How Chiropractic Care May Relieve Chronic Sinus Headaches and Cervicogenic Pain
Updated: Oct 20
Sinus headaches can feel like a problem that starts in the face, but not every “sinus” headache comes from the sinuses alone. In some cases, head pain may overlap with neck-related headache patterns, especially when pain begins near the base of the skull and travels upward.
A published case report by chiropractors Chad Hagen and Barbara Mansholt describes a 50-year-old woman who sought care for constant suboccipital headaches, meaning pain at the back of the head near the upper neck. She also had a long history of allergy-related sinus headaches. After upper cervical chiropractic care, her neck-related headaches resolved, and her chronic sinus headaches unexpectedly stopped as well.
That result does not prove chiropractic care treats allergies or sinus disease. A case report follows one person, so it cannot establish cause and effect. Still, it raises a useful question: when chronic “sinus headaches” keep returning, could the neck be part of the picture?
What makes cervicogenic headaches different
A cervicogenic headache starts from a problem in the neck, even though the pain may be felt in the head. The upper cervical spine, muscles, joints, and nerves can refer pain upward into the skull, temples, forehead, or behind the eyes.
Common features may include:
Pain that begins in the neck or base of the skull
Head pain that worsens with certain neck movements or postures
Tenderness in the upper neck
Reduced neck mobility
Pain that feels one-sided or starts on one side, though patterns vary
This matters because cervicogenic headaches can resemble other headache types. Some people assume pressure in the forehead or around the eyes must be sinus-related. Others may treat recurring headaches with over-the-counter medication without looking at the neck, posture, jaw, or nervous system.
A true sinus headache is usually linked with signs of sinus inflammation or infection, such as congestion, fever, thick nasal discharge, facial tenderness, or symptoms that worsen when bending forward. Allergy symptoms can also create pressure and discomfort. Still, headache patterns can overlap, and more than one factor may be involved.
The case report in plain language
The patient in the case report was a 50-year-old woman with two main concerns.
She had constant bilateral suboccipital pain for three weeks. That means both sides of the upper neck and lower skull area hurt without relief. She had already tried stretching and massage, but the pain did not resolve.
She also had a long history of sinus headaches, about once per week for most of her adult life. She managed those symptoms with daily over-the-counter medication, including antihistamines.
Her physical exam did not show red flags. In healthcare, red flags are signs that may point to a more serious condition, such as neurological changes, infection, trauma, unexplained weight loss, or sudden severe headache. When those signs appear, referral or urgent medical evaluation may be needed.
The chiropractic approach in this report included upper cervical specific radiographs for Atlas Orthogonal biomechanical analysis. The patient was scheduled for care once per week for four weeks. Adjustments were given as indicated using Atlas Orthogonal, Thompson, and sacro-occipital technique assessments.
After three treatments, the suboccipital headaches resolved. The unexpected part was that the patient also reported her sinus headaches had stopped. She discontinued her routine antihistamine use, and her allergy symptoms did not return during the reported follow-up.
Why the upper neck may matter in head pain
The upper neck has a close relationship with headache symptoms because of shared nerve pathways. Pain signals from the top of the cervical spine can interact with pain pathways that serve parts of the head and face.
This does not mean every sinus headache is really a neck problem. It means the neck can contribute to pain that feels like it is coming from the head, face, or around the eyes.
In the case report, the patient’s main complaint was suboccipital pain, a classic area to assess when cervicogenic headache is suspected. The improvement in her sinus symptoms was unexpected, and the authors called for more research into possible upper cervical connections.
A careful reading matters here. The report supports chiropractic care as a recognized option for managing cervicogenic and tension-type headaches. It does not prove that chiropractic adjustments cure allergies, sinusitis, or chronic sinus disease.
When sinus headaches may need a broader evaluation
Recurring headaches deserve a thoughtful assessment, especially when they keep coming back despite medication. A chiropractor, primary care clinician, allergist, dentist, or physical therapist may each notice different contributors.
A broader evaluation may look at:
Neck mobility and tenderness
Headache timing and triggers
Sinus and allergy symptoms
Jaw clenching or temporomandibular joint irritation
Sleep quality and pillow support
Medication use and rebound headache risk
Neurological signs or symptoms
Seek urgent care for a sudden “worst headache,” headache after trauma, fever with stiff neck, weakness, confusion, vision changes, or a new headache pattern that feels unusual.
For non-urgent chronic headaches, tracking symptoms can help. Write down where the pain starts, where it moves, what it feels like, how long it lasts, and what helps or worsens it. Patterns often become clearer on paper.
What this case suggests, and what it does not
This case is interesting because the patient improved in two areas: the cervicogenic-type suboccipital headaches and the long-standing sinus headache pattern. The timing suggests chiropractic care may have played a role, but one case cannot rule out other explanations.
Symptoms may change because of natural variation, reduced medication use, seasonal changes, placebo effects, improved movement, lower nervous system irritation, or other factors. That is why larger studies are needed.
The practical takeaway is still useful. If chronic sinus headaches keep returning, especially with neck pain at the base of the skull, it may be reasonable to ask whether cervicogenic pain is involved. A clinician who understands headache patterns can screen for red flags, assess the neck, and help decide whether conservative care is appropriate.
Chiropractic care may be one part of that plan. For some people, care may also include medical evaluation, allergy management, hydration, sleep changes, ergonomic changes, exercise, or physical therapy.
This article is for informational purposes only and does not replace medical advice, diagnosis, or treatment. Persistent or changing headaches should be evaluated by a qualified healthcare professional.
A simple takeaway
Chronic sinus headaches are not always simple. When facial pressure, head pain, and upper neck pain overlap, the source may be more complex than the sinuses alone.
The case by Hagen and Mansholt shows that upper cervical chiropractic care helped one patient recover from suboccipital cervicogenic headaches, with an unexpected stop in her long-term sinus headache symptoms. The result is promising, but it should be viewed as a starting point for further research, not a guarantee.
For people with recurring headaches and neck pain, the best next step is a careful evaluation that looks beyond labels and follows the symptoms.
Citation
Hagen C, Mansholt B. Unexpected resolution of chronic sinus headaches following chiropractic care for cervicogenic headaches: A case report. Case report on chiropractic management of suboccipital headaches with concurrent chronic allergy-induced sinusitis.
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