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What we help with

Neck-related and tension-type headaches

A neck-related (cervicogenic) headache starts in the neck; a tension-type headache feels like pressure or tightening on both sides of the head. Guidelines recommend spinal manipulation for the first, and mobilization, soft-tissue work and exercise for the second; studies show small improvements. This care sits alongside our neck pain care, and guidelines say it should begin by screening for warning signs.

What is a neck-related headache, and how is it different from a tension-type headache?

A neck-related (cervicogenic) headache is one that starts in the neck, while a tension-type headache is felt as pain or pressure on both sides of the head, face or neck.

Which headaches does this page cover?

Only neck-related and tension-type headaches; any other kind of headache needs a medical diagnosis first.

If your headaches do not match either pattern, or their pattern changes, start with your medical doctor.

Which headache warning signs need urgent medical care?

Get emergency care for a sudden, severe headache, or a headache with fever, confusion, weakness, numbness, or trouble speaking or seeing.

How does Dr. LeGault care for headaches?

Headache care here pairs hands-on treatment of the neck and upper back with exercises, and the plan is reviewed with you as it goes.

Exercise is built in: Dr. LeGault teaches neck and posture exercises in the office, sends them home in the Physitrack app or on paper, and progresses them over your visits.

What do guidelines support for neck-related headaches?

Guidelines support spinal manipulation and mobilization for neck-related headaches, with exercise, and studies show small improvements.

For this type of headache Dr. LeGault offers spinal adjustments and mobilization of the neck and upper back, by hand or on a drop table.

What do guidelines support for tension-type headaches?

For tension-type headaches, guidelines favor mobilization, soft-tissue techniques and specific exercises, with manipulation used only inside that combined care.

Dr. LeGault, a Graston Technique provider, may include soft-tissue work with Graston instruments on the muscles of the neck and upper back.

What happens at a headache visit?

Guidelines say headache care should begin with a thorough history, including screening for warning signs, and an examination of the neck and head.

At LeGault Chiropractic the first visit opens with a detailed health history and a discussion of your headaches, then a physical examination, with orthopedic and neurological testing if appropriate. If chiropractic care is appropriate, treatment may begin the same day.

When X-rays are clinically appropriate, they are taken off-site. You can book without a referral, and nobody signs a long-term contract.

A few notes on when your headaches start, how long they last and what sets them off make the first conversation easier. For booking and paperwork, see what to expect at your first visit.

Are neck adjustments for headaches safe?

Serious problems after neck adjustments are rare, while brief soreness or a mild treatment-related headache is common.

When can I see Dr. LeGault for headaches, and is my plan accepted?

Dr. Steven K. LeGault, DC sees headache patients on the days listed below, and the practice accepts the plans listed; coverage depends on your plan.

Hours by day
DayDr. LeGault
Monday8:00 AM – 6:00 PM
Tuesday2:00 PM – 6:00 PM
Wednesday8:00 AM – 6:00 PM
Thursdaynot stated
Fridaynot stated
Saturday8:00 AM – 12:00 PM
  • UPMC
  • Highmark
  • Aetna
  • UnitedHealthcare
  • Other Blue Cross Blue Shield plans
  • Medicare (participating provider)
  • Pennsylvania auto insurance (first-party medical benefits (PIP), billed directly)
  • Workers’ compensation

Coverage depends on your plan.

We can verify and check your benefits before your first visit, or you can check with your insurer directly. For self-pay options, call 412-364-4100.

Questions, answered

How many visits are usual for headaches?

There is no fixed number and no long-term contract. For neck-related headaches lasting more than three months, the OPTIMa guideline describes manual therapy of up to 10 sessions over six weeks, and the 2026 guideline suggests a referral if headaches have not responded well enough after about four weeks.

Will exercises be part of my headache care?

Yes. Guidelines include exercise for both types: specific low-load neck and shoulder-blade exercises for tension-type headaches, and supervised movement exercises for neck-related headaches that started in the last six weeks.

Can I come in for headaches after a car accident?

Yes, once a medical check has ruled out a head injury: a head injury in the last three months is one of the warning signs above. Car-accident care is billed to auto insurance.

I take painkillers for my headaches most days. Is that a problem?

It can be. Taking painkillers for headaches too often can itself cause headaches, so talk to your medical doctor or pharmacist about it. We do not advise starting, stopping or changing medicines.

Dr. Steven K. LeGault sees patients on Monday, Tuesday, Wednesday and Saturdayhow to find our office off McKnight Roadinsurance plans we acceptcoverage depends on your planJust off McKnight Road, on-site parking

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References

  1. NHS (England). Tension headaches. nhs.uk Health A to Z; page last reviewed August 1, 2025. (opens another site)

    What a tension headache feels like, common triggers, and headaches from taking painkillers too often.

  2. Blanpied PR, Gross AR, Elliott JM, et al. Neck pain: revision 2017. Journal of Orthopaedic & Sports Physical Therapy. 2017;47(7):A1–A83. (opens another site)

    Neck pain with headache: manipulation and mobilization at 6 to 12 weeks, combined with exercise beyond 12 weeks, movement exercises under 6 weeks (Grade B).

  3. OPTIMa headache guideline (2019): Côté P, Yu H, Shearer HM, et al. Non-pharmacological management of persistent headaches associated with neck pain. European Journal of Pain. 2019;23(6):1051–1070. (opens another site)

    Manual therapy may be considered for neck-related headaches over three months; exercises and combined care for tension-type; benefits small at most.

  4. National Institute for Health and Care Excellence (NICE). Headaches in over 12s: diagnosis and management. Clinical guideline CG150; last updated June 3, 2025. (opens another site)

    Headache features that need medical evaluation, and headaches linked to frequent painkiller use.

  5. 2026 chiropractic headache guideline: Trager RJ, Daniels CJ, Hawk C, et al. Chiropractic management of adults with cervicogenic or tension-type headaches: development of a clinical practice guideline. Journal of Integrative and Complementary Medicine. 2026;32(4):325–344. (opens another site)

    Written for chiropractors: manipulation for cervicogenic headache; mobilization and soft-tissue techniques for tension-type; history and screening first; imaging only when indicated.

  6. 2022 meta-analysis on cervicogenic headache: Bini P, Hohenschurz-Schmidt D, Masullo V, et al. The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache. Chiropractic & Manual Therapies. 2022;30:49. (opens another site)

    Small reductions in intensity and frequency in the two most reliable trials; most trials at high risk of bias; side effects rarely tracked.

  7. Ceballos-Laita L, Ernst E, Carrasco-Uribarren A, et al. European Journal of Integrative Medicine. 2025;76:102462 (systematic review of eight randomized trials). (opens another site)

    Eight trials; very low certainty; uncertain whether chiropractic spinal manipulation beats sham or comparison treatments for headaches.

  8. Swait G, Finch R. What are the risks of manual treatment of the spine? A scoping review for clinicians. Chiropractic & Manual Therapies. 2017;25:37. (opens another site)

    Mild, short-lived reactions are common; serious complications are rare.

  9. Biller J, Sacco RL, Albuquerque FC, et al. Cervical arterial dissections and association with cervical manipulative therapy: a statement from the American Heart Association/American Stroke Association. Stroke. 2014;45(10):3155–3174. (opens another site)

    Association in younger patients; causation not established; rate probably low.

  10. Rushton A, Carlesso LC, Flynn T, et al. International framework for examination of the cervical region for potential of vascular pathologies of the neck prior to musculoskeletal intervention (IFOMPT). Journal of Orthopaedic & Sports Physical Therapy. 2023;53(1):7–22. (opens another site)

    Serious blood-vessel incidents are extremely rare; screen for warning symptoms and risk factors before neck treatment.