What Actually Happens During a Chiropractic Adjustment in Montgomery
Chiropractic adjustments explained by Dr. McNally in Montgomery, AL: the exact procedure, the popping sound, and why diagnosis comes first. Call to book.
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The headache starts the same way almost every time. It begins at the base of your skull or somewhere along the back of your neck on one side, then works its way forward toward your eye or temple. By the afternoon it has settled in behind one eye, and rubbing your neck or your shoulders does not make it let go.
If this pattern sounds familiar, and if it tends to show up after a long stretch at a desk or a night of restless sleep, you may be dealing with a cervicogenic headache. Here in Montgomery, this is one of the more overlooked headache patterns I see in my practice at Chiropractic Care Clinic on Bell Road.
This post explains what a cervicogenic headache actually is, how it differs from migraine and tension-type headaches, why your desk chair keeps coming up in this conversation, and what an examination for this type of headache actually involves.
"Cervicogenic" simply means "coming from the neck." A cervicogenic headache does not start inside your skull. It starts in the joints, muscles, and nerves of your upper neck, and the pain is then felt in your head instead of where it began.
Here is why that happens, in plain terms. The nerves that carry pain signals from the upper neck joints connect, at the level of the spinal cord, to the same nerve pathways that carry pain signals from parts of your head and face. The signals share a junction, so your brain can misread the address. Pain that actually starts at the top two or three joints in your neck can be felt as a headache behind the eye or across the temple.
This is a musculoskeletal referral pattern, meaning it involves the joints and soft tissue of the spine rather than the brain itself, and it falls squarely within what a chiropractic examination is equipped to assess.
Knowing this matters because of where most people look first. If the pain is felt in the head, it is natural to assume the problem is in the head. But if the actual source is a joint in the upper neck, examining only the head will keep missing it, visit after visit.
Not every headache that involves the neck is a cervicogenic headache, and it is important to be precise here rather than guess from a list of symptoms.
A few features tend to point toward a neck-based cause. The pain is usually one-sided and stays on that same side. It typically starts at the base of the skull or the neck and travels forward, rather than starting behind the eyes or wrapping around the whole head. Neck movement is often reduced or stiff compared to the other side. The headache can be provoked or made worse by certain neck positions or by holding one posture for a long stretch. And there is often a specific tender spot in the upper neck that, when pressed, feels connected to the headache itself.
Migraine and tension-type headache are different conditions with different mechanisms. They are primary headache disorders, meaning the headache itself is the condition, rather than a symptom referred from the neck. They are diagnosed differently and managed differently. If you want to understand how this differs from migraine or tension headaches in more detail, that comparison is worth reading on its own.
It is also honest to say these patterns can overlap. A person can have migraine and also have neck involvement that makes each episode more uncomfortable, or a tension-type pattern that shares some features with a cervicogenic one. That overlap is exactly why a proper diagnosis matters more than trying to match your symptoms to a description on a website.
If you work at a desk in Montgomery, and a large share of my patients do, your neck likely spends hours each day holding your head slightly forward of where it is meant to sit. That position is called a forward head posture, and it changes how much work your upper neck joints and muscles have to do just to hold your head up.
Your head weighs roughly as much as a bowling ball. When it sits directly over your shoulders, your spine supports that weight efficiently. When it shifts forward, even by an inch or two, the muscles at the base of your skull and the joints in your upper neck have to work harder to hold it there, for hours at a time.
This is not about having the wrong chair for one afternoon. It is about sustained load: the same joints and muscles held in close to the same position, without much movement, for most of a working day, day after day. The neck was built to move through a wide range of motion. It was not built to hold one static position for eight hours straight. Over time, that sustained load is a common mechanical driver behind the upper neck joint irritation that can produce a cervicogenic headache.
Diagnosis comes before any treatment decision. Here is the order I follow during an examination, and why each step matters.
I start with your history: where the pain starts, which side it is on, what seems to bring it on, how long it has been going on, and what you have already tried, including any drugstore pain relief. This history alone often points toward or away from a neck-based cause before I ever touch you.
Next I check the range of motion in your neck, comparing side to side and paying attention to the quality of the movement, not just how far it goes. A restriction on the same side as your headache is a meaningful finding.
I then palpate, meaning I apply direct pressure by hand, to the joints at the top of your neck and the muscles around them. If pressing on a specific spot reproduces the headache you actually experience, that is one of the more useful pieces of diagnostic information available, because it links a specific structure to your symptom rather than relying on guesswork.
I also assess your posture, specifically how your head sits over your shoulders at rest, since this connects directly to the mechanical load described above.
Part of this examination is also screening for signs that point away from a mechanical neck cause and toward something that needs a physician's attention. I cover some of those signs in the next section.
In some cases, based on your history or what I find on examination, I use on-site X-ray imaging. This is not a routine step for every headache. It is used when the history or examination findings call for a closer look, and it shows exactly one thing: bone structure, alignment, and joint spacing. It does not show muscles, nerves, or headaches directly.
All of this exists to answer one question: what is actually causing this headache. If you want to understand the fuller range of headache care options that get discussed once a diagnosis is in place, that is covered in more detail separately. But the examination has to come first. No treatment decision should be made before there is an actual diagnosis behind it.
Part of doing this job properly is knowing what should not be evaluated here at all. Ruling out what falls outside a chiropractic examination is part of the diagnosis, not an afterthought.
Some headaches need prompt medical evaluation, and that is not a judgment call to make alone at home. Contact your physician or seek urgent medical care if you experience any of the following:
If any of these describe what you are experiencing, a chiropractic examination is not the right first stop. Your physician or an emergency department is, and getting that evaluation is the right move.
A headache that starts in your neck will keep being missed for as long as only your head gets examined. If the pattern described here sounds like yours, especially if it is one-sided, starts at the base of your skull, and tends to follow long stretches at a desk, the next step is a proper examination, not a treatment plan chosen in advance.
I see patients from across Montgomery at Chiropractic Care Clinic on Bell Road for exactly this kind of evaluation. To schedule an examination, call (334) 997-7463.
