Dr. Nicole’s Own Journey With Chronic Headaches

Dr. Check’s interest in upper cervical chiropractic care began with her own experience.

She remembers having headaches as early as six or seven years old. By age 12, those headaches had progressed into daily headaches and migraines.

Her family tried numerous approaches, including neurologists, naturopathic medicine, acupuncture, dietary changes, and traditional chiropractic care.

Eventually, they visited an upper cervical chiropractor.

Dr. Check says that after two adjustments to her atlas, she experienced her first headachefree period in approximately a year.

That experience ultimately changed the direction of her life and inspired her to pursue chiropractic medicine herself.

What Is Upper Cervical Chiropractic Care?

When people hear “chiropractor,” they may immediately think of forceful twisting, cracking, or popping.

Upper cervical chiropractic care takes a different approach.

Dr. Check explains that the focus is specifically on the relationship between the occiput, atlas, and axis, the structures at the very top of the cervical spine.

Rather than making broad adjustments throughout the body, upper cervical techniques use detailed measurements to determine how the upper cervical spine is positioned and whether treatment may be appropriate.

Some techniques use gentle manual adjustments, while others use instruments to deliver very small, targeted impulses.

What Does Your Neck Have to Do With Your Jaw?

Quite a lot.

The jaw and upper cervical spine exist within an interconnected system of joints, muscles, nerves, and soft tissues.

Dr. Check explains that when the head moves forward, what she jokingly calls the “chicken neck” posture, the muscles of the upper neck and jaw may be placed under additional strain.

Forward head posture can also sometimes be a compensation for airway issues as the body attempts to create more room for breathing.

For someone experiencing TMD, this matters.

If the neck is constantly compensating, the jaw may be affected. And if the jaw isn’t functioning well, the neck may also respond.

That’s why Dr. Mistry doesn’t look at TMJ disorders as simply a problem inside the jaw joint.

When Jaw Treatment Helps — But Something Is Still Missing

Dr. Mistry and Dr. Check share the story of a patient named Meredith, who gave permission for her experience to be discussed.

When Meredith first came to Dr. Mistry, she was experiencing constant jaw pain, instability in her left jaw joint, clicking, and neck pain.

TMJ treatment helped resolve her jaw pain, improved the feeling of stability, and significantly reduced the joint noise.

But the neck pain persisted.

That’s when Dr. Mistry recommended that Meredith see Dr. Check.

After beginning upper cervical care, Meredith noticed additional improvements. Dr. Check also incorporated techniques addressing structures and soft tissues surrounding the jaw.

The combination ultimately helped Meredith make further progress with both her neck symptoms and remaining jaw clicking.

Her experience illustrates one of the biggest themes of this episode:

Sometimes getting better requires more than one set of eyes on the problem.

The Atlas and the Rest of the Body

One of Dr. Check’s favorite ways to explain the atlas is to imagine an egg sitting in an egg cup.

The atlas is the cup.

The head is the egg.

If the cup tilts, the egg has to compensate.

The same concept can be applied to the body. When the upper cervical region is out of balance, Dr. Check explains that compensations may appear farther down the postural chain.

One shoulder may sit higher. Muscles through the back may tighten. The pelvis can compensate. One leg may even appear functionally shorter than the other.

Those changes can influence the way someone stands, walks, breathes, swallows, and moves their jaw.

It’s another reason treating the body as a collection of completely separate parts doesn’t always tell the whole story.

Headaches, Neck Tension and TMJ

Persistent headaches are one of the most common reasons patients seek Dr. Check’s help.

She also frequently sees patients who describe chronic stiffness, recurring knots through the shoulders, restricted neck movement, fatigue, or a feeling that their head and neck simply aren’t moving normally.

Many of those symptoms can overlap with what Dr. Mistry sees in patients with TMD.

That overlap doesn’t mean every headache comes from the neck or every TMJ problem requires chiropractic treatment.

It means the neck deserves to be evaluated when the symptoms suggest it may be part of the problem.

Not Every TMJ Patient Needs a Chiropractor

This is an important point.

When asked whether every TMJ patient should see an upper cervical chiropractor, Dr. Check’s answer is simple:

No.

Some patients have no significant neck symptoms or findings suggesting upper cervical treatment would benefit them.

Dr. Mistry sees the same thing in her practice.

Sometimes treating the jaw improves the neck symptoms too. Other times, most symptoms improve but neck pain, headaches, or another issue persists.

That’s when bringing another provider into the treatment plan may make sense.

The goal isn’t to send every patient to every type of practitioner.

The goal is to recognize when another piece of the puzzle needs attention.

Why a Team Approach Can Matter

TMD can be complicated.

Two people can walk into Dr. Mistry’s office with similar jaw pain and ultimately require very different treatment plans.

One person may respond beautifully to an orthotic alone. Another may need physical therapy. Another may benefit from upper cervical chiropractic care. Others may require additional evaluation of their airway, posture, bite, muscles, or other contributing factors.

That’s why collaboration is such an important part of this episode.

Dr. Check explains that when she sees a patient whose jaw appears to be a significant part of the problem, she’ll refer that patient to Dr. Mistry. Likewise, Dr. Mistry may refer a patient to Dr. Check when jaw treatment has helped but neck-related symptoms remain.

Neither provider is trying to be everything to everyone.

They’re trying to determine what each individual patient actually needs.

Listener Question: How Do I Find an Upper Cervical Chiropractor?

Dr. Check recommends specifically searching for an upper cervical chiropractor, rather than simply searching for general chiropractic care.

Patients may also encounter names of specific upper cervical approaches, including Atlas Orthogonal, NUCCA, Blair, and Orthospinology.

Different techniques use different methods of analysis and adjustment, so patients should ask providers about their training, evaluation process, and approach before beginning treatment.

Listener Question: Does Every TMJ Patient Need Upper Cervical Care?

Again, no.

If the neck is functioning well and there aren’t findings indicating an upper cervical problem, chiropractic care may not be necessary.

But when someone has persistent neck pain, restricted movement, chronic headaches, postural issues, or symptoms that remain after their jaw has improved, evaluating the cervical spine may be worthwhile.

The important part is determining what is actually contributing to the individual’s symptoms rather than automatically applying the same treatment to every patient.

What The TMJ Doc Wants You to Know

Your jaw and your neck are neighbors, and they don’t operate independently.

The position of your head can influence the muscles surrounding your jaw. Your bite and jaw function can influence the way your head and neck respond. Breathing, posture, muscle tension, and the cervical spine can all become part of that relationship.

That doesn’t mean every TMJ patient has a neck problem.

It means that when symptoms persist, it’s important to keep asking why.

Dr. Mistry’s approach is to look beyond the painful joint and understand the larger system surrounding it. And when another provider’s expertise is needed, collaborative care can be an important part of helping the patient move forward.

In this episode of Unclenched, Dr. Priya Mistry, Dr. Alex, and Dr. Nicole Check unpack the neck–jaw connection and show why sometimes the key to understanding what’s happening with the jaw starts by looking just above and just below it.

Listen to the full episode of Unclenched to hear the complete conversation with Dr. Nicole Check.