The Role of Physiotherapy in Headache and Associated Neck Pain

January 31, 2025

The Role of Physiotherapy in Headache and Associated Neck Pain

Headaches are a common and often debilitating condition that affects daily functioning, concentration, social interactions, and overall quality of life. Physiotherapists frequently treat different types of headaches, each with distinct causes and symptoms.

Research showed the use of strengthening and endurance exercises for the neck, scapula and shoulder may be beneficial in reducing pain and improving function…

Common Types of Headaches Treated by Physiotherapists

Migraine Headaches

A migraine headache typically presents on one side of the head with severe throbbing pain. It is often accompanied by:

Nausea and vomiting
Sensitivity to light and sound
Episodes lasting hours to days

Migraines can be triggered by hormonal changes, poor sleep, or certain foods and drinks. Neck pain may also be referred from the head during a migraine episode. Vestibular migraines can cause dizziness and imbalance, which may benefit from vestibular therapy.

Cervicogenic Headaches

A cervicogenic headache originates from dysfunction in the neck’s joints or muscles. It is often mistaken for a migraine, as it can also cause severe pain on one side of the head, especially with neck movement or poor posture.

Physiotherapy can help by:

Releasing muscle tension through soft tissue massage, stretches, and dry needling
Correcting posture and strengthening neck muscles to reduce stress on joints
Reducing the frequency and severity of cervicogenic headaches

Tension-Type Headaches (TTH)

Tension-type headaches are the most common primary headaches, characterized by:

A dull, aching sensation around the temples, forehead, behind the eyes, or at the back of the head and neck
A tightening band-like pressure around the head
Muscle stiffness and tenderness in the neck and jaw

Though the exact cause is unclear, TTH is linked to heightened pain sensitivity, brain neurotransmitters, and environmental factors like stress and anxiety. Myofascial trigger points in the neck and shoulders may also contribute to tension headaches.

Physiotherapy treatment includes:

Manual therapy, such as myofascial release and joint mobilisation
Strengthening postural muscles to relieve tension
Evidence-backed techniques to improve quality of life and reduce headache-related disability

Temporomandibular Disorder (TMD) Headaches

TMD-related headaches stem from dysfunction in the jaw muscles, joints, or connective tissues. These headaches often present with:

Pain in the jaw, temple, and around the ear
Worsening symptoms in the morning
Clicking or grinding sounds from the jaw
Limited jaw movement and tightness in the face

TMD headaches can mimic other types of headaches and may even trigger migraines, making diagnosis challenging.

Physiotherapy for TMD headaches focuses on:

Relieving muscle tightness and improving jaw function
Stress management and lifestyle changes
Complementary approaches, including medication if necessary

Neck Pain and Headaches

Neck pain often accompanies migraine and tension-type headaches, but in these cases, the pain is usually a symptom rather than the root cause. However, when a headache coexists with cervical spine dysfunction, distinct treatment strategies are required.

How Physiotherapy Can Help with Headaches

A physiotherapist can assess the underlying cause of your headache and develop a personalized treatment plan. Common physiotherapy techniques for headaches include:

Soft tissue mobilisation, massage, and stretching to improve mobility and relieve muscle spasms
Joint mobilisation for the neck and jaw to restore function
Vestibular therapy for managing vestibular migraines
Electrical stimulation (TENS, EMS) to alleviate pain
Postural correction and strengthening of deep neck flexors and upper body muscles to support better posture and reduce neck strain

When to Seek Professional Help

Although physiotherapy is highly effective for many headache types, some headaches may signal more serious conditions. Consult a doctor or physiotherapist if you experience any red flags, such as sudden, severe headaches, vision changes, or neurological symptoms.

References:

Jull, G., & Hall, T. (2018). Cervical musculoskeletal dysfunction in headache: How should it be defined? Musculoskeletal Science and Practice, 38, 148–1.
Page, P. (2011). Cervicogenic headaches: An evidence-led approach to clinical management. Int J Sports Phys Ther, 6(3), 254–266.
Martelletti, P., & Steiner, T. J. (2011). Handbook of Headache: Practical Management. Springer Science & Business Media.
Calixtre, L. B., et al. (2015). Manual therapy for temporomandibular disorder: A systematic review of randomized controlled trials. Journal of Oral Rehabilitation, 42(11), 847-861.

By seeking physiotherapy treatment, you can address the root causes of your headaches and find long-term relief, improving both comfort and daily function.

For More Help:

For more information and help, please contact Janika at the Wellington Branch.

Janika

Physiotherapist & Practice Owner

headache