Headache and Migraine

At our practice in Munich we treat headaches nearly everyday, up to 50 times per week.

The headache starts at the base of your skull, works its way upward, and by midday the day is effectively over. Or it's a migraine - light hurts, sound hurts, even moving. Most people reach for ibuprofen and wait. But when headaches keep coming back, they are telling you something mechanical is going on - often in the cervical spine - and that can be treated. At American Chiropractic Haus in Munich-Bogenhausen, no referral required, and same-week appointments are often available.

Not All Headaches Are the Same — The Types That Matter

The most common question we hear: "Is this a migraine or just a really bad headache?" The distinction is clinically relevant — because it determines what actually helps.

Cervicogenic Headache — Where Chiropractic Has the Most to Offer

Cervicogenic headaches originate in the cervical spine. Restricted joints, tight musculature, or irritated nerves in the C1–C3 region send pain signals into the head — typically one-sided, starting at the base of the skull, often radiating into the temple or behind the eye. Crucially: neck movement changes the symptoms (that is the distinguishing feature). Many patients say they feel the need to "crack their own neck" or stretch the pain away.

Cervicogenic headaches respond very well to manual therapy and spinal manipulation. This isn't a claim — it's what the research shows.

Tension-Type Headache

The most common headache type — a dull, bilateral pressure, often described as a helmet or vice. Frequent causes include tight musculature in the neck and shoulders, poor sitting posture, stress, and inadequate sleep. The mechanical component makes tension-type headache a strong candidate for chiropractic care.

Migraine

Migraine is a neurological disorder — not just a bad headache. It progresses in phases (prodrome, possible aura, headache phase, postdrome), lasts 4 to 72 hours, is often unilateral and pulsating, worsens with physical activity, and is typically accompanied by nausea, light sensitivity, and sound sensitivity.

Can a chiropractor help with migraine? Yes — with an important nuance. Not equally with every migraine type. Where migraine has a cervical component — which is more common than many people realise — chiropractic treatment can reduce both frequency and intensity of attacks.

Cluster Headache

A rare, extremely severe, one-sided headache around the eye, often with tearing and nasal congestion. Cluster headaches are not the same as migraine. They have a different neurological origin and require different treatment approaches. Chiropractic plays a limited role here — we say that plainly.

Föhn Headaches in Munich — A Local Phenomenon With Real Physiology

When the Föhn wind descends from the Alps, Münchners know what's coming. Föhn headaches are not imagined. Barometric pressure changes and shifts in air ionisation can lower the headache and migraine threshold in sensitive individuals — the trigemino-vascular system responds to these environmental stimuli, especially when it is already sensitised. Chiropractic cannot change the weather. But it can improve the biomechanical foundation — cervical mobility, muscle tone, neuromuscular control — so that the threshold at which a Föhn triggers a headache is higher. Many of our Munich patients describe exactly this.

How Do I Know If My Headache Is Coming From My Neck?

Typical signs of a cervicogenic headache:

Starts at the base of the skull or upper neck, spreads toward the temple, forehead or behind the eye
One-sided — consistently on the same side
Changes with neck movement, pressure, or position
Occurs after prolonged sitting, driving, or screen work
Accompanied by neck pain or restricted head movement
Morning headache after sleeping in an unfavourable position

What points toward migraine:

Pulsating, one-sided pain of moderate to severe intensity
Nausea, vomiting, sensitivity to light and sound
Worsens with physical activity
Possible aura (visual disturbance, tingling, speech difficulty before the headache)
Attack duration of 4 to 72 hours

Can you have both?

Yes. Cervical triggers can initiate or amplify migraine attacks. This is clinically well-documented and one of the reasons why migraine patients can benefit from cervical spine treatment — even though migraine itself is a neurological condition.

Red flags — see a doctor immediately if:

Sudden, thunderclap headache of extreme severity (possible subarachnoid haemorrhage — emergency)
Headache with fever, neck stiffness, light sensitivity (possible meningitis — emergency)
Headache after head injury or fall
First severe headache after age 50
Headache with neurological deficits (vision loss, weakness, speech difficulty)
Headache that worsens when lying down or wakes you from sleep (possible raised intracranial pressure)

These patterns require immediate medical assessment — not a chiropractic appointment.

What To Do About Headaches — Right Now

What can help short-term:

Ibuprofen or paracetamol at the recommended dosage can dampen acute pain — they don't treat the cause
Water: dehydration is a frequently underestimated trigger, particularly for migraine
Cold compress to the back of the neck for tension-related headache
Heat applied to the shoulders if the pain radiates from this region (20 minutes is enough, then take a break)
Dark, quiet room for migraine — reducing stimulation is physiology, not self-indulgence
Gentle neck mobilisation (slow rotations) if the headache has a cervical origin

What doesn't help with migraine:

Caffeine as a rescue measure works short-term but can deepen the headache cycle when overused
Too many painkillers — medication overuse headache is a real, well-documented complication that develops with more than 10–15 treatment days per month

What nobody does but should: Keep a headache diary. When does it occur? Where? How long? What precedes it? Which trigger — weather, food, sleep, menstrual cycle, screen time, stress? This pattern is diagnostic gold — for your GP, your neurologist, and for us.

What Causes Recurring Headaches?

Headaches don't just come from the head; in fact, many patients relate that painful knots in the muscles of the shoulder, upper back, or jaw radiate or cause a headache. This is why assessment by a professional is important.

The role of the cervical spine

The upper three cervical segments (C1, C2, C3) converge in the spinal cord with the trigeminal nerve — the primary nerve for facial and head pain. This convergence model explains why stimuli from the neck can be perceived as headache. Blocked facet joints, tight suboccipital musculature, dysfunction at the craniocervical junction — all of these can repeatedly send pain signals into the head.

Posture and screen work

Hours of screen work with a forward head posture places enormous load on the cervical spine. For every centimetre the head migrates forward, the effective load on the cervical spine increases significantly. The suboccipital muscles — the small muscles between the skull base and the upper cervical spine — are under constant tension. This is one of the most common mechanical drivers of headache we see in practice.

Sleep position

Headache at the back of the head on waking? A pillow that's too high, poor neck support, or a twisted cervical position during sleep can keep the suboccipital region under sustained tension through the night.

Stress, hormones, weather

These factors lower the individual pain threshold. They are rarely the sole cause, but frequently the trigger that pushes an already-sensitised system over the edge. Treatment that stabilises the system makes these triggers less potent.

The role of the jaw in headaches

Stress, poor sleep hygeine, an abnormal bite - all of these can play a role in the tension of the muscles of your jaw. Many patients relate some jaw tension related to their headaches, particularly headaches that are stronger in the morning hours or at the end of a stressful work day.

How Does a Chiropractor Treat Headaches?

At American Chiropractic Haus, we stay up to date on the latest evidence and treatment protocols. Our chiropractors have read the latest research so that you don't have to. Here is what chiropractic care can do for headaches and what the research actually says:

Bronfort et al. (Journal of Manipulative and Physiological Therapeutics, 2001, PMID 11562654) concluded in a systematic review: spinal manipulation shows superior results to massage for cervicogenic headache and comparable efficacy to commonly used first-line prophylactic medications for tension-type and migraine headache. [Bronfort G, Assendelft WJ, Evans R, Haas M, Bouter L. Efficacy of spinal manipulation for chronic headache: a systematic review. J Manipulative Physiol Ther. 2001 Sep;24(7):457-66. PMID: 11562654.]

Tuchin, Pollard & Bonello (JMPT, 2000, PMID 10714533) demonstrated in a randomised controlled trial that over 80% of migraine participants reported significant improvement following chiropractic spinal manipulative therapy — in frequency, intensity, and medication use. [Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. J Manipulative Physiol Ther. 2000 Feb;23(2):91-5. PMID: 10714533.]

Haas et al. (Spine Journal, 2018) showed a clear dose-response relationship for spinal manipulation in cervicogenic headache: more targeted treatment sessions led to better outcomes — evidence for a structured course of treatment rather than a single session. [Haas M, Bronfort G, Evans R, Schulz C, Vavrek D, Takaki L, Hanson L, Leininger B, Neradilek MB. Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. Spine J. 2018 Oct;18(10):1741-1754. doi: 10.1016/j.spinee.2018.02.019. Epub 2018 Feb 23. PMID: 29481979; PMCID: PMC6107442.]

Nambi et al. (PLOS ONE, 2024) compared cervical manipulation, thoracic manipulation, and conventional physiotherapy in cervicogenic headache: cervical spinal manipulation produced significantly better outcomes in pain intensity, frequency, and quality of life. [Nambi G, Alghadier M, Eltayeb MM, Aldhafian OR, Saleh AK, Alsanousi N, Albarakati AJA, Omar MA, Ibrahim MNA, Attallah AA, Ismail MA, Elfeshawy M. Comparative effectiveness of cervical vs thoracic spinal-thrust manipulation for care of cervicogenic headache: A randomized controlled trial. PLoS One. 2024 Mar 29;19(3):e0300737. doi: 10.1371/journal.pone.0300737. PMID: 38551917; PMCID: PMC10980233.]

Our approach — three treatment phases

Phase 1 — Identify the driver, reduce acute pain

Before we treat, we examine. That means a full history (headache pattern, triggers, medication, previous treatment), a clinical-neurological examination, and a functional analysis of the cervical spine — range of motion, joint mobility, muscle tension, neurodynamic testing. We want to know whether your headache has a cervical origin before we do anything.

When the assessment confirms this, treatment begins with targeted adjustments of the upper cervical spine — particularly the occipitoatlantal junction (C0/C1/C2) and the C2/C3 segment. These are typically hypomobile or restricted in cervicogenic headache.

Phase 2 — Break the pattern, restore mobility

Our specialist for neck and headache conditions, Christin Maskus, works specifically with techniques that normalise the movement pattern of the upper cervical spine and decompress the suboccipital musculature. Alongside adjustment, we use:

Soft tissue therapy to the neck and shoulder musculature
DNS techniques to activate the deep cervical flexors — the stabilisers that are frequently inhibited in headache patients
Posture correction and ergonomic guidance for screen-based work

Phase 3 — Build resilience, prevent recurrence

Headache reduction is the target — headache freedom is the benchmark. In this phase, we develop with you a tailored programme of home exercises, trigger management, and lifestyle modifications that stabilise treatment gains long-term.

During subsequent appointments — and once your response to the treatment has been analyzed — it is customary to offer general lifestyle advice tailored precisely to your individual needs and symptoms. This may include, for example, ergonomic adjustments to your workspace, recommendations for a specific pillow or mattress to optimize your sleeping position, or even dietary modifications. Every patient is unique; therefore, an individualized treatment plan is always developed in close collaboration between you and your chiropractor.

When to See a Chiropractor for Headaches

Come and see us if:

Headaches recur regularly — multiple times per week or month
Pain starts at the base of the skull and radiates toward the temple or eye
Neck pain and headaches occur together
Headaches begin in the morning on waking
Screen work or long drives trigger headaches
Painkillers no longer work adequately or you take them regularly
You have a known migraine condition and want to reduce attack frequency
Föhn weather regularly lowers your headache threshold

When to see a neurologist or GP:

For red flags (thunderclap headache, blood pressure headache, or different/stronger than usual headache) your GP or emergency department is the right first stop. When migraine medication is inadequate or attack frequency is increasing, a neurologist is appropriate. We work well in teams — and refer specifically when it makes sense.

Make an appointment

FAQ — Frequently Asked Questions About Headaches & Migraine

Q: What is the difference between a headache and a migraine? A headache is a symptom — migraine is a neurological disorder. Migraine progresses in phases, lasts 4 to 72 hours, is typically one-sided and pulsating, and is accompanied by nausea and sensitivity to light and sound. Not every severe headache is migraine — and not every migraine feels the same. The distinction matters because it influences treatment.

Q: Can a chiropractor help with migraine? Yes, in many cases. A randomised controlled trial (Tuchin et al., 2000) found that over 80% of migraine participants reported significant improvement in frequency, intensity, and medication use following chiropractic spinal manipulative therapy. The strongest effect occurs when migraine has a cervical component — when neck tension or cervical dysfunction is involved as a trigger.

Q: Can I get a headache after chiropractic treatment? It can happen, particularly after the first session or after a long break between appointments. Similar to a deep tissue massage, the body sometimes responds with temporary muscle soreness or an adjustment reaction. Drink plenty of water after treatment — dehydration amplifies this effect. It typically resolves within 24 hours. If the headache is unusually intense, persists, or feels different from your usual pattern, contact us or your doctor.

Q: Which doctor should I see for headaches? Your GP and neurologist are the primary contacts for diagnosis, medication, and imaging. Chiropractors treat the mechanical component — particularly for cervicogenic and tension-type headache, and as a complement for migraine. We can be seen directly without a referral and will direct you to other specialists when appropriate.

Q: Why do I get headaches when the Föhn comes? Föhn changes air pressure, humidity, and the electrical charge of the air. The trigemino-vascular system, which is involved in headache and migraine generation, responds to these environmental stimuli — especially when it's already sensitised. Chiropractic can raise the threshold by improving cervical spine biomechanics and reducing baseline tension in the system.

Q: What are the warning signs of a dangerous headache? Seek immediate medical attention for: a sudden, extreme headache described as a thunderclap, headache with fever and neck stiffness, headache with vision loss or weakness or speech difficulty, headache following head injury, or a first severe headache after age 50. These patterns may indicate serious conditions requiring urgent assessment.

Q: Are daily headaches normal? Daily headaches are not normal — they are a signal that something needs to be addressed. Chronic daily headache (more than 15 days per month) can result from medication overuse, chronic tension patterns, or an untreated mechanical cause. Have it assessed.