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Most of the headaches we see in Richmond aren't coming from the head. They're coming from the neck, the jaw, or the way both get loaded all day. That's treatable — and it's what the first appointment is for.
Start here
These four patterns cover most of what walks through the door. They respond to different treatment, which is why the assessment comes before the hands.
Why it happens
The top three joints of the neck share a nerve pathway with the trigeminal nerve, which supplies sensation to the face and much of the head. When those joints stiffen, or when the muscles around them are held under load for hours, the brain can read that input as head pain. The problem is in the neck. The symptom shows up above the eye.
The jaw does the same thing. Clenching loads the temporalis and masseter, both of which refer into the temple and the ear. Patients who grind at night frequently wake with what they describe as a morning headache.
Headaches that are sudden and severe, follow a head injury, or come with fever, vision changes, weakness or confusion need medical assessment, not manual therapy. We'll tell you if that's what we're seeing.
Treatment
Which discipline you start with depends on what the assessment finds. Whichever door you come in, the findings follow you across.
Massage therapy
Work through the suboccipitals, upper trapezius, masseter and temporalis, including intra-oral technique where the jaw is driving it. Usually the fastest relief for tension-type and clench-related headaches.
Physiotherapy
Joint mobilisation at the upper cervical segments plus deep neck flexor retraining, so the neck can hold the position your day demands without recruiting the muscles that refer into your head.
Acupuncture
Needling to the scalp, neck and shoulder girdle, often paired with massage. Frequently chosen where sleep, stress and jaw clenching are all feeding the same pattern.
Book in three taps
These six list headaches, migraines or TMJ dysfunction among the things they treat most. Pick one and you land straight on their Jane booking page.
Not sure which discipline? Book with any of them. If the assessment points somewhere else, they'll move you across in-house rather than sending you back to the start.
Your first visit
We work out which of the four patterns you're dealing with, and whether more than one is contributing. That alone changes what treatment should look like.
You don't come back for the treatment. Assessment and hands-on work happen in the same appointment, and most patients notice a change in neck range before they leave.
You're told roughly how many visits this should take and what you'll do between them. If manual therapy isn't the right answer for your headaches, you're told that too.
It depends on what's driving it. True migraine is a neurological condition and manual therapy doesn't cure it — but a large share of people who describe migraines have a significant neck or jaw contribution layered on top, and treating that reduces how often the episodes fire and how long they last. Your practitioner will be straight with you about which part of your picture they can influence.
Tension-type and cervicogenic headaches often ease within one to three sessions. Longstanding patterns, jaw involvement and post-accident headaches usually take longer. You'll get an estimate after the first assessment rather than an open-ended package.
Yes. Post-whiplash headache is one of the most common things we treat under ICBC. In the first 12 weeks after a crash, ICBC pre-approves 25 physiotherapy, 25 chiropractic and 12 massage sessions. Bring your claim number and we direct bill.
Treatment of the jaw muscles from inside the mouth, with a gloved hand, to reach the pterygoids and the inner border of the masseter. It's brief, it's done with your consent at every step, and for clench-driven headaches it often reaches what external work can't.
No. Massage therapy, physiotherapy, chiropractic and acupuncture are all direct-access in British Columbia, including for ICBC claims. Some extended health plans want a referral before they reimburse, so check your own policy.
Book an assessment and find out which pattern you're actually dealing with.