Statistically, up to 20% of adults experience frequent headaches, with approximately 1–4% reporting headaches on more than 15 days per month. While there are many types of headaches—and within each subtype, multiple underlying causes and triggers—research suggests that musculoskeletal factors can contribute to certain headache presentations. What would a doctor of chiropractic look for during the initial visits to determine whether a course of chiropractic care could benefit the headache sufferer?

The first step is to take a patient history that explores past and present health, as well as details specific to the chief complaint—headaches, in this case. The responses help determine whether the headache pattern is consistent with musculoskeletal referral from the neck or surrounding tissues. Important clues include band-like pressure around the head; pain that begins in the neck or base of the skull and may spread to the temples, forehead, or behind the eyes; headaches triggered by prolonged computer work, poor posture, neck movement, stress, or jaw clenching; pain that worsens after desk work or driving; improvement with massage, stretching, or heat; and co-occurring neck stiffness or shoulder tightness.

If the patient presents with red flags—such as a new type of headache after age 50, the worst headache of their life, recent head trauma, signs of infection (e.g., fever), or neurological symptoms such as weakness, numbness, or vision changes—they may be referred for urgent medical evaluation.

The history guides the physical examination, during which the chiropractor assesses range of motion of the cervical spine—particularly the upper cervical segments—for restrictions, asymmetries, or reproduction of symptoms. They will also palpate soft tissues in the head and neck, including the suboccipital muscles, upper trapezius, sternocleidomastoid, temporalis, masseter, and levator scapulae, to identify tenderness or trigger points and determine whether these reproduce the patient’s headache. Orthopedic testing and postural assessment further help identify musculoskeletal contributors.

The specific treatment approach varies by patient, but generally involves conservative therapies aimed at restoring joint mobility and reducing muscle tension. This may include spinal manipulation or mobilization, soft tissue therapy, trigger point techniques, physiotherapy modalities, targeted exercises, and postural education. If a musculoskeletal disorder is a primary contributor—as is often the case in tension-type or cervicogenic headaches—patients may experience significant improvement or resolution. For other headache types, such as migraines, care may help reduce the frequency, intensity, and duration of episodes.