Seek emergency care immediately for
A sudden severe headache peaking within seconds, headache with fever and neck stiffness, headache following a head injury, headache with confusion, weakness, slurred speech or visual loss, or a headache unlike any you have had before.
The kinds we see most
Tension-type headache. A band of pressure across both sides of the head, often described as a tight cap. Typically builds through a long day, frequently accompanied by tight neck and shoulder musculature. Not dangerous, and genuinely miserable when it happens four days a week.
Cervicogenic headache. Headache arising from the upper cervical spine. Usually starts at the base of the skull and wraps forward, generally one-sided and staying on that side, provoked by neck positions or sustained posture. Frequently mistaken for migraine.
Both of these have a mechanical component, and both are worth examining properly rather than managing indefinitely with analgesia.
The working-week pattern
If your headaches are worse on Thursday than Monday and largely absent on holidays, the load is coming from something you do repeatedly during the week.
Usually that is sustained posture. Your head weighs about five kilograms, and holding it forward of your shoulders to look at a screen means the muscles and joints at the back of the neck work continuously against a lever, all day. Joints adapt to how they are loaded, and the upper cervical segments are where that adaptation frequently shows up as headache. More on this on our tech neck page.
Worth ruling out: medication-overuse headache
Regular use of pain relief for headaches can, past a certain frequency, start perpetuating the headaches themselves. It is easy to miss because the pattern looks like worsening headaches rather than a side effect. If you are reaching for something most days, mention it: it changes the plan, and it needs your GP involved rather than more treatment from us.
How we assess it
A first visit takes about 30 minutes. A detailed history of the headaches — where, what character, how often, what provokes them, what you have tried — then examination of the upper cervical segments, the thoracic spine, the shoulder girdle and your habitual posture, along with specific testing to establish whether the neck reproduces your headache.
We record frequency and intensity at the start, so the question “is this working?” has a numerical answer at review rather than depending on memory.
What care might involve
- Adjustment of restricted upper cervical and thoracic segments
- Soft tissue work to the sub-occipital and upper trapezius musculature
- Cold laser therapy where the region is irritable
- Rehabilitation for the deep neck flexors and postural chain, plus practical workstation advice
And if the examination says your headaches are not coming from your neck, you will be told that, along with a recommendation about who to see instead.