Neck pain is one of the most common problems I see, and it often comes with a headache attached. Desk work, driving, phones, stress and sleeping awkwardly all play a part.
Common causes of neck pain
- Sustained postures: hours at a desk, laptop or phone
- Sleeping awkwardly, the classic “woke up and couldn’t turn my head”
- Stress, which shows up in the shoulders and neck for many of us
- Minor strains from sport, lifting or a sudden movement
- Whiplash after a car accident. Get this checked by a doctor first.
- Age-related changes in the joints and discs, which are very common and often painless
Headaches from the neck
Some headaches are driven by the joints and muscles of the upper neck. These are called cervicogenic headaches. They typically:
- Start at the base of the skull or the neck and spread forward, sometimes to behind the eye
- Are usually on one side
- Come with a stiff neck
- Are brought on by neck movements or long periods in one position
Tension-type headaches, the common “band around the head” kind, often come with tight neck and shoulder muscles too.
Migraine is a different condition, best managed with your doctor, although some people with migraine also have neck pain that’s worth treating.
How a chiropractor treats neck pain and headaches
After a full history and examination, treatment may include:
- Soft tissue work for tight muscles in the neck, shoulders and upper back
- Mobilisation or manipulation of stiff joints in the neck and upper back, if appropriate and if you’re comfortable with it
- Dry needling for tight, tender trigger points
- Exercises to strengthen the deep neck and upper back muscles, which is important for keeping headaches away
- Practical changes to your desk, screen, pillow and daily habits
Research suggests that combining manual therapy with exercise works better for neck pain than either alone, which is why you’ll leave with exercises as well as treatment.
Warning signs: see a doctor first
Get medical help straight away if a headache or neck pain:
- Is sudden and severe, like a thunderclap, or “the worst headache of your life”
- Comes with fever, a stiff neck and a rash, or confusion
- Comes with weakness, numbness, slurred speech, double vision, dizziness or trouble walking
- Follows a head injury or accident
- Is new and different if you’re over 50
- Steadily gets worse over days or weeks, or wakes you from sleep
Call 10177 or 112 from a cellphone in an emergency.
Simple things to try today
- Move your neck gently through comfortable ranges every hour if you’re at a desk
- Raise your screen to roughly eye level
- Check your pillow: it should keep your neck roughly level with the rest of your spine
- Heat on tight shoulders
- Take regular breaks, drink water, and don’t skip meals
Read next: teens, screens and neck pain or what is dry needling?
Questions parents and patients ask
How do I know if my headache is coming from my neck?
Headaches from the neck (cervicogenic headaches) usually start at the back of the head or neck, are often on one side, and come with neck stiffness. They tend to be brought on or made worse by neck movements or sustained postures like desk work. An examination can help confirm it.
Is it safe to have my neck adjusted?
For most people, neck manipulation by a trained chiropractor is safe, and temporary soreness is the most common side effect. Serious complications are very rare. If you're uncomfortable with neck manipulation, there are gentler alternatives like mobilisation and soft tissue work that can also help. You always have the choice.
This guide is general information, not a diagnosis. If you're worried about yourself or your child, get checked by a health professional. In an emergency, call 10177 or 112 from a cellphone.