Neck Pain and Headaches: Why Pain at the Base of Your Skull Often Starts in Your Neck

By Francesca Allison-Lewis, MChiro · Chiropractor, Maidenhead Chiropractic Clinic · Published 25 August 2026

A headache does not always start in the head.

Sometimes it starts with a stiff neck. A tight feeling at the base of the skull. A dull ache that creeps upwards. Pain that sits on one side, or seems worse after a long day at a screen.

If that sounds familiar, your neck may be part of the picture.

This does not mean every headache is a neck problem. It does not mean chiropractic care is the right answer for everyone. Headaches can have many causes, and some need medical assessment.

But there is a recognised type of headache that can arise from the neck, often called a cervicogenic headache. Most patients do not search for that word. They search for “neck pain and headache”, or “pain at the base of my skull”.

That is what this article explains.

What the pattern can feel like. Why desk work can make it worse. When to seek medical help. And how a chiropractor in Maidenhead may assess whether your neck is contributing to your symptoms.

Can neck pain cause headaches?

Yes. Neck pain can be linked with headaches, especially when the pain starts at the base of the skull and travels upwards. This is sometimes called headache arising from the neck, or cervicogenic headache. An assessment is needed because not all headaches are caused by the neck.

The upper neck has joints, muscles and nerves that can refer pain into the head. That is why some people feel the problem as a headache, even though the irritation may be coming from the neck.

This often feels different from a simple tension headache.

Patients commonly describe it as a deep ache at the base of the skull, sometimes travelling into the back or side of the head. It may feel worse after sitting at a screen, driving, sleeping awkwardly or holding one position for too long.

Some people also notice reduced neck movement. Turning to check a blind spot may feel stiff. Looking down at a laptop or phone may bring symptoms on.

The key point is this.

A recurring headache with neck stiffness is worth assessing properly. You should not have to guess whether the neck is involved.

What does a headache from the neck feel like?

A headache linked to the neck often starts at the base of the skull and may spread upwards into the back, side or front of the head. It can be one-sided and may come with neck stiffness or reduced movement. It often feels worse after long periods in one position.

The pattern matters.

Many people describe pain that starts where the skull meets the neck. It may sit like a tight band at the back of the head. It may travel towards the temple or behind the eye. Sometimes it stays mostly on one side.

One-sided pain can worry people, especially if it is new. It is one reason an assessment is important.

A neck-related headache may also be linked with certain movements or positions. For example:

• sitting at a desk for several hours
• looking down at a laptop
• driving for a long time
• sleeping with the neck turned
• stress that leads to shoulder and neck tension

That does not prove the neck is the cause. It simply gives useful clues.

A chiropractor will look at how your neck moves, where it feels restricted, what brings the symptoms on and whether anything suggests you should be referred elsewhere.

How is this different from migraine?

Migraine is different from headache arising from the neck. Migraine may include nausea, light sensitivity, visual changes or severe throbbing pain. Neck pain can happen with migraine too, so the two can overlap. If your headache pattern changes, becomes severe, or comes with worrying symptoms, seek medical advice.

This is where people can get confused.

Neck pain and migraine can appear together. Some people with migraine also feel neck stiffness before or during an attack. That does not automatically mean the neck caused the migraine.

A neck-related headache is usually assessed by looking at the full pattern. Where does the pain start? What movements affect it? Is the neck stiff? Are there neurological symptoms? Has the headache changed recently?

At Maidenhead Chiropractic Clinic, we do not diagnose every headache as a neck problem. That would not be safe or accurate.

We assess first. If your symptoms suggest you need medical care, we will tell you.

Can desk work cause neck pain and headaches?

Long periods at a screen can contribute to neck pain and headaches, especially when your screen is too low, your shoulders are tense, or you stay in one position for too long. HSE guidance advises short, frequent breaks, for example 5 to 10 minutes every hour.

Desk work is not dangerous in itself.

The problem is staying still for too long, especially with the head tilted forwards and the shoulders held tight. Over time, the muscles at the base of the skull can become irritated. The upper neck joints may also feel stiff.

Small changes can help.

Try this simple desk check.

1. Raise your screen

Your eyes should be roughly level with the top of the screen. If your screen is too low, your head tends to drop forwards.

2. Keep your forearms supported

Your forearms should be approximately horizontal. This helps reduce strain through the shoulders and neck.

3. Bring the keyboard and mouse closer

You should not have to reach forwards to type or click.

4. Sit back into the chair

Let the chair support you. Perching on the edge often leads to tension through the back and neck.

5. Break up long spells at the screen

Short, frequent breaks are better than long, occasional ones. HSE gives the example of 5 to 10 minutes every hour being better than 20 minutes every 2 hours.

6. Move your neck gently through the day

You do not need a complicated routine. Turn your head, roll your shoulders, stand up, walk around and change position.

The aim is not perfect posture.

The aim is variety.

Your body is designed to move. It is not designed to sit like a statue until 5pm.

What movement helps when your neck feels stiff?

Gentle movement can help many people with simple neck stiffness. Start with easy, comfortable movements rather than forcing a stretch. If movement causes sharp pain, symptoms into the arm, dizziness, or worsening headache, stop and seek advice.

Keep it simple.

A stiff neck often responds better to gentle movement than to aggressive stretching. You are not trying to win a flexibility contest. You are trying to remind the area that it is allowed to move.

Try small, comfortable movements:

• slowly turn your head left and right
• look gently up and down
• roll your shoulders backwards
• stand up and walk for a minute
• change position before the neck starts to ache

Do not force through sharp pain.

Heat or ice can help settle symptoms too. NHS inform suggests using either on the neck, always with a barrier such as a towel — never directly on the skin — and leaving a few hours between treatments.

Stop if you notice increased redness, discolouration or blistering of the skin.

If symptoms travel into your arm, or you notice pins and needles, weakness, dizziness or a sudden worsening headache, get advice before carrying on.

When should you get medical help for neck pain and headaches?

Seek urgent medical help if your headache is sudden and severe, follows a significant injury, or comes with weakness, confusion, fever, vision changes, fainting, chest pain, or symptoms down both arms or legs. See a GP if symptoms are persistent, worsening, or linked with pins and needles or a cold arm.

Most neck pain and headaches are not caused by anything serious.

But some symptoms need medical attention first.

You should also speak to your GP if your neck pain is persistent, getting worse, or comes with pins and needles, weakness or a cold arm.

NHS inform advises speaking to your GP urgently if your neck pain comes with a severe headache, if you notice clumsiness in your hands, numbness, pins and needles or worsening weakness in one or both arms, or if you have had problems with balance or walking since the neck pain started. Contact your GP if you develop blurred vision, ringing in your ears or dizziness, or if the neck pain started while you were unwell with another condition.

A good chiropractor will ask safety questions before treatment. If your symptoms do not look suitable for chiropractic care, you should be referred to the right place.

That is part of doing the job properly.

What does a chiropractor look at?

A chiropractor assesses how your neck, upper back and shoulders move, and whether the joints or muscles may be contributing to your symptoms. They also check for signs that your headache needs medical assessment instead. Treatment is only offered if it is appropriate.

At Maidenhead Chiropractic Clinic, the first step is always listening.

We ask about your symptoms, when they started, what makes them better or worse, and whether anything has changed. We also ask about your work, sleep, exercise, previous injuries and general health. You can read more about what happens at your first appointment.

Then we examine how your neck and upper back move. We may assess the joints, muscles and nerves around the area.

If chiropractic care is appropriate, treatment may include gentle hands-on techniques, advice on movement, and practical guidance for work or home. You can see the full range of conditions we treat.

The aim is to understand why your neck keeps becoming irritated, not just to chase the headache each time it appears.

We use gentle techniques and adapt care to the person in front of us. If you are nervous about treatment, please say so. It helps us look after you properly.

You may also find our guide on chiropractor or physiotherapist for lower back pain useful if you are deciding which profession is the best fit for you.

What if the problem is your desk setup?

If your symptoms are worse at work, your setup may be part of the problem.

That does not mean your chair is “bad” or that you need to buy a new desk tomorrow. Often, the answer is smaller than that.

Screen height. Breaks. Keyboard position. How long you sit without moving.

For local employers, Maidenhead Chiropractic Clinic also offers Office Health Screens. These are workplace talks and screening sessions designed to help staff understand posture, movement and when to seek help.

They are not a diagnosis and they do not promise outcomes. They are simply a practical way to support better habits at work.

Frequently asked questions

Why is the pain at the base of my skull only on one side?

One-sided pain at the base of the skull is common and, on its own, is not usually a cause for alarm. The joints and muscles at the top of the neck sit in pairs, one on each side, and it is normal for one side to become more irritated than the other — particularly if you tend to turn one way at a desk, sleep on one side, or carry a bag on one shoulder.

One-sidedness is also a recognised feature of headache arising from the neck, which is why it is worth mentioning at an assessment rather than ignoring.

If the pain is new and severe, or comes with any of the symptoms listed above, seek medical advice first.

Why do I wake up with neck pain at the base of my skull?

Waking with a stiff, sore neck usually points to position rather than damage. Sleeping with the neck turned or propped at an angle holds those upper neck joints and muscles in one position for hours, which is the same sustained loading that a long day at a screen produces — just overnight.

The NHS suggests keeping your head at the same height as the rest of your body, using a low, firm pillow, and avoiding sleeping on your front.

If you wake with it most mornings, or it is not settling within a few weeks, it is worth having the neck looked at rather than working through another pillow.

Can neck pain cause dizziness?

Neck pain and dizziness do sometimes occur together, but dizziness has many possible causes — inner ear problems, blood pressure, medication and others — and several of them need medical assessment rather than manual therapy.

Do not assume your neck is responsible. Tell your GP about it, and tell any chiropractor or physiotherapist you see before they treat you, because it changes how they assess and what they do.

Dizziness that comes on suddenly, or with visual changes, weakness, difficulty speaking or a severe headache, needs urgent medical attention.

Can stress cause neck pain and headaches?

Stress does not directly cause a neck problem, but it changes how you hold yourself. People under pressure tend to raise the shoulders, clench the jaw, breathe more shallowly and stay still at a desk for longer without noticing.

That adds up to more of the sustained, unvaried loading that irritates the upper neck in the first place.

It is one reason movement breaks are worth protecting on the busiest days, which are exactly the days most people skip them.

How long should neck pain and headaches last before I get them checked?

NHS inform advises that in many cases a new neck problem, or a flare-up of a longstanding one, should begin to settle within 8 weeks without needing to see a healthcare professional — and that if yours has not improved within 8 weeks of following self-help advice, it is worth talking to someone about your symptoms. That is the benchmark. It is not a rule.

A useful practical marker: if it keeps returning every working week, if it disturbs your sleep, or if the headaches are becoming a regular fixture rather than an occasional one, it is worth an assessment rather than another few weeks of guessing.

Can a chiropractor help with headaches?

UK chiropractors are permitted to offer care for headache arising from the neck — that is, headache where the neck is the source. They do not treat headaches in general, and no responsible chiropractor will tell you they do.

The honest answer is that it depends entirely on what is causing your headaches, which is what an assessment is for. If your pattern does not suggest the neck, you should be told so and pointed somewhere more useful.

That is exactly what the £20 Spinal Screen below is for.

Not sure whether your neck is involved?

If you keep getting headaches with neck stiffness, it is reasonable to ask whether the neck is part of the problem.

You do not have to work it out alone.

Maidenhead Chiropractic Clinic offers a £20 Spinal Screen. This is a short, informal appointment with a chiropractor. It gives you the chance to talk through your symptoms, have your neck and spine looked at, and find out whether chiropractic care may be suitable.

If we think you need to see your GP, a physiotherapist or another healthcare professional, we will say so.

If you would rather book a full assessment, a new patient consultation is £75. This includes a full case history, examination and diagnosis.

You can book online through our PracticeHub booking page, or call 01628 879580.

We are based at Castle Royle, Knowl Hill, just minutes from Maidenhead. There is free parking, and we are open seven days a week, including evenings and weekends.

Open seven days a week, including evenings and weekends.