If you’ve had a cracking headache, then you know how debilitating they can be as a once off experience, let alone a recurring feature of your week or month. You are not alone however!

Australian studies have shown that 87% of people have experienced a headache in the last year. 

For some, this is a one off event, but we often see people who have been dealing with headaches for much longer periods – sometimes decades!

It’s common practice to rely on medication, which can help in the short term. However, continually reaching for the panadol only masks the underlying issue and doesn’t address the root cause of your headache.

So what causes headaches?

There are MANY factors that can trigger headaches and influence their intensity and duration.

These include:

  • Muscles and joints in the neck
  • Referral from muscles in the head or jaw
  • Hormones
  • Allergies
  • Dehydration
  • Lack of sleep
  • Stress and anxiety (think work, financial, family stressors etc.)
  • Vision issues
  • Or more sinister pathologies

More often than not your headache is driven by more than one of these factors. As Physios we have extensive experience assessing and treating the neck’s influence on your headache. 

However, without exploring and addressing the relevant contributing factors to you with your healthcare professional, it’s unlikely you’ll get the long lasting results you’re looking for.

So how do I know if my headache is coming from my neck? 

Common signs that your headache may be related to your neck are:

  • Head pain that is triggered by:
    • Neck movement 
    • Sustained or awkward postures of your neck e.g. is it worse after a long day at work.
    • Applying pressure with your fingers to the joints of your upper neck
  • Restricted movement of your neck
  • Feeling of stiffness in your neck
  • Pain that is on one side of your head or face (it can alternate or be both sides as well)
  • Pain localised to:
    • Forehead 
    • Back of the head
    • Side of your head
    • Eyes
  • Neck/jaw/temple area is tender to touch
  • Other symptoms can include:
    • Nausea
    • Vomiting
    • Dizziness
    • Light sensitivity
    • Blurred vision
    • Arm or shoulder pain

Also its worth noting that you DON’T need to have neck pain in order for your headache to be coming from your neck.

Referral patterns from structures in the neck

Ok, sounds like my headache may be coming from my neck – what next?

1️⃣ – Rule out sinister pathologies & address contributing factors

The first step in the treatment of any musculoskeletal pain, including headaches, is to rule out the presence of sinister pathologies (tumors etc.). The good news is a lot of the questions we’re trained to ask in our initial consultation helps to do just that, and no investigation is required unless we feel it would be worth looking into further. 

Once we’ve ruled out sinister causes, then a thorough assessment of potential contributing factors is made and strategies to address these put in place. For example, we may be able to adjust your ergonomic setup and posture to reduce your symptoms in the short term. 

The research suggests that posture has NO direct cause to musculoskeletal pain, however we know that sustained postures over time can place increased stress on the neck structures that can then in turn increase your headaches. 

2️⃣ – Hands on treatment for headache relief

Manual therapy targeted to releasing the muscle and joints in your neck and upper back can also greatly assist in the early stages. With these techniques, we look to try and reproduce your exact headache. We then use this as a treatment tool to assist with decreasing symptoms and providing some relief. 

The muscles surrounding this area of your neck can often be sensitive and overworked, so massage and dry needling can help to settle this down. Often this type of treatment will mean that you will leave your appointment with your headache reduced or maybe even completely gone!

While we would love you to walk out with instant relief, these effects are generally short lived. The long term benefits lie in improving the strength and mobility of the surrounding areas. Typically, headache sufferers will also be stiff and weak in their upper back and shoulder muscles.

Hands on therapy involves working on the muscles of neck and upper back

3️⃣ Creating long lasting change to your headaches

For long term management we know that a combination of targeted stretches and strengthening exercises are an extremely effective tool. Strengthening the tissues that support the neck means they will be able to tolerate more LOAD.

Load means something different for everyone, for some it may be related to time spent working at your desk, or how far you can run before the onset of pain or headache!

How we increase this load is important, and if you have tried exercise for headaches in the past and it hasn’t worked – this may be why…

✅ Getting rehab for headaches right:

We typically see rehab programs fall short of getting the desired results for headache sufferers by not performing them often enough, for long enough and not intense enough.

Exercise, in order for it to be effective for headaches, it needs to be:

  • Often enough (2-3x per week)
  • For long enough (12+ weeks)
  • Intense enough (minimum 7/10 difficulty)

Rehab done right (along with addressing other contributing factors) can be very effective in reducing the frequency, severity and duration of headaches. 

This approach can be extremely rewarding, however requires a bit of hard work and tenacity to see a long lasting improvement to persistent headaches.

If you’d like to learn more about how we can help or would like to chat to one of our experienced physios, call our friendly staff at the clinic on 8490 0777. We’d love to hear from you.


Ready to start on the road to recovery? BOOK ONLINE HERE.


– Esther Young (Headache Physio)