Headache & Neck Pain Treatment

What Is Headache & Neck Pain?

Many chronic headaches — particularly tension-type and cervicogenic headaches — originate from dysfunction in the upper cervical spine rather than the head itself. Cervicogenic headache is a specific condition where pain is referred from the neck joints and muscles into the head, often felt at the base of the skull, temple, or behind the eyes.

Physiotherapy for headache and neck pain focuses on identifying whether this cervical origin is present, and if so, treating it directly — an approach that's often far more effective for headache frequency and severity than treating the head symptom in isolation.

Symptoms & Causes

Common symptoms include:

• Headache typically starting at the base of the skull and spreading to one side of the head
• Headache that worsens with certain neck movements or sustained postures
• Associated neck stiffness or restricted range of motion
• Pain that may radiate to the shoulder or temple
• Headaches linked to prolonged desk work or poor sleep posture
• Headache pattern that tends to be one-sided and consistent in location

Common underlying causes:

• Upper cervical joint dysfunction, particularly at the top of the neck
• Sustained poor posture, especially prolonged forward-head positioning
• Muscle tension in the neck and upper shoulders, particularly the suboccipital muscles
• TMJ-related muscle referral, where jaw tension contributes to headache patterns
• Stress-related muscle guarding around the neck and shoulders

How We Assess It

Assessment includes:

• Cervical joint testing — particularly the upper cervical segments (C0-C3), which are most commonly implicated in cervicogenic headache
• Muscle palpation for trigger points — identifying specific points in the neck and shoulder muscles that reproduce your headache symptoms when pressed
• Postural analysis — assessing head, neck, and shoulder alignment for patterns that contribute to ongoing strain
• Headache pattern history — a detailed conversation about your headache location, triggers, and behavior, used to distinguish cervicogenic headache from migraine or other headache types that require a different management approach

This distinction matters — cervicogenic headache responds well to physiotherapy, while other headache types may need different or additional management.

Our Treatment Approach

Treatment typically includes:

• Manual therapy directed at the upper cervical joints — gentle, specific mobilization to restore normal movement at the segments most linked to headache referral
• Soft tissue release — targeting muscles known to refer pain into the head, particularly the suboccipitals and upper trapezius
• Postural correction — addressing the sustained positions and movement patterns that keep loading the neck and triggering headaches
• Dry Needling — frequently used for headache-related trigger points that don't fully resolve with manual therapy alone

Most patients are also given specific neck exercises and postural strategies to manage and prevent headache episodes between sessions.

Benefits of Treatment

• Reduces frequency and intensity of cervicogenic headaches
• Improves upper neck mobility
• Addresses postural and muscular contributors to headache
• Reduces reliance on pain medication for chronic headaches
• Complements TMJ and general neck pain treatment for compound cases
• Provides a long-term management strategy rather than only short-term relief

Who Should Consider This / Contraindications

Physiotherapy is well suited to headaches with a clear mechanical or postural neck component, particularly recurring headaches that follow a consistent pattern linked to neck movement or posture. However, certain headache presentations require immediate medical evaluation rather than physiotherapy:

• Sudden, severe "worst-ever" headache
• Headache accompanied by neurological symptoms (vision changes, slurred speech, weakness, confusion)
• Headache following significant head trauma
• New headache pattern in someone over 50, or headaches with fever and neck stiffness

Our therapists screen for these red flags at your first visit and will refer you for urgent medical evaluation if present, rather than proceeding with physiotherapy.