You have had a headache four days out of the last seven. You took ibuprofen on two of those days, drank more water on another, and told yourself it was probably stress or the weather. Somewhere along the way, you started calling it a migraine, because that is what people call a bad headache.
Here is the thing: the label you put on your headache determines the treatment you go looking for. And if the label is wrong, you can spend months chasing relief that was never going to work. At Lakeside Spine and Injury Center, this is one of the most common conversations Dr. Andrew Allen has with new patients — not because people are careless, but because headaches are genuinely confusing.
Most Headaches Fall Into a Few Recognizable Patterns
Headache medicine sorts headaches into primary types (the headache itself is the problem) and secondary types (the headache is a symptom of something else). Tension-type headaches and migraines are both primary. Cervicogenic headaches — the ones that originate in the neck — are secondary, and they are the ones we see most often in a chiropractic office.
You can absolutely have more than one type. In fact, plenty of people do, which is exactly why self-diagnosis gets muddy.
What a Tension Headache Actually Feels Like
Tension-type headaches are the most common headaches on earth. They tend to show up like this:
- Pressure, not pounding. People describe a band around the head, a vice, or a dull weight.
- Both sides. Tension headaches are usually bilateral rather than parked over one eye.
- Mild to moderate intensity. Annoying and draining, but you can usually keep working.
- No nausea, no aura. Light or sound might bother you slightly, but not the way a migraine does.
- Tender muscles. Press on the base of your skull, your upper traps, or your temples and you find sore spots.
That last point matters more than people realize. Tension headaches are strongly associated with tightness and trigger points in the muscles of the neck, upper back, and jaw — which means they respond well to hands-on care aimed at those tissues.
What a Migraine Actually Feels Like
A migraine is a neurological event, not just a severe headache. The classic presentation looks quite different:
- Throbbing or pulsing pain, often on one side of the head.
- Moderate to severe intensity that gets worse with ordinary activity like walking up stairs.
- Nausea, sometimes vomiting.
- Real sensitivity to light and sound. Not mild irritation — the kind that sends you to a dark room.
- Aura in some people: visual zigzags, blind spots, tingling in the face or hand, or trouble finding words, usually 20 to 60 minutes before the pain.
- Duration measured in hours to days, often followed by a wrung-out “hangover” day.
Migraines also tend to have triggers that repeat: poor sleep, skipped meals, hormonal shifts, barometric pressure changes (hello, Colorado spring), certain foods, or a stretch of high stress followed by sudden relaxation.
The Third Category Nobody Mentions: Cervicogenic Headaches
This is the one that gets misfiled constantly. A cervicogenic headache starts in the neck and refers pain into the head. The upper cervical joints and the muscles around them share nerve pathways with the areas that supply sensation to your skull and face, so an irritated joint at the base of your neck can produce pain behind your eye.
Signs that point toward a neck source:
- The pain usually stays on one side and does not switch sides episode to episode.
- It starts at the base of the skull and travels forward.
- Certain neck positions or movements bring it on — long drives, a bad night on the wrong pillow, hours at a laptop.
- Your neck rotation is limited compared to the other direction.
- Pressing specific spots in the neck reproduces your headache.
Cervicogenic headaches can look almost exactly like migraines, right down to nausea and light sensitivity in some people. We wrote a whole piece on sorting this out: Are Your Headaches Actually Coming From Your Neck? Here Is How to Tell.
Why the Difference Changes Your Treatment
This is the practical payoff. The three types respond to different things:
- True migraine is primarily managed medically — abortive and preventive medications, trigger management, sleep and nutrition consistency. Manual care can help with the neck and shoulder tension that often rides along with migraines, but no chiropractor should tell you an adjustment cures migraine.
- Tension-type headache responds well to soft tissue work, trigger point release, improving neck and upper back mobility, and fixing the daily postures feeding the tightness.
- Cervicogenic headache is the one where addressing the neck directly tends to make the biggest difference, because the neck is the source rather than a bystander.
If you have been treating a cervicogenic headache like a migraine, you have been managing symptoms of a mechanical problem with tools built for a neurological one. That is why nothing sticks.
How We Sort It Out at Lakeside
An evaluation for headaches and migraines at our office is mostly detective work. Dr. Allen will ask where the pain starts, where it travels, what you were doing in the hours beforehand, and what makes it better or worse. Then comes the hands-on part: checking how each segment of your cervical spine moves, palpating the suboccipital muscles, upper traps, and levator scapulae, and seeing whether pressure on any of them reproduces your specific headache.
That reproduction test is the useful one. When we press a knot at the base of your skull, and you say “that’s it, that’s my headache,” we have found something worth treating. From there, care usually blends soft tissue therapy with gentle chiropractic adjustments to restore movement, plus a few things to change between visits. If persistent neck pain is part of your picture, that gets addressed as its own problem rather than an afterthought.
Headaches That Need Medical Attention, Not a Chiropractor
Being honest about limits matters. Please get prompt medical evaluation if you have:
- A sudden, severe headache that peaks within seconds — the “worst headache of my life”
- Headache with fever, stiff neck, confusion, or a rash
- Headache after a head injury, especially with vomiting or drowsiness
- New weakness, numbness, slurred speech, or vision loss
- A headache pattern that changes abruptly, or new headaches after age 50
Those are emergency-room or primary-care conversations, and we will tell you so directly.
Keep a Two-Week Headache Log
If you do one thing after reading this, do this. For two weeks, jot down the date, the time it started, where the pain began, what it felt like, what you were doing in the two hours before, and what you tried. Bring it in.
Patterns you cannot see day to day jump off the page over fourteen days — the Thursday afternoon headaches after long meetings, the ones that follow poor sleep, the ones that only show up after a drive down I-70. That log routinely tells us more than any single exam finding.
You Do Not Have to Just Live With It
Frequent headaches are common, but common is not the same as normal. If yours are showing up weekly, changing what you say yes to, or sitting in the back of your mind as something you have simply accepted, it is worth finding out which kind you actually have.
Call us at (303) 351-0744 or book a free 30-minute evaluation. We will tell you honestly whether this is something we can help with — and if it is not, we will point you toward who can.
