One of the common effects that can happen after a chiropractic neck adjustment is a headache. While it is not always fun, the headache by itself is NOT always a negative thing, but may actually be a sign of healing. The key is being able to tell the difference.
In this article, we will shed the light on a few of the important things to consider whether a headache following a chiropractic neck adjustment is a positive sign of change or a negative sign that something isn’t quite right.
#1 - What are the chances of getting a headache after a chiropractic neck adjustment?
By downloading the ChiroWebMD mobile app you can better control your patient portal.
Based on the research, around 30% of people will experience a headache in the 24-48 hours following a chiropractic neck adjustment. Sometimes the headache can actually be a strong migraine or may involve a bit of nausea, vertigo, or sore muscles as well along the neck of the neck and shoulders. Sometimes the discomfort can go on for around 3-6 weeks but is much less common.
We sometimes use the analogy of “Opening Pandora’s Box.” When a person NEEDS to go through a healing process, sometimes once that process is begun the body needs to go through a bit of deconstruction and reconstruction in the process. We don’t like it, but we have to respect and work with it. The principal reason is the change in blood flow, muscle tension, and nerve activity.
Now, a certain very small percent of the population (estimated 0.00002%) may have a preexisting condition that may be associated with a serious injury. However, the odds of serious injury IF the chiropractor has performed a series of tests in order to determine what the most appropriate procedure is BEFORE doing the neck adjustment go down significantly. So the question is, how do you know the difference if a headache after a chiropractic neck adjustment is serious or not?
#2 - How do you know the difference if a headache after a chiropractic neck adjustment is serious?
It breaks down to your test results. First, your chiropractor should perform some type of objective test to know that you need a neck adjustment in the first place, and also some type of testing thereafter in order to tell if the right adjustment was given. Now, even then you can still get a headache even with the right adjustment (more on that later), but the first part is knowing how your body responds after that neck adjustment. Did your tests improve or not?
If the answer is no, then something may be amiss. But if the answer is yes, even if it is a very strong headache, then it is frequently something that your body simply has to work through. It is is ever most severe - namely, if a person who has never experienced a migraine or vertigo in their life before suddenly experiences these types of symptoms - then worst case, a CT scan of the brain may help to rule-in or rule-out pathology. Again, this is exceptionally rare and seldom ever comes to that. Now, if people DO have a history of migraine or vertigo, or other neurological symptoms, then it is actually quite a different story.
#3 - What if you have a history of headaches, vertigo, or other symptoms and they feel worse after a chiropractic neck adjustment?
Again, it is important to do some type of testing in order to know if your body is responding favorably post-adjustment. If not, your chiropractor may need to modify your adjustment. If yes (that is your findings improved), then it may well be part of the healing process. The connective tissue that lines the inside of your spinal canal in your upper neck has the exact same nerve and blood supply as the tissue around your brain. If you have ever experienced a hangover, your know how awful you feel. Well, if there is a sudden change in the mechanical tension of this tissue following an adjustment, it is possible that you can start to experience detox symptoms as your body produces change.
When this happens, it is possible that you may re-experience old symptoms including vertigo, migraines, headaches, or other problems. This type of response is sometimes known as a healing crisis. Now, we repeat that it is imperative that your chiropractor perform a series of tests in order to tell the difference between a healing crisis as a sign of forwarding progress (even through it doesn’t feel like it) and a headache as a sign of backward progress.
As you have probably figured by now, we are adamant that testing is the key to knowing the difference. We do not advocate for any chiropractor or other health or medical care practitioner to ever prescribe or perform a procedure without doing some type of testing first in order to determine what is most likely appropriate. That said, there may still be times when people’s bodies respond in unsuspected ways that any doctor, as a human being first, doesn’t like to see (e.g., unknown allergies or reactions to certain medications if you’ve never taken them before, triggering an old compensation that the body itself actually requires so that your symptoms aren’t actually more severe).
This is part of the risk-reward assessment that goes into any healthcare decision. Ultimately, it is the innate wisdom in your own body that determines the timing and sequence of any healing. So, if/when you may experience a headache after a neck adjustment, there may be other things that are necessary for you to do as well.
#4 - What other things can be associated with a headache after a chiropractic neck adjustment?
One of the interesting observations that we have made over time is that when we have a personal experience of a headache after a neck adjustment (even as light as we perform and without twisting, cracking, or spinal manipulation) and even when their post-adjustment tests do improve when they experience a headache there are also memories or old emotions that come up to the surface.
Although the exact explanation is still unknown, it has long been recognised that memory and trauma can be stored at a cellular level in the body. Thus, when a change such as a neck adjustment is performed, the body has the opportunity to finally heal from these old traumas. However, what it often means is that there is a period where those old symptoms can return (again, a healing crisis) so that the body is able to heal the right way when it may not have been able to do so before.
Again, it is very important to keep a close eye on your condition if you are experiencing a headache or other symptoms if your body is retracing towards health. Nevertheless, if this happens, as unpleasant as the headache or other symptoms may be, on the other side of it, people find that they are much stronger and healthier than before, like a weight has been lifted from their entire being.
#5 - How can you minimise the chances of experiencing a headache after a chiropractic neck adjustment?
There are many different styles of chiropractic adjustments, stretches, exercises, or spinal manipulations. Foremost in our mind is finding out what type of procedure is most appropriate for you - the individual - because what works for one person does not work for others. Especially when working with the top two vertebrae in the neck, there are 360 degrees of possible combinations that each of these vertebrae can potentially lock up and need to be released. Thus, it is important to determine what is the right combination for you.
The types of tests that we perform in our own practice first involve a series of structural, movement, and neurological tests to determine first if you do actually have a problem with the alignment of your neck that requires investigation. If so, we also perform a series of specific diagnostic images that show the exact location, direction, and degree of misalignment in your neck so that we can be most precise with our treatment and minimise the chances of triggering a headache or other symptoms.
Moreover, we also pay attention to what is called mechanical congruence. In brief, it is the idea that any procedure should be performed in a way that does not agitate any of the surrounding muscles, ligaments, or nerves. Thus, the method that we use (known as the Blair Upper Cervical Technique) does not actually use ANY spinal manipulation, twisting, or cracking as many procedures do. And because we go the effort of discovering the exact degree of misalignment, we need only use a very slight amount of external force (similar to clicking a pen), which helps to reseat the position of the vertebrae in the neck in the gentlest way possible.
Yes, even then people can still develop headaches, especially if their nerve system is very sensitive or if they have experienced a lot go troubles over a long period of time. Hence, we perform these tests for all of our patients on every office visit (except x-rays) so that we can measure their progress and better understand what their body is doing, whether any symptoms such as headaches are a normal part of the process, or is we need to modify our care strategies at any time.
Admittedly, no one in medical or healthcare has it all figured out (and anyone who says they do is either a miracle healer or an idiot). We don’t either. Nevertheless, by following a precise series of protocols to minimise the chance of aggravation while simultaneously maximising our chance of success, it is our aim to help people restore their health and wellbeing naturally so that they can enjoy the things in life that matter most to them.
Eriksen K, Rochester BP, Hurwitz EL. Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction Associated with Upper Cervical Chiropractic Care: A Prospective, Multicenter, Cohort Study. BMC Musculoskeletal Disorders 2011, 12:219 doi:10.1186/1471-2474-12-219.
Eriksen K. Upper Cervical Subluxation Complex: a review of the chiropractic and medical literature. Lippincott, Williams, and Wilkins. Baltimore (MD). 2004.
Flanagan MF. The Downside of Upright Posture. Two Harbors Press, 2010.
Flanagan MF. The role of the craniocervical junction in craniospinal hydrodynamics and neurodegenerative conditions. Neurology Research International, 2015; Article ID 794829:
Leboeuf-Yde C, Pedersen EN, Bryner P et al. Self-reported nonmusculoskeletal responses to chiropractic intervention: a multination survey. J Manipulative Physiol Ther. 2005 Jun;28(5):294-302; discussion 365-6. https://www.ncbi.nlm.nih.gov/pubmed/15965403
Swait G, Finch R. What are the risks of manual treatment of the spine? A scoping review for clinicians. Chiropr Man Therap. 2017 Dec 7;25:37. doi: 10.1186/s12998-017-0168-5. eCollection 2017. https://www.ncbi.nlm.nih.gov/pubmed/29234493