Why Your Neck (and Upper Back) Might Be Giving You a Headache

If you’ve ever had a headache that just wouldn’t quit, you might have blamed stress, dehydration, or “that one extra cup of coffee.” But here’s the twist — the real troublemaker could be hanging out much lower: your neck and thoracic spine.

Yes, the upper part of your spine (the part between your shoulder blades) and the delicate stack of bones in your neck can cause — or at least contribute to — many types of headaches. And once you understand how it works, you’ll never think of “just a headache” the same way again.

The Anatomy Behind the Ache

Your neck (cervical spine) and upper back (thoracic spine) are like a busy train station for your nervous system.

• Nerves from your neck connect directly to areas in your head and face.

• Muscles from your neck and shoulders attach to the base of your skull, where a lot of headaches are born.

• Joints in your thoracic spine influence posture, which changes the way your neck has to work.

• Vertebrae in the neck can be out of alignment or stiff, causing increased muscle tightness.

  
  

When something is tight, weak, or misaligned in this region, it can set-off a chain reaction: poor movement → nerve irritation → muscle tension → headache.

The “Neck Connection” to Headaches

There’s a specific headache type called a cervicogenic headache. This isn’t a “true” migraine — instead, pain starts in the neck and radiates into the head. You might feel:

• One-sided head pain

• Pain that starts at the base of your skull and moves forward

• Pain triggered by certain neck positions or prolonged posture (hello computers and phones!)

• Headache pain that increases with head turning

Muscles like the sub-occipitals (tiny muscles at the base of your skull) and the upper trapezius (the top of the shoulder muscle) can tighten up and compress nerves, sending pain upward.

The Thoracic Twist: How Your Upper Back Gets Involved

Your thoracic spine acts like a foundation for your neck. When your upper back is stiff, out of alignment, or your posture slumps forward, your neck has to crane forward to keep your eyes level with the horizon. This “forward head posture” puts extra load on the neck muscles and joints - especially the sub-occipital muscles. Over time, tension builds up and pain radiates into the head. It’s like stacking bowling balls on top of a leaning tower — the base can’t support the load, so the structure starts to complain.

The Takeaway

Your head might be where the pain shows up — but your neck and thoracic spine are often the ones stirring the pot. By improving posture, mobility, and strength in this area, you can reduce the frequency and intensity of headaches (and maybe even ditch the pain meds).