Carrollwood · Tampa Bay
Dry Needling for Headaches in Tampa
Not every headache starts in your head. Some start in your neck and shoulders.
We see two kinds of headache most often: tension-type headache, and cervicogenic headache, which is head pain that starts in the muscles and joints of your neck. Dry needling treats the trigger points and myofascial pain in those muscles. You see Dr. Bobby Koser, DC, chiropractic physician, at every visit.
The headaches we see most often
What does a tension-type headache feel like?
Most people describe it as a dull, pressing band around the head, or a tightness across the forehead and the back of the skull. It often builds slowly over a day and tends to come with tight muscles in the neck, jaw, and shoulders. It is the most common headache type in adults. The most common exam finding with it is tenderness in the muscles of the scalp, neck, and shoulders, not a problem inside the head itself.
What is a cervicogenic headache?
A cervicogenic headache is head pain that is referred from the joints and muscles of the neck, usually starting at the base of the skull or on one side of the neck and spreading forward toward the eye or temple. It often gets worse with certain neck positions or after sitting at a desk for a long stretch, and it can mimic a migraine closely enough that the neck gets overlooked as the source.
What a muscle-referred headache feels like
Muscles in the neck and shoulders can send pain up into the head. This is called referred pain, and it happens through trigger points: tender knots within a tight band of muscle. A trigger point at the base of your skull can feel exactly like a headache behind your eye. One in your upper trapezius can send an ache up the side of your neck into your temple. Patients often point to their neck when we ask where the headache starts, once we ask the question directly.
Common patterns include a headache at the base of the skull, a headache in the back of the head that starts on one side and creeps upward, an ache that follows a tight upper trapezius or shoulder up toward the temple, or head pain that gets worse with certain neck movements or after long periods of poor posture.
How the exam finds the muscles involved
Before we needle anything, we examine the muscles and joints of your neck and shoulders by hand, looking for tenderness, tight bands, and restricted movement, and we ask where your headache starts and how it spreads. What we feel and what you describe together point to the muscles doing the work. On a Pain Source Exam, we may also take a live ultrasound look at the area, and you watch the screen with us while we explain what you’re looking at.
Your exam covers your whole presentation, headache included. Neck and shoulder involvement in a headache is common, but it isn’t automatic, and part of the exam is finding out whether it applies to you.
What dry needling does
Thin needles are placed into the muscle to treat trigger points and myofascial pain, the same technique used for neck and shoulder tension anywhere else in the body, applied to the muscles behind your headache. There is no medication on the needle or in it. Most trigger points in the neck and shoulders are treated by feel, and for most headache patients, that is this visit.
When is ultrasound guidance used, and when isn’t it?
Some of the muscles involved in a cervicogenic headache sit deeper along the neck, closer to the spine, and are harder to isolate by feel alone. For those, we use live ultrasound so we can see the needle reach the exact spot we’re treating, and so can you, on the screen. For the muscles that sit closer to the surface, like the upper trapezius and much of the neck and shoulder, treatment by feel is the usual approach. We’ll tell you which fits your case, and why, before we begin.
What the Research Shows
Cited in full, so you can check it yourself.
On chiropractic care. For cervicogenic headaches, the kind that start in the neck, a 2020 meta-analysis of seven clinical trials found that spinal manipulation, the treatment at the core of chiropractic care, reduced headache pain, frequency, and related disability in the weeks after care.1 Long-term benefit has not yet been shown. Many headache patients here receive an adjustment and dry needling at the same visit, because the exam usually finds both a joint component and a muscle component.
On dry needling. A 2021 systematic review and meta-analysis pooled 11 clinical trials of dry needling for headache. For tension-type and cervicogenic headaches, dry needling improved headache-related disability more than the comparison treatments, and short-term pain relief was similar to other care.2 Two caveats: most of the trials were small, and the authors called for more high-quality research. One more, and it matters: the same analysis found no significant effect for migraine, so we do not offer dry needling as a migraine treatment. If migraine is your diagnosis, the acupuncture research below is the relevant lane.
1. Fernandez M, Moore C, Tan J, et al. Spinal manipulation for the management of cervicogenic headache: a systematic review and meta-analysis. Eur J Pain. 2020;24(9):1687–1702. PubMed
2. Pourahmadi M, Dommerholt J, Fernández-de-las-Peñas C, et al. Dry needling for the treatment of tension-type, cervicogenic, or migraine headaches: a systematic review and meta-analysis. Phys Ther. 2021;101(5):pzab068. PubMed
Headaches have more than one cause
This page covers tension-type and cervicogenic headache: headaches connected to the muscles and joints of the neck. Migraine and cluster headache are medical diagnoses made by a physician, not something we diagnose or treat here as a disease. If your headaches have migraine features (throbbing pain, sensitivity to light or sound, nausea, or an aura) or if you have cluster headache or another pattern you haven’t had evaluated, talk to your physician first. Neck muscle involvement can still be part of a broader picture your physician is managing, and we’re glad to work alongside that care.
One more pattern worth naming: sharp, shooting pain in the back of the head, often starting where the skull meets the neck and running up the scalp. The clinical name is occipital neuralgia. It involves an irritated nerve rather than a muscle knot, but it can feel much like a muscle-referred headache at the base of the skull, and the two can coexist. Telling them apart is part of the exam. If what we find needs a physician’s evaluation, we say so and help you get there.
When a headache needs a doctor instead
Some headaches need urgent medical care rather than a chiropractic visit. A headache that is sudden and severe, follows a head injury, or comes with symptoms you have not had before should be seen the same day. If your history points that way, we’ll tell you and help you get to the right place.
Prefer an acupuncture framework instead?
Dr. Bobby Koser, DC, chiropractic physician, is certified in acupuncture by the Florida Board of Chiropractic Medicine. He also sees headache patients through acupuncture, a separate framework from dry needling and based on a different set of principles. It’s a different visit with a different exam. There is research here worth knowing: a Cochrane review of 22 studies found acupuncture reduced how often migraines occurred, with fewer side effects than preventive medication, and it did better than placebo needling by a margin the reviewers called small.3 If you’d rather start there, visit our acupuncture page.
3. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;2016(6):CD001218. PubMed
What it costs to start
$195Regular price $330
Self-pay only, one per patient.
Pain has a source. This visit looks for where it is coming from.
- A complete examination with Dr. Koser, which may include a live ultrasound look at the muscles and soft tissue where it hurts.
- Treatment the same visit unless the examination finds a reason it should not: a chiropractic adjustment, dry needling, cupping, laser, or electrical stimulation with infrared, chosen from what the examination finds and what is safe for you.
- Your findings explained the same day.
You’ll leave knowing what we found and what it means. First visit with us, one per patient.
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Self-pay patients only. Not valid with insurance, PIP/auto claims, Medicare, or Medicaid. Injured in a car accident? Book the Auto Accident Injury Visit instead.
THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.
Every other bookable price is on our pricing page.
Common questions
What kind of headache does dry needling help with in Tampa?
At HealthSpine, dry needling is used for tension-type headache and cervicogenic headache: headaches connected to the muscles and joints of the neck and shoulders. It is not a treatment for migraine as a diagnosis. If you have migraine, cluster headache, or a headache pattern that has never been checked, your physician should evaluate that first.
What does a cervicogenic headache feel like?
A cervicogenic headache typically starts at the base of the skull or on one side of the neck and spreads toward the eye or temple. It often worsens with certain neck positions or after long periods of poor posture, and the pain is referred from neck joints and muscles rather than starting inside the head.
Does ultrasound guidance get used for headache treatment?
Sometimes. Deeper neck muscles that are harder to isolate by feel are treated with live ultrasound guidance, so we can see the needle reach the exact spot we’re treating. More superficial muscles, like the upper trapezius, are usually treated by feel. We’ll tell you which fits your case before we begin.
Is dry needling the same as acupuncture for headaches?
No. Dry needling targets specific muscles based on your examination; acupuncture is based on a different, traditional framework. Dr. Koser is certified in dry needling by the Florida Department of Health and in acupuncture by the Florida Board of Chiropractic Medicine. Our acupuncture page covers that option separately.
When should a headache be treated as an emergency instead of booking a visit?
A headache that is sudden and severe, follows a head injury, or comes with symptoms you have not had before needs emergency care, not an appointment here. Call 911 or go to the nearest emergency department. If you are not sure whether it is an emergency, treat it as one.
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This page is general health information and is not medical advice for any individual. The studies summarized describe groups, not any one person’s outcome, and whether a finding explains your symptoms can only be determined by examination. Talk to Dr. Bobby Koser, DC, about your own situation, and seek emergency care immediately for the warning signs described on this page.
Find where your headache starts. Treat it with precision.
Book online, or call and we’ll talk it through. Serving Carrollwood, Northdale, Citrus Park, Westchase, Lutz, Town and Country, Seminole Heights, Tampa Heights, and the greater Tampa Bay area.
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