Migraine and Headache Treatment in Williamsville, NY

Why So Many Headaches Begin in the Neck

The top three nerves in your neck feed into the same pool of brainstem neurons that receives sensation from your face and scalp. Researchers call that shared relay the trigeminocervical nucleus, and it explains something patients tell us constantly: the pain feels like it lives behind the eye or across the temple, yet pressing on the base of the skull reproduces it exactly. Your brain is not confused. It simply cannot always tell which input line a signal arrived on. So an irritated joint at the top of the neck, or a knot in a suboccipital muscle the size of your thumb, can produce pain that maps across the head in a pattern nobody would guess came from below.

Tension type headache works a little differently. Sustained low level contraction in the upper trapezius, the levator scapulae and the muscles along the back of the skull is thought to raise the resting tone of that tissue and leave the nerve endings inside the muscle easier to provoke. Patients describe a band, a vise or a weight, usually on both sides, usually building through the day. Screens, driving, a phone held low and jaw clenching all feed it. Over months the nervous system can turn its own volume up, so a level of muscle tension that used to pass unnoticed starts registering as pain. That shift in sensitivity is well documented, and it is one reason treating early may go better than treating late.

Migraine is different again. It is a neurological condition with its own machinery, and chiropractic care does not cure it. What we can say honestly is that neck pain and stiffness show up in a large share of migraine attacks, often in the hours before the head pain itself, and that a sensitized upper neck appears to lower the threshold at which an attack starts. So the useful question is not whether the neck causes migraine. It is whether reducing the mechanical load coming from the neck lowers how often that threshold gets crossed. Many of the patients we see report that it does. Some report no change, and when that is what the record shows, we say so rather than keep treating.

• Pressing the base of the skull or the side of the neck reproduces your familiar headache
• Pain is usually one sided and stays on the same side attack after attack
• Turning or holding your head makes it worse, and lying down with support eases it
• Headaches follow long screen sessions, long drives, or a night on the wrong pillow
• You wake with the headache already there, or with a stiff, sore neck
• Rotation is limited on one side when you turn your head with the chin tucked
• Rubbing the shoulders helps for an hour, then the headache comes back

Who Treats Headache Patients at Our Office

Dr. Niccole Jefferlone owns the practice and is the doctor most associated with stubborn headache and migraine cases here. She graduated from D'Youville College and treats the entire musculoskeletal system, shoulders, feet and joints included, which matters more for head pain than it sounds. A headache pattern often tracks back to how a patient holds a shoulder, or to an old ankle injury that changed how they stand at a workbench. She also handles sports injuries and strained and torn muscles, and she co-leads the non-surgical spinal decompression program, so when a headache turns out to be riding on a lower cervical disc problem she is not handing the case off. Her approach is to examine first and let the findings pick the technique.

Her certifications shape the hands-on part of a headache visit. As a Certified Graston Technique Provider she uses contoured instruments on the dense, ropey tissue along the upper trapezius, the sternocleidomastoid and the small muscles under the base of the skull. The old explanation, that instruments break down scar tissue, is not well supported. A temporary change in how the nervous system reads that tissue is the likelier mechanism, trials are small, and results are mixed. She is certified in SpiderTech taping, which some patients find holds a change for a few days, though the proposed mechanisms are unproven and measured effects are usually small. She is also a Certified Webster Technique Provider, a pelvic and sacral method used in pregnancy whose use for breech presentation rests largely on case reports.

You are not limited to one doctor. Dr. Safeya Muhammad has been here eleven years, is CACCP certified through the ICPA, is Webster Technique certified and Spinning Babies trained, and carries the prenatal, pediatric and family side of the practice. Dr. Megan Berndt joined in 2026 with a master's degree in sports rehabilitation. Dr. Matt Millanti, here ten years, has extensive experience with non-surgical spinal decompression. All four doctors treat patients at this Williamsville office, so you can ask the front desk for a specific one. Munroe Chiropractic has been open since 1987 and has helped more than 40,000 patients, and in 2026 the practice became part of the Complete Care Chiropractic family, with the same team at the same location.

What Our Headache Exam Is Actually Looking For

Good headache care starts with a long conversation, not a table. We want the pattern: when the headaches started, whether one side dominates, what time of day they arrive, how long they last, what you have already tried, and how many days a month you take something for pain. That last number matters, because frequent use of over the counter or prescription pain relievers can itself drive a daily headache pattern, and no amount of manual treatment will outrun that. We ask about sleep position, jaw clenching, old car accidents, concussions, and the ergonomics of the place where you spend your working hours. Most of the useful information arrives before anyone touches your neck.

Then the hands-on part. We check how each cervical segment moves, one level at a time, and compare left to right. We test rotation with the neck flexed, since restriction there points toward the upper joints specifically. We palpate the suboccipitals, the upper trapezius, the levator, the scalenes and the jaw muscles, watching for the moment your face changes, because reproducing your familiar headache with pressure is one of the more useful findings in the whole exam. A neurological screen covers reflexes, sensation, strength and cranial nerve function. If the history or the findings suggest we need to see structure, digital imaging is available on site, and we cover when spinal x-rays are worth taking on their own page.

The point of all that is sorting. Cervicogenic headache is a referred pain problem with a mechanical source we can often find and change. Tension type headache is largely a muscle and sensitization problem that responds to similar work but behaves differently over time. Migraine has its own biology and frequently travels with a neck component worth treating on its own merits. Plenty of people have two of these at once, which is why a patient can improve substantially and still have attacks. Sorting also tells us when chiropractic is not the answer and the right move is a referral to your physician or a neurologist. For the broader picture, the full list of conditions we treat sits on its own page.

Nothing about this process is rushed, and nothing about it is generic. Two people can walk in describing the same headache and leave with different plans, because one has a locked upper cervical joint and a short, angry suboccipital group, and the other has a jaw that never stops working and a mid back that has given up holding them upright. Treating both the same way would help one and waste the other's time. We would rather spend the first visit finding out which person you are than start with a protocol and hope it fits. That is also why we write the plan down, including roughly how many visits we expect before we reassess.

• Headache pattern, side, timing, duration, and how many pain relief days per month
• Segment by segment motion testing of the upper cervical spine, left compared to right
• Rotation tested with the chin tucked, which isolates the top two joints
• Palpation of the suboccipitals, upper trapezius, scalenes and jaw muscles for referred pain
• A neurological screen covering reflexes, sensation, strength and cranial nerves
• Posture, desk setup, pillow and sleep position
• Digital x-ray on site, only if the history or exam gives us a reason

Headaches That Need a Medical Evaluation First

Most headaches are not dangerous. A small number are, and the difference usually sits in the story rather than in the severity. A headache that reaches full intensity within a minute or two, the kind people describe as the worst of their life or as a thunderclap, needs emergency evaluation now, not an appointment next week. So does a headache with fever and a stiff neck, which can signal infection around the brain and spinal cord. A headache that begins after a blow to the head, particularly with confusion, vomiting or drowsiness, belongs in an emergency department. We would rather send you somewhere else and be wrong than treat you and be wrong.

New neurological signs deserve the same urgency. Weakness on one side, slurred speech, a drooping face, double vision or loss of vision, numbness that spreads, or trouble with balance are not headache symptoms to sit on. A brand new headache pattern that starts after age fifty is another one we take seriously, because the odds of an underlying cause rise with age, and a headache clearly different from anything you have had before should be evaluated by a physician before anyone starts adjusting your neck. The same goes for a headache that steadily worsens week over week rather than coming and going, or one that consistently wakes you out of sleep.

We screen for this at the first visit, and we keep screening. Headache patterns change, and a patient who was straightforward in March can present differently in September. If your headaches change character, become more frequent, stop responding to something that used to help, or start arriving with symptoms you have not had before, tell us, and tell your physician. We are comfortable working alongside a primary care doctor or a neurologist, and we are comfortable saying that a particular headache sits outside what conservative care should be handling. Nothing on this page is a diagnosis. It is a set of things worth knowing before you decide who to call.

• The headache came on like a thunderclap, or it is the worst you have ever had
• You have a headache along with fever, a stiff neck, or a rash
• The headache started after a head injury, a fall, or a collision
• You have new weakness, slurred speech, vision loss, facial droop, or loss of balance
• You are over fifty and this is a brand new headache pattern
• The headache is steadily worsening week after week instead of coming and going
• You are pregnant and have a new severe headache with swelling or vision changes

Upper Cervical Adjusting and the Soft Tissue Work Around It

Treatment usually has two halves. The first restores motion to cervical segments that are not moving well. Depending on the patient that can be a specific Diversified adjustment, a light toggle contact at the very top of the neck, a seated cervical adjustment for people who would rather not lie face down, or a Thompson Drop table assist that lets us use less force for the same result. Flexion-Distraction, traction and Sacro-Occipital Technique come in when the lower neck or the pelvis is part of the pattern. The mechanics of the thrust, and what the sound actually is, live on our page about how a chiropractic adjustment works. Here the goal is narrower. We want to quiet the joint input feeding your head.

The second half is the tissue. Trigger points in the upper trapezius, the sternocleidomastoid, the suboccipitals and the temporalis have well mapped referral patterns, and those maps look a great deal like the headaches patients draw for us. Direct pressure, Active Release Technique and instrument assisted work with Graston instruments approach the same goal from different angles, which is to restore glide between layers of tissue and lower the resting tone in muscles that never fully switch off. How much of the benefit is mechanical and how much is a change in pain sensitivity is not settled. If your head pain travels with neck, shoulder or jaw complaints, our symptom by symptom guide covers how we work up each of those.

A typical headache visit is short and specific. Expect some soft tissue work, one or two adjustments, and a stretch or two to do at home between visits. Early on, appointments are usually closer together, because tissue and the nervous system respond better to repetition than to one long session, and then they spread out as the pattern breaks up. Some people feel looser and a little tired the same afternoon. Mild soreness in the treated tissue for a day is common and is not a setback. What we watch is direction. If a reasonable course of visits produces no measurable change in your headache diary, we change the approach or refer you out rather than repeating something that is not working.

Tracking Triggers and Measuring Real Progress

Headaches are episodic, and human memory handles episodes badly. Ask someone in a bad week how things have been going, and the good weeks vanish from the answer. That is why we ask headache patients to keep a simple record from the first visit: the date, how long it lasted, a rough intensity from one to ten, whether you took anything for it, and one line about the day. Paper is fine. A note on your phone is fine. Four weeks of that is worth more than any single conversation, because it converts a vague sense of being better or worse into headache days per month, which is the measure that actually tells us whether care is working.

The record also surfaces triggers, with one important caveat. Some of what people call triggers are really early symptoms of an attack that has already begun. Craving something sweet, yawning or feeling foggy can be the migraine starting rather than the thing that caused it, which is how chocolate got blamed for decades. Real patterns tend to be duller than that: short sleep, a skipped meal, a long drive, a change in caffeine, alcohol, hormonal timing, or three days of deadline work with the shoulders up around the ears. When a physical pattern shows up in the log, we can often do something about it directly, either with treatment or with a change to how you sit, sleep or lift.

About the evidence, plainly. Research on manual therapy for cervicogenic headache is reasonably supportive, and some trials report reduced headache frequency and intensity that holds for months, though the studies are small. For tension type headache the findings are more mixed, with some studies showing benefit and others showing little difference from other active treatments. For migraine the picture is limited and inconsistent, which is why we frame the goal as fewer headache days and less reliance on medication rather than elimination. When care works, attacks that used to last two days may last half a day, and the gaps between them stretch out. Results vary, and some people do not respond at all.

• Date and start time, plus roughly how long the headache lasted
• Intensity from one to ten at its worst
• Where it sat: one side, both sides, behind an eye, or a band around the head
• Anything you took for it, including over the counter medication
• Sleep the night before, meals, caffeine and alcohol
• What your neck and shoulders were doing the day before, including long drives or screen sessions
• Anything unusual, such as weather swings, a stressful stretch, or hormonal timing

Getting Started at Our Williamsville Office

We are at 6035 Main Street in Williamsville, and we are open six days a week, which matters more for headache patients than it sounds. Monday through Friday we are here from 8:00am to 7:00pm, closed from 1:00pm to 2:00pm for lunch, and on Saturday from 8:00am to 2:00pm. When a headache pattern is active, being able to come in early, late or on a weekend often means you get treated during the flare instead of a week after it. Call or text (716) 632-4476 and our staff will find you a time. If you want to save a few minutes at the first visit, the new patient forms are on our Paperwork page.

Payment is straightforward. We accept Workers' Compensation, No-Fault auto claims and Medicare. For private health insurance we are out of network by choice, a decision that keeps treatment decisions between the doctor and the patient rather than an insurer's utilization rules, and we provide itemized receipts, often called superbills, that you can submit to your plan for whatever out of network benefit it offers. Cash and self-pay patients are welcome, and we take major credit cards, checks, and FSA or HSA funds. If you are unsure what applies to you, call and ask before the first visit. Our front desk handles these questions every day and would rather answer them up front than after treatment starts.

Headaches after a car crash deserve their own note, because they are common and because the paperwork trips people up. New York is a no-fault state, so if you were driving or riding in a vehicle, your own auto policy generally covers medically necessary treatment after a collision regardless of who caused it, subject to the basic economic loss limit on that policy and to filing deadlines that arrive sooner than most people expect. We will not guess at your numbers. Call or text and our staff will help you check what your policy actually says. This office has handled no-fault, workers' compensation and personal injury documentation for decades, and thorough records matter to a claim nearly as much as the treatment does.