Headaches and migraines in Summerland

What are headaches and migraines?

Headaches have many possible causes, and most aren't a sign of anything serious.

Some arise from a problem in the neck; these are called cervicogenic headaches. I ask about your headache pattern and assess your neck to see whether there may be a connection. A headache can last from half an hour to several days. Headaches that keep coming back, or change their pattern, are worth having checked.

Different headaches need different care

• Neck-related headaches. These may begin near the base of the skull and spread toward the forehead or behind an eye. Neck movement can sometimes bring them on, but symptoms alone don't confirm the cause.
• Tension-type headaches. These often feel like pressure or a tight band around the head. Neck and shoulder tenderness may occur alongside them. I assess those symptoms without assuming the neck is the only cause.
• Migraine. Migraine can involve throbbing pain, nausea and sensitivity to light or sound. Chiropractic care is not a primary treatment for migraine, and evidence for treating migraine itself remains uncertain. I can assess accompanying neck pain while you continue appropriate medical care.

Common signs

I ask about these features to guide the assessment. No single symptom confirms a neck-related headache.

• Where it starts. Where the pain begins and whether it spreads across your head.
• A stiff neck. Whether your neck feels stiff or difficult to turn.
• What sets it off. Whether desk work, driving or other activities affect the pain, and whether neck movement brings on your usual headache.
• What it feels like. Whether the pain feels like pressure, an ache or a throb.
• Which side. Whether the pain stays on one side or changes sides.
• What comes with it. Whether neck, shoulder or upper-back discomfort comes with it, or you feel sick and bothered by light or sound.

When to get help

How I assess headaches

1. 1
   We talk first. You tell me where the headache starts, what it feels like, how often it comes and what you've tried. I also ask about your general health and any medicines you take.
2. 2
   I check your neck. I look at how your neck moves, and press on the joints and muscles at the base of your skull, neck and shoulders to see whether that brings on your usual headache.
3. 3
   I check for anything that needs a doctor first. I ask about the warning signs listed above and, if your symptoms call for it, check your nerves, balance and coordination. If your headache doesn't fit a neck-related pattern, I tell you and suggest you see your doctor.
4. 4
   We agree on a plan. I explain what I found in plain words, and what my care can and can't address. If my care fits your headaches and you want to start, we can begin that day.

A first visit for headaches takes about 40 minutes, and a follow-up about 20. You can ask questions at any point, and say no to any technique.

Treatment options

If the assessment suggests a neck-related problem, I may recommend a combination of the following. I'll explain what each option is intended to address. I also ask about screen time, your pillow, stress and daily routines, to find practical changes worth trying.

What you can do at home

Simple habits are a good place to start with everyday headaches. Before your visit and between visits:

• Drink plenty of water, and try not to skip meals.
• Keep a regular sleep routine. Sleeping in can make some headaches worse.
• Take breaks from screens and long drives. Stand up, look away and move your neck and shoulders.
• Ask a pharmacist which pain medicine suits you. Taking pain medicine for headaches on 10 or more days a month can itself cause headaches. If you need it that often, talk to your doctor.
• Keep a headache diary. Note when each one starts, how long it lasts, what you were doing and what you took. Bring it to your visit.
• Make time to unwind. Stress can make headaches worse.
• Do the neck exercises I give you, if your plan includes them. I email them after your visit.
• Tell me if your headaches change. Texting is fine, though I'm with patients for much of the day. A new or different headache may need your doctor first, so check the lists above.

Common questions