What causes headache?

Whiplash has a profound effect on the brainstem and is certainly a major cause of headache.

What causes headache, and especially back of head pain, is not an easy question to answer as there are multiple precipitating factors. So this is not an exhaustive treatise on the subject. For that I would have to write a book; but here are a few pointers.

Some 80 percent of cephalgia is reckoned to be tension in nature. This is not from stress, but tightness of the meninges surrounding the spinal cord and brain. That could be related to long hours spent over the computer, or an old whiplash injury, for example.

The meninges, consisting of three layers, cover the brain and spinal cord which interestingly are really one organ. Anatomists have now discovered that the outermost covering is directly connected to one of the tiny muscles in the neck.

So anything that stretches the meninges, like whiplash, causes that muscle to spasm, and will directly give you a back of head pain.

And any force that stretches that tiny muscle has an impact directly on the brain and spinal cord. It's one of the most sensitive areas in the body.

Pick up something that weighs perhaps a kilogram, and hold it with a bent elbow for a few minutes, without moving your arm. Feel how the limb tires? Then the biceps starts to spasm.

And then your arm says to you, put the damn thing down, won't you?

This page was last updated by Dr Barrie Lewis on 19th December, 2018.

The jaw joint is another major factor in what causes headache; whether it's bruxism, or grinding of the teeth at night, or simply TMJ dysfunction, tension develops in the muscles supplying the area, especially the face and side of the head.

This is rather different to back of head pain, often radiating deep in the face, or to the eye and masquerading as migraine or sinusitis; they are all supplied by the same Trigeminal nerve. And, because its sensory nucleus is located in the upper neck, that's often where it's felt too.

What causes headache?

What causes headache is a question oft heard in the chiropractic clinic.

The suboccipital muscles are a common cause of headache.

See these tiny muscles at the top of your neck - one of them, never mind which, is directly connected to those meninges. That's exactly what they start to say when you've been sitting too long at the computer - just like mine are saying right now! - or behind the wheel of the car. It's time to move! they are trying to tell us. So move.

Back of head headache

As you are beginning to realise back of head headache, and the whole subject is remarkably complex; manipulation of the cervical spine, and the jaw joints is only part of the solution. It's tied with ergonomics, movement, posture, and so on. If you are desk bound, expect to have pain.

Cervical facet syndrome

Another very common cause is the cervical facet syndrome in the upper neck; it's the area that we chiropractors are most concerned about in answering your question, what causes headache; but it's only one part of the whole. 

You may be interested in some of the anatomy of this area if you are wondering what causes headache.

This is called an oblique Xray, showing where the nerves emerge from tiny gaps between the vertebrae called a foramen.

Two nerves, the Greater and Lesser Occipital nerves emerge from the upper foramena and supply the scalp. See if you can trace them from where they emerge from the spine, and that handsome dude will tell you where the headache is likely to be.

I've been working on this page for an hour and a half, and my suboccipital muscles are starting to tell me that if I don't take a tea break, I'm going to find out big time what one of the causes of headache is.

The causes of headache may often be located in the cervical spine; this oblique x-ray view may be useful in discovering the cause.
The greater occipital nerve is often affected by whiplash injuries causing headache.

One sided headache

The greater occipital nerve distribution shows the typical one sided headache pattern.

So you take a break too. I'll be waiting for you when your tea is made, not going anywhere, promise! I'm making mine just with some very weak black (this time, green is better scientists tell us) in a thermos of boiled drinking water, to which I'm going to add a good squeeze from a grapefruit that I've just cut. Keep it natural! The rest I'll eat for breakfast. Don't forget the pulp, that's where the flavonoids and phytosterols are found. None of that stuff from a carton!

A little diversion ...

If you're a black or green tea lover like I am, you may know (perhaps you don't) that teabag tea tastes crap, excuse the vocab, in comparison with loose tea. I always used to think it was the bag, but no. I'm treating a Lipton man right now, from the Dutch factory, and he tells me that process it in quite a different way. A crap way, sorry if you're a tea bag man or woman. It's worth the effort of dealing with the tea leaves.

So, done. Finished with my little hobby horse. Got your tea? Let's continue ...

TMJ anatomy

Could your migraine headache be emanating from the jaw joint? Perhaps a little better understanding of the TMJ anatomy might bring some clarity.

Spasms at night of the temporalis muscle from clenching the teeth is a major cause of headache.

TMJ ear pain

TMJ ear pain and back of neck headache are bedfellows. If you are questioning what causes headache, then don't forget to consider the jaw joint.

Do you get a headache just above the ear, round the jaw joint, a one sided headache, and sometimes simultaneously at the base of the neck?

Do questions about clicking, popping jaw joints or grinding teeth ring any bells?

A malfunctioning TMJ, the jaw joint, is one of the main causes of terrible migraine headache. Not every chiropractor I'm afraid will have the knowledge and expertise to treat this, but it's one of my favourite conditions. Chiropractors can and should treat every joint in the body, except those between the ossicles in the inner ear!


What causes headache is not an easy question to answer as there are multiple causes; meningitis is a rare one.

PLEASE, PLEASE, if you have a stiff neck and headache AND A FEVER don't call your chiropractor, phone your doctor. Now. And that applies to your child too, of course. And your spouse. Meningitis is a killer. I'll never forget when my best friend lost his wife at 50 odd with sudden onset of fever and headache, and she was gone in three days. And no, I wasn't the guilty party. They wisely didn't consult me.

I could go on and on. What causes headache is complex subject eyesight, brain tumours, toxemia of pregnancy, just the flu, but this page is long enough.


Oh, I nearly forgot, Twit! Is there neck pain treatment for your headaches. Of course! And an interesting What causes Headaches Casefile. Does arthritis of the neck cause headache? It can be very misleading.


The telephone, particularly if you hold it between your ear and shoulder, is a major in answering what causes headache. For just the price of a couple chiropractic consultations you can get a headset; prevention as always is better than a cure.

A pinched nerve in the neck from holding the telephone incorrectly is another cause of headache.

Chiropractic help

Chiropractic help is the place to be, in the absence of obvious medical symptoms like fever, if you are asking what causes headache, and especially if there is associated neck pain or jaw joint clicking and popping; the first stop for the patient suffering from headaches must surely be the chiropractor.

Pain ironically is your friend. Simply attempting to turn it off where there is an obvious source makes no sense whatsoever; rather get to the root of what causes headache. 

At the Chiropractic Coalface we regularly see relatively young persons with the onset of significant arthritis in the neck after trauma. Virtually always there is a history of headache. A careful and thorough examination of the cervical spine, and appropriate treatment at the time of the accident would have helped prevent a lifetime of spinal pain and cartilage deterioration. Do you have a headache?

Pain medicines

Pain medicines are another cause of headaches; whether they cause rebound headache, or because as the National Kidney Foundation reports they can damage your kidneys, you want to strictly limit them.

This accident in which a track hoe struck a bridge could certainly cause headaches.

» » What causes headache?

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

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Interesting questions from visitors

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You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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