Dr. David Kulla, DC provides individualized evaluation and conservative care for patients with headaches, neck pain, and musculoskeletal conditions that may contribute to certain types of head pain at Synergy Wellness Chiropractic & Physical Therapy in New York City.
With more than 26 years of clinical experience, Dr. Kulla evaluates the cervical spine, upper back, posture, mobility, muscle function, neurological findings, and headache history to determine whether a mechanical neck condition may be contributing to a patient’s symptoms.
Our Manhattan office is located at 237 First Avenue near East 14th Street, convenient to Union Square, the East Village, and Gramercy.
What Causes Headaches?
Headaches are not all the same. There are many different primary and secondary headache disorders, and identifying the type of headache is important before deciding on treatment.
Common headache categories include:
- Migraine
- Tension-type headache
- Cervicogenic headache
- Cluster headache
- Headache associated with medication use
- Headache related to infection, trauma, vascular conditions, or other medical disorders
Some headaches originate primarily within the nervous system, while others are secondary to another condition involving the neck, blood vessels, infection, trauma, or other structures.
Migraine Is Different From a Neck-Related Headache
Migraine is a neurological disorder that can cause moderate to severe headache along with symptoms such as nausea, sensitivity to light or sound, visual disturbances, and other neurological symptoms.
Neck pain and stiffness are very common in people with migraine and may occur as part of the migraine attack itself. This means that having neck pain during a migraine does not automatically mean that a spinal problem caused the migraine.
Patients with suspected migraine should be appropriately evaluated, and medical treatment or consultation with a primary-care physician, neurologist, or headache specialist may be appropriate.
What Is a Cervicogenic Headache?
A cervicogenic headache is a secondary headache in which pain is referred from structures in the cervical spine or surrounding tissues to the head.
Symptoms may include:
- Head pain associated with neck pain or stiffness
- Reduced cervical range of motion
- Headache aggravated by certain neck movements
- Pain that begins in the neck or back of the head and travels forward
- Predominantly one-sided head pain in some patients
- Tenderness or restricted movement in the upper cervical region
Cervicogenic headache can sometimes resemble migraine, which is why a careful history and examination are important.
How Are Headaches Evaluated?
Dr. David Kulla, DC evaluates headache patients for musculoskeletal and neurological findings that may indicate whether the cervical spine or surrounding structures are contributing to their symptoms.
An evaluation may include:
- Detailed headache and medical history
- Review of headache frequency, duration, and triggers
- Cervical range-of-motion testing
- Posture and movement assessment
- Orthopedic examination
- Neurological testing
- Evaluation of the upper cervical spine and thoracic spine
- Assessment of shoulder and surrounding muscle function
- Review of previous MRI, CT, or X-ray studies when available
Not every headache requires imaging. When headache characteristics or examination findings suggest a possible secondary cause, additional medical evaluation or diagnostic imaging may be necessary.
Neck Pain and Headaches
Some patients with headaches also have significant neck pain, restricted cervical movement, previous whiplash, muscle tension, or mechanical dysfunction in the upper cervical region.
When examination findings suggest that these structures are contributing to a cervicogenic headache, treatment may focus on improving cervical and thoracic mobility, muscular function, posture, and movement.
This is different from assuming that every migraine originates from the neck.
Chiropractic Care for Cervicogenic Headache
Chiropractic care may be one conservative option for appropriately diagnosed cervicogenic headache and mechanical neck pain.
Depending on the patient’s findings, treatment may include:
- Gentle cervical or thoracic mobilization
- Spinal manipulation when appropriate
- Soft-tissue treatment
- Postural and ergonomic recommendations
- Therapeutic exercise
- Neck and upper-back mobility work
- Strengthening and stabilization exercises
Treatment is individualized. Not every headache patient requires cervical manipulation, and alternative lower-force approaches may be used depending on the patient’s history, comfort, diagnosis, and examination findings.
Physical Therapy and Exercise for Headache-Related Neck Pain
Physical therapy and therapeutic exercise may be useful when headache symptoms coexist with cervical stiffness, muscular dysfunction, reduced endurance, or movement limitations.
A rehabilitation program may include cervical and thoracic mobility, shoulder-blade control, postural endurance, strengthening, ergonomic modifications, and gradual return to normal activity.
What Chiropractic Care Does Not Treat
Chiropractic treatment should not be presented as a cure for every headache disorder or migraine.
Patients with primary migraine may benefit from medical treatments such as acute migraine medications, preventive therapy, lifestyle modification, or consultation with a headache specialist. Chiropractic or physical therapy may sometimes be used alongside medical management when significant neck or musculoskeletal symptoms are also present.
When a Headache Requires Prompt Medical Attention
Some headache symptoms require urgent medical evaluation rather than routine musculoskeletal treatment.
Seek prompt medical attention for:
- A sudden, extremely severe or “thunderclap” headache
- A new headache with weakness, numbness, difficulty speaking, or significant visual changes
- Headache following significant head or neck trauma
- New headache accompanied by fever or systemic illness
- A rapidly worsening or substantially different headache pattern
- New headache beginning after age 50
- Headache associated with loss of consciousness or severe confusion
- New headache during pregnancy or shortly after delivery
- Severe headache associated with significant neck pain and new neurological symptoms
Headache and Migraine Videos
These videos from Dr. David Kulla and Synergy Wellness discuss headaches, neck-related symptoms, and conservative musculoskeletal care.
Schedule a Headache and Neck Pain Evaluation in NYC
If you experience recurring headaches together with neck pain, stiffness, limited cervical motion, or a history of neck injury, Dr. David Kulla, DC can evaluate whether musculoskeletal factors may be contributing to your symptoms.
If your symptoms are more consistent with migraine or another primary headache disorder, medical or neurological evaluation may also be recommended.
Synergy Wellness Chiropractic & Physical Therapy
237 First Avenue, 5th Floor
New York, NY 10003
Near East 14th Street in Manhattan
Call (212) 533-4900 or book an appointment online.