Sports Injury Treatment - Spokane, WA
Reviewed By: Stephen Byers, DC CSCS
CERVICOGENIC HEADACHES--AND WHAT ACTUALLY FIXES IT
Cervicogenic headaches — headaches that start in the neck and refer up into the head — are one of the most common and most fixable headache types we treat at the Movement Clinic. Most of the time the problem isn't in the head at all. It's in the upper back, the breath, and the small muscles at the base of the skull working overtime.
First — Is It Actually a Cervicogenic Headache?
Not all headaches respond to the same approach. A headache that's coming from your neck responds very differently than a migraine or a tension-type headache, and getting the diagnosis right matters. Here's the quick way to tell:
CERVICOGENIC HEADACHES
The pain often starts at the base of the skull and refers up over the top of the head, sometimes wrapping around to the temples or behind the eyes. It's usually one-sided. It gets worse with certain neck positions or movements, and it almost always comes with neck stiffness or tension. Many patients report a hard run or heavy lift kicking it off.
TENSION HEADACHE
A band-like pressure around the whole head, usually both sides at once. Less position-dependent. Often stress- or fatigue-driven.
MIGRAINE
Typically more severe, often pulsating, with sensitivity to light or sound. May involve aura (visual changes), nausea, or vomiting. Can last hours to days and isn't usually triggered by neck position alone.
Many patients we see have some combination — most often cervicogenic headaches layered on top of tension or migraine patterns. Our Movement Assessment helps untangle which is which and identifies what we can address with movement-based care. If your headache pattern doesn't fit our scope, we'll let you know and help refer you to the right provider.
Does This Sound Familiar?
Pain that follows you in and out of training
"I get a dull ache at the base of my skull that turns into a full headache."
"My headaches always start a day or two after I lift heavy."
"I get a headache on long runs that won't go away even after I stop."
"The pain wraps from the back of my head around to my eyes."
"My headaches kick in after long days at the desk."
"Ibuprofen helps temporarily — but nothing actually solves it."
Why It Happens
Two patterns we see in almost every patient with cervicogenic headaches
FORWARD HEAD POSTURE
This is the chronic, postural version. When the upper back loses mobility and rounds forward, the head and neck have to extend to keep the eyes level with the horizon. The small muscles at the base of the skull — the suboccipital triangle — end up holding the head in that extended position all day. Those muscles are densely packed with nerves and have direct connections to the pain-sensitive structures around the back of the head. When they're overworked for hours and days at a time, they refer pain up over the skull and forward toward the eyes. That's the headache.
NECK LOADING WITH TRAINING
The second pattern is what we see in athletes specifically. Two versions of it show up:
Cardio athletes. Runners and other cardio athletes often default to chest-and-neck breathing instead of diaphragmatic breathing. The accessory breathing muscles in the neck — the scalenes and sternocleidomastoid — work hard on every breath. Multiply that by hours of training per week and the neck muscles are in a constant state of low-grade overload. Headaches show up after long efforts and on the days following.
Lifters. When the upper back is too stiff to rack a barbell or set a press position properly, the neck takes the load. Bracing through the neck during heavy lifts — especially squats, deadlifts, and overhead pressing — overworks the same muscles that drive cervicogenic headaches. The headache typically shows up a day or two after the lift.
The two patterns can also occur together, which is why our Movement Assessment looks at both the neck and the upper back before we build a treatment plan.
What's Driving It
The physical reasons these patterns develop
Cervicogenic headaches don't happen in isolation. They're usually the body's way of working around a limitation. When we evaluate patients with cervicogenic headaches, we commonly find one or more of these:
TIGHT SUBOCCIPITAL MUSCLES
The small muscles at the base of the skull are what actually generate the headache. When they're chronically tight from postural overload or training load, they refer pain up into the head.
LIMITED THORACIC MOBILITY
When the mid-back can't extend, the head drifts forward and the suboccipital muscles get recruited to hold it up. This is the upstream cause of most cervicogenic headaches we see.
POOR DIAPHRAGMATIC BREATHING
When the diaphragm isn't doing its job, the accessory breathing muscles in the neck pick up the slack. For cardio athletes especially, that means hours of low-grade neck overload every week.
WEAK DEEP NECK FLEXORS
The small stabilizing muscles at the front of the neck should support head position throughout the day. When they're underactive, other muscles — including the suboccipitals — take over and stay locked down.
NECK BRACING WHEN LIFTING
Allowing the neck to take load during heavy lifts is a learned pattern, usually from poor upper back mobility or unclear coaching. Most lifters were never taught how to brace through the trunk while keeping the neck out of the equation.
POOR RECOVERY BETWEEN SESSIONS
Small irritations accumulate. Without consistent recovery work, the muscles that generate headaches never get a chance to settle — turning occasional headaches into a chronic pattern.
Our Approach
How we evaluate cervicogenic headaches at the Movement Clinic
Most headache treatment starts with the symptom — ibuprofen, ice, prescription medications. We start with the movement, because that's where the answer usually is.
01
FULL MOVEMENT ASSESSMENT
We assess basic mobility, stability, and movement patterns across your whole body — not just your neck. This is where we distinguish cervicogenic headaches from tension and migraine patterns and identify the upstream drivers.
02
ACTIVITY-SPECIFIC BIOMECHANICAL TESTING
We test thoracic mobility, breathing patterns, neck stability, and how your body handles loaded positions in your sport. Cervicogenic headaches rarely live in the neck alone — we look up and down the chain to find the real driver.
03
SPORTS CHIROPRACTIC CARE
Targeted adjustments restore motion to stiff joints in the upper back, ribs, and neck so the suboccipital muscles aren't forced to work overtime. Soft-tissue treatments help release the tight muscles at the base of the skull that are referring pain into the head.
04
ACTIVITY-SPECIFIC REHABILITATION
We use exercises to wake up the deep neck flexors, retrain diaphragmatic breathing, restore thoracic extension, and teach proper bracing during lifting. The goal isn't just to feel better — it's to fix the patterns that triggered the headaches in the first place.
05
RETURN TO ACTIVITY PLANNING
We work with you on training modifications — breathing drills for cardio sessions, technique adjustments for lifting, desk setup, warm-up routines — so you can keep training without triggering the same headache patterns.
Every plan starts with a Movement Assessment.
Common Question
Should you stop training if you have cervicogenic headaches?
Some initial rest can be helpful during an acute flare-up, but long-term avoidance is rarely the solution. ain is a signal that something needs to change — usually how you're moving, breathing, or training — not necessarily that training needs to stop. With the right plan, most patients are able to keep training while we work to resolve the headaches.
What we want to understand is why the headaches are happening. Once that's clear, we can usually modify your lifting technique, your breathing pattern during cardio, your training volume, and your daily posture — and the headaches start to improve without giving up your sport.
Headaches lasting more than 1–2 weeks, headaches that wake you up at night, headaches associated with neurological symptoms (vision changes, numbness, weakness, slurred speech), or a sudden severe headache unlike any you've had before are all signs that you should be evaluated immediately — by us or an emergency provider, depending on the severity. We'll help you sort out which is which.
What to Expect
Realistic recovery timelines
Every athlete is different, but here's what we typically see based on the nature of the issue.
6-8 VISITS
Acute Flare-up
Recent onset, first-time issue. Fast response with the right treatment and activity modification
4-8 WEEKS
Persistent or Recurring Headaches
Headaches that have been present for weeks or months, or keeps coming back. Requires addressing the underlying movement dysfunctions.
8-16 WEEKS
Performance Rebuild
Full recovery requires building the necessary mobility, strength and movement mechanics needed to stay pain-free for the long term.
Frequently Asked Questions
Questions patients ask us about cervicogenic headaches
Q: Can a chiropractor actually help with cervicogenic headaches?
A: Yes — particularly cervicogenic headaches and many tension headaches. Chiropractic care that combines adjustments with targeted mobility and strength work addresses both the pain and the underlying patterns driving it. Most patients see meaningful improvement within a few weeks. For migraines, our approach can sometimes reduce frequency or severity, but migraines often involve other systems that require coordination with your primary care provider or a neurologist.
Q: Do I need imaging before coming in?
A: No. In most cases of cervicogenic headache, imaging isn't the first step. Our movement assessment gives us the information we need to get started. If we find any red flags or signs that imaging would change the plan, we'll let you know.
Q: How do I know if my headache is cervicogenic or a migraine?
A: The quickest tells are location, side, and triggers. Cervicogenic headaches usually start at the base of the skull, are typically one-sided, and get worse with certain neck positions. They almost always come with neck stiffness. Migraines are usually more severe, often pulsating, may include sensitivity to light or sound, aura, or nausea, and aren't usually triggered by neck position alone. Our Movement Assessment will help confirm which is driving your symptoms — and many patients have a mix of both.
Q: Will treatments make my headaches worse?
A: Some patients feel a temporary increase in soreness for 24-48 hours after their first adjustment, especially if the upper back and neck have been very stiff. This usually settles quickly and is followed by a clear reduction in headache frequency or intensity. We'll talk through what to expect after your first visit so you know what's normal.
Q: Will I need ongoing care forever?
A: No. Most cervicogenic headache patients move through three phases: a Recovery phase where we address the pain and underlying movement issue, a Stabilization phase where we lock in the gains with rehab, and an As-Needed phase where you graduate from care or come in occasionally for tune-ups.
Q: How is this different from seeing a regular chiropractor or physical therapist?
A: Our team specializes in working with athletes and active individuals. We assess movement patterns, understand the demands of running, lifting, and sustained postures, and build treatment plans that include targeted exercise and adjustments. We're focused on solving the underlying problem and getting you back to doing what you love without headaches.