“The Optician Said My Eyes Were Fine." So Why Did They Hurt Every Day?”
Topic: Headaches, cervicogenic headaches, tension-type headaches, muscle referral patterns
This story is inspired by the many people we've cared for over the years. Names and details have been changed and combined to protect privacy. If you recognise yourself in this story, you're certainly not alone.
Emma’s story
Emma had always looked after herself. She ate well, played padel twice a week, and loved her job as a journalist. Most days were spent at her desk, chasing deadlines, interviewing people and piecing together stories. It was busy, often stressful, but she genuinely enjoyed it. Then, about six months earlier, something changed.
It started as a dull ache behind her right eye. At first it was easy to ignore. She assumed she'd simply had too much screen time or needed an earlier night. But over the following weeks the pain kept returning.
By the middle of the afternoon she found herself rubbing her eye, blinking more often and struggling to concentrate. It wasn't her vision that bothered her most; it was the constant ache. It distracted her from writing, broke her concentration and made every deadline feel a little harder to meet.
She realised she hadn't had an eye test for a while, so she booked an appointment with her optician.
At the optician
After a thorough examination, the optician smiled reassuringly.
"The good news is your eyes are healthy. Your prescription hasn't changed and everything looks completely normal."
It should have been reassuring. Instead, Emma walked out feeling even more anxious.
If my eyes are fine... why do they hurt?
Over the next few weeks the headaches became more frequent. The ache behind her eye was no longer the only symptom. Some days it spread into her temple. Other days it wrapped across her forehead like a tight band that refused to let go. By the evening her head often felt heavy, as though someone had tightened an invisible strap around it. She noticed she was becoming more sensitive to long days at her computer. Looking down at her laptop for hours seemed to make everything worse, and stressful deadlines almost guaranteed she'd finish the day with a headache. Painkillers sometimes took the edge off, but never really solved it.
She started questioning everything.
Was it dehydration?
Was it too much caffeine? Or not enough?
Was she spending too long looking at screens?
Then her thoughts became darker.
What if it's something serious?
Could it be a brain tumour?
Looking back, there had been another clue all along. Her neck had felt stiff for months. By the end of most working days her shoulders were practically touching her ears, and she often caught herself rolling them backwards to try and ease the tension. She never connected the two. To her, the neck stiffness was just part of having a desk job.
The pain was in her eye, so surely that was where the problem had to be.
Out for coffee
One Saturday afternoon she met a friend for coffee. When the waiter came over, Emma ordered a decaf.
"I'm trying to rule things out," she laughed. "I don't want caffeine making these headaches worse."
Her friend paused.
"Have you ever thought it might actually be coming from your neck? My cousin had headaches that turned out to be caused by really tight muscles. She had some treatment and it made a huge difference."
Emma smiled politely. It sounded unlikely. The pain was behind her eye. How could her neck possibly have anything to do with it? She pushed the thought aside.
Contacting us
That evening, curled up on the sofa, she found herself doing what most of us do when we're worried. She picked up her phone and started scrolling. Half an hour later, the familiar ache behind her eye was back.
As she rubbed her forehead, she remembered what her friend had said. Almost without thinking, she searched for a local clinic and filled in an enquiry form, asking whether a massage might help.
When we replied, our advice surprised her.
Rather than booking a massage straight away, we suggested starting with a full chiropractic assessment. Not because massage wouldn't necessarily help, but because before treating anything, we wanted to understand why she was getting these headaches.
Head pain can have many different causes: tight muscles, irritated joints, nerves or even something more serious that needs urgent medical attention.
The first step is always making sure you know which one you're dealing with.
Emma booked an appointment.
Coming to Evolv
She admitted afterwards that she felt nervous walking through the door.
"What if you find something scary?"she asked.
We began exactly where every assessment should begin. We asked detailed questions about her symptoms, looked for any warning signs that suggested something more serious, carried out a neurological examination, assessed her cranial nerves, tested the movement of her neck and shoulders, and gently examined the muscles and joints around her upper neck.
As the assessment progressed, a pattern began to emerge. The structures around the top of her neck and shoulder were reproducing the exact pain she felt behind her eye.
The muscles in her upper trapezius and the muscles at the base of her skull were referring pain forwards into her head, while the widespread tight, band-like pressure across her forehead fitted with a tension-type headache, likely aggravated by prolonged desk work and stress.
For the first time in six months, Emma finally had an explanation that made sense.
What is a cervicogenic headache?
A cervicogenic headache is a headache that actually starts in the neck.
The pain is usually referred from joints, muscles or other structures in the upper part of the neck and can be felt:
Behind one eye
Around the temple
Across the forehead
At the back of the head
Around the base of the skull
Many people never suspect their neck because that's not where the pain is strongest.
This is why a thorough assessment is so important. Two people can both have pain behind the eye but for completely different reasons.
