Headache and Lower Back Pain: Is There a Link?
Yes, headache and lower back pain can be connected. Your spine works as one chain, from the pelvis to the skull. When one part is out of alignment, other parts compensate. A problem in your lower back can change the way your neck carries your head. This can lead to tension headaches, or to cervicogenic headaches that start at the base of the skull.
Key points
- Back problems can cause headaches by forcing the neck to compensate for misalignment lower down the spine.
- Cervicogenic headaches feel as if they start at the back of the head. They are driven by the neck and upper spine.
- Scans done lying down can miss alignment problems that only show up when you are standing and bearing your weight.
- A whole-body standing image shows the full chain from feet to head in one low-radiation scan.
- If you have a sudden, severe headache with neck stiffness, fever or loss of vision, get urgent medical help.
Can back problems cause headaches?
Yes. Back problems can cause headaches because the spine is a connected chain. Your body is designed to keep your eyes level with the horizon. If your lower back curves too much or too little, your mid-back and neck must adjust. That adjustment puts extra strain on the muscles, joints and nerves at the top of your spine. This can trigger headaches.
This type of headache is sometimes called a cervicogenic headache. It does not start inside the brain. It starts in the structures of the neck and upper spine. The pain is felt further up, in the back of the head, the temples or behind the eyes.
Think of it like a building. If the foundation shifts, the walls lean and the roof cracks. Your pelvis is the foundation, your lower back is the wall, and your head and neck are the roof. A tilt or shift at the bottom can show up as pain at the top.
What does headache with back pain feel like?
People who have headache and back pain together often describe a pattern that feels different from a typical migraine or tension headache. Here are some common signs.
A dull ache that starts where the neck meets the skull and spreads forward.
Your neck feels tight and hard to move, and your lower back aches at the same time.
Sitting or standing for long periods makes both the headache and the back pain worse.
Usual headache medicine helps for a short time, but the headache keeps coming back.
When to get urgent help. If you have a sudden, severe headache with neck stiffness and fever, or you have numbness, weakness, loss of bladder or bowel control, or sudden changes in your vision, contact your doctor or go to the nearest emergency department straight away. These symptoms need urgent medical care, not a scan booking.
What causes headache and lower back pain together?
Several alignment and structural factors can cause headache and back pain at the same time. What they share is this: the body makes up for a problem in one area by overloading another.
Too much or too little curve in the lower back shifts the balance of the whole spine above it.
An uneven pelvis tilts the base of the spine. This has a knock-on effect all the way up to the neck.
The head drifts in front of the shoulders. This puts heavy strain on the neck muscles and joints.
Even a small difference in leg length can tilt the pelvis and create a compensating curve through the spine.
These causes often cannot be seen on a standard scan done lying down, because gravity is not pressing on the spine in the usual way. The misalignment only becomes clear when you are upright and bearing your own weight.
How does a standing scan help find the cause?
A standing whole-body EOS scan captures your whole skeleton from head to feet in one image, while you are upright and bearing your weight. This matters because imaging done lying down relaxes the muscles. It can hide alignment problems that only appear when gravity acts on your body the way it normally does.
When headache and lower back pain happen together, a clinician needs to see the full picture. A standard X-ray or MRI of only the lower back will not show how the pelvis, spine and head relate to one another under load. An EOS scan does exactly that, using about 90% less radiation than a standard X-ray, around ten times less.
The scan takes just a few seconds. You simply stand still inside the machine. The image lets your clinician follow the chain of compensation from bottom to top and find exactly where the imbalance begins.
When MRI is the better choice. EOS shows bones, joints and alignment. If your clinician suspects a disc problem, a trapped nerve or another soft-tissue cause for your symptoms, MRI is usually the better tool. In many cases, both types of imaging work well together.
What helps when headache and back pain happen together?
The most useful first step is getting an accurate picture of your alignment. Without knowing where the imbalance starts, any approach is guesswork. A whole-body standing image gives your physiotherapist, osteopath or consultant something concrete to work from.
Once the cause is found, your treating clinician may recommend a range of approaches. These might include targeted exercises, manual therapy or changes to posture. ScanAlign provides the diagnostic imaging, not the treatment itself. But detailed alignment data can make a real difference to the plan your clinician builds for you.
So before you start a treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in your pelvis, your legs or your spine changes what will actually help.
Not sure whether a standing alignment scan is right for your symptoms? Talk to us first, at no cost.
Book a free video consultationFrequently asked questions
Yes. When the lower back is misaligned, the upper spine and neck compensate to keep your head balanced. That extra strain on the neck muscles and joints can trigger headaches, especially cervicogenic headaches that start at the base of the skull.
A cervicogenic headache is a headache caused by a problem in the neck, not the brain. It typically starts as a dull ache at the back of the head or behind one eye. It is often linked to stiffness or limited movement in the neck.
If you get a sudden, severe headache with neck stiffness and fever, or if you have numbness, weakness, loss of bladder or bowel control, or sudden changes in your vision, get urgent medical help straight away. Contact your doctor or go to the nearest emergency department.
Because the cause of your headache may not be in your head. If a pelvic tilt or a curve in your lower back is forcing your neck to compensate, you need to see the full chain from feet to skull. A whole-body standing scan shows exactly how each region relates to the others under gravity.
An EOS scan is a type of X-ray that captures your whole body while you are standing up. It uses about 90% less radiation than a standard X-ray, around ten times less. The result is a detailed image that shows bone alignment under real, weight-bearing conditions.
Yes. The EOS system uses about 90% less radiation than a standard X-ray. You can find more about safety and what to expect on our FAQs page.
No. ScanAlign is a private, self-pay service and you can refer yourself. You start with a free video consultation so we can check the scan is suitable for your symptoms.
The price for patients travelling from abroad is confirmed during the free video consultation. You can read more on our FAQs page.
EOS shows bones, joints and alignment. For soft tissues such as discs and nerves, MRI is usually the better tool. Your clinician can advise which type of imaging suits your situation. Sometimes both are helpful.
ScanAlign is based at 19 Harley Street, London. The clinic operates under The Harley Street Hospital's CQC licence.
Find out where the imbalance starts
Before you plan a trip to London, a free video consultation lets us check whether a standing alignment scan is the right next step for your headache and back pain.
Book a free video consultation Learn more about EOS scanningSources
- Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. The Lancet Neurology. 2009;8(10):959-968.
- NHS. Headaches. nhs.uk/conditions/headaches.
- Glassman SD et al. The impact of positive sagittal balance in adult spinal deformity. Spine. 2005;30(18):2024-2029.
Written by Abbas Dhami (Specialist Diagnostic Radiographer)
Learn more about how spinal alignment is assessed on our spine conditions page.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.