical nerves that detect sensation on the back of, and vertex of the skull. After receiving these three inputs into the trigeminocervical nucleus (brainstem), more nerves go to the cortex to tell the brain what it feels, and if there is pain.

Screen Shot 2015-01-27 at 4.44.18 PM

In here lies the fascinating thing. If this brainstem nucleus receives a pain signal, and then relays it to the brain, it is very difficult for the brain to interpret which source it is coming from.It can get confused if it is coming from the face, the neck, or the back of the skull. Sometimes in clinic, it is possibScreen Shot 2015-01-27 at 4.44.34 PMle to determine that a headache over the eye, in the temples, or at the back of the skull might be in fact coming from the neck, in the same way a heart attack refers pain to the upper-limb. A clinician might palpate a joint, or muscle in the neck that results mimics and reproduces a patient’s headache symptoms and localizes the cause to a particular structure.

From the anatomy we know that this phenomenon exists and that by treating the neck through soft tissue massage, mobilization, and adjustments, a great deal of relief can be provided for headaches of these type. Thankfully, a good body of research also indicates that care from a manual therapist can also provide a great deal of relief in caring for migraine and tension-type headaches as well. There is no need to suffer


Bryans, Roland, et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of manipulative and physiological therapeutics34.5 (2011): 274-289.

Bogduk, Nikolai, and Jayantilal Govind. “Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment.” The Lancet Neurology 8.10 (2009): 959-968.

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