A lot of headaches are driven — at least in part — by what's happening in your neck, upper back, and jaw. For cervicogenic and tension-type headaches especially, manual therapy, targeted exercise, and clear education outperform "wait and see" by a wide margin. Migraine is a different beast, and we treat it as one — alongside neurology, not in place of it.
The first job is diagnosis. Most patients walk in with "headaches" — what they actually have is some combination of cervicogenic, tension-type, post-traumatic, and migraine, and the right plan depends on which is which. We listen to the headache history (location, frequency, triggers, family history, medication use), screen for red flags, and run a focused exam: cervical range of motion, suboccipital and trapezius palpation, upper-cervical joint testing, neurological screen.
Once we know what we're dealing with, we explain it in plain English and start treatment. Tools we use depending on what the exam shows:
Some headaches — especially acute cervicogenic or tension-type — resolve during the visit itself. It's not the rule, but it happens often enough that we always assess for it. If yours is one of these, the rest of the plan is mostly about keeping it from coming back.
For chronic or recurring headaches we can help, 1–2 visits per week for a few weeks is a more typical timeline. Most patients notice fewer headaches, lower intensity, shorter duration, or some combination in this window.
Visits drop. Exercises progress. We re-test and document the change. We don't keep you on the schedule longer than the evidence supports.
If your headaches aren't responding the way they should, we change the plan, image something we didn't before, or refer to neurology. Sticking with a plan that isn't working is how patients waste years.
We're in-network with BCBS, PacificSource, Moda, Medicare, Oregon Health Plan (OHP), IHN, and VA Community Care via TriWest. We bill in-network and out-of-network as a courtesy — you don't file claims yourself. Cash-pay, HSA/FSA, and a discounted time-of-service rate are also options. See our insurance page for the full breakdown →
For cervicogenic and tension-type headaches, the underlying story is some version of: upper-cervical joints aren't moving the way they should, the surrounding muscles are working too hard, and the pain-perception system is dialed up. Pain refers forward from the upper neck through shared neural pathways — which is why a problem at C1 or C2 can feel like the pain is in your forehead or behind your eye.
What that means for treatment: improving how the upper neck moves and how the surrounding muscles function reliably reduces headache load — frequency, intensity, or both. That's not a wellness claim; it's what the better-designed clinical trials consistently show.
Migraine is different. It's a neurovascular disorder with genetic and physiological components that aren't fully understood. Manual care won't "fix" migraine. But many migraine patients also have cervicogenic and tension-type drivers stacked on top — and treating those reliably reduces overall headache burden, even when migraine itself remains under neurology's care.
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Come in for: recurring headaches that seem related to your neck or posture, post-trauma headaches without red flags, tension-type patterns that aren't responding to over-the-counter measures, headaches with associated neck stiffness or upper-back pain, headaches that aren't being adequately controlled by your current plan.
Go to the ER if you have any of: sudden, severe "thunderclap" headache (worst headache of your life), new neurological deficits (slurred speech, weakness, vision changes, confusion), fever and stiff neck, headache after significant head trauma, new-onset headache after age 50 with risk factors, or headaches that wake you from sleep with neurological symptoms. These are red flags for serious conditions that need different care.
If you're not sure, call us at 541·753·1287. We'll tell you straight whether to come in or go somewhere else.
For cervicogenic and tension-type headaches, yes — there's solid evidence for manual therapy, soft tissue work, and graded exercise. For migraine specifically, manual care can sometimes reduce frequency or intensity as part of a broader plan, but it's not a primary treatment for migraine and we coordinate with neurology rather than replacing it. The first visit is mostly about figuring out which kind of headache you actually have.
Most new headache patients are seen within 1–3 business days. Call us at 541·753·1287.
Not necessarily. Cervical manipulation is one tool, not the only one. Joint mobilization, instrument-assisted techniques, soft tissue therapy, and exercise can do most of the same work. If you'd rather not have a high-velocity adjustment to the neck, say so — we'll get you better another way.
The risk of serious adverse events from cervical manipulation is very low. The largest population study (Cassidy et al., 2008) found the risk of vertebrobasilar stroke after a chiropractic visit was comparable to the risk after a primary-care visit — meaning the association reflects people seeking care for symptoms of an evolving event, not the manipulation itself. We screen for red flags and choose technique accordingly. If you have specific concerns, we'll talk through them.
Usually no. For typical tension-type or cervicogenic headache patterns without red flags, imaging changes the plan rarely. We do screen for red flags — sudden 'thunderclap' onset, neurological deficits, fever, new headache after age 50, post-trauma severe headaches — and refer or order imaging when those are present.
Yes, especially if your neck or upper-back are part of the picture. Many migraine sufferers also have cervicogenic and tension-type components that, when treated, reduce the overall load on the system. We'll be honest about what we can and can't help with, and we'll coordinate with your neurologist or primary care.
Often, yes — post-traumatic headaches frequently have a strong musculoskeletal component (cervicogenic + tension-type), and they respond well to active care. If you were in a car accident in Oregon, your auto policy likely covers this through PIP. See our auto injury page for the breakdown.
Faster than you might think for some headaches — acute cervicogenic and tension-type headaches sometimes resolve during the first visit. Chronic and recurring headaches that we can help typically respond over the first 2–4 weeks of consistent care. We re-assess at fixed intervals — if you're improving, we taper. If you're not, we change the plan or refer.
