Neck Pain Headache

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Headaches, Neck Pain


Treatment for Headaches and Neck Pain.

Picture this - you regularly get headaches, and have been to the Doctor about it, and been prescribed medication to treat it. People go months taking medications to ease their headache, but this ‘Migrane’ won’t go away!

The first thing I want to share with you is that so many headaches are, in my opinion, mis-diagnosed as Migraines. People go months, if not years, taking strong medications to ease their headaches. However, if the correct cause is identified, a few simple physiotherapy sessions can often resolve their headaches forever!

Occasionally, I see such patients in my clinic - often referred by people who previously suffered a similar condition. I get great satisfaction from in treating them! Why? Well once the correct cause is identified, a few physiotherapy sessions often resolves their headaches for good! Great results with a happy smile on my client’s face.

How neck pain can be related to headaches

This does not imply that all headaches are neck-related, but my opinion is that a neck related cause should always be ruled out. Attend a Physiotherapist with a training in the treatment of neck-related headaches, then you can eliminate this simple possibility before you decide on any longer term treatment or medication - or at least discuss this possibility with your doctor. Most doctors will appreciate this connection and investigate it before embarking on other forms of treatment.

The upper neck (known anatomically as C0/1) can refer pain into your forehead and upper head. This is a nerve referral (quite similar to sciatica where a nerve in your lower back refers pain down the back or side of your leg).

The muscles of your upper back attach into the base of your skull. If they become tight they can pull your upper neck joints into compression causing headaches. In these situations, re-aligning or mobilising this joint often alleviates the headache.

This type of headache is common in office workers with poor posture and “chin poke”. Such clients may end up wearing glasses as they associate their headaches with the brightness of the screen as opposed to the true cause - their own posture as they sit and work at their computer.

Another common cause occurs when you are stressed - and often end up clenching your jaw at night in your sleep. This can result in muscles in your neck and face becoming tight - resulting again in a headache. Clients in this situation frequently ends up being treated with bite guards provided by their dentists to alleviate the clenching. However, some simple stretches could alone, or in conjunction with the bite guard alleviate can your headache quicker and more effectively.

Treatment of mechanical headaches involves mobilising the tightened muscles, ligaments and joints. With my own clients, I then educate them on postural positions and posture exercises to prevent these structures from tightening up again. Prevention is always better than cure, so posture correction and education in my opinion is a must for us all, especially if you have a more sedentary lifestyle and sit down for an extended period of time.

Here are two recent examples of patients with neck related headaches that I typically see (I have changed the names for privacy).

Jim’s Headaches

Jim is a 75 year old man who attended me with a twenty year history of intermittent severe headaches. He reported that they were aggravated by stress and his doctor had been treating them with medication for years. They were so severe, that he was losing days in his life when they came on.

After assessing him I realised he was severely restricted in both joint and muscle mobility of his upper neck. I talked to him about the connection between the two, treated him and sent him home with some exercises.

After his first physiotherapy/craniosacral therapy session I didn’t hear from him again for a few weeks. Worried, I rang him but he happily informed me that he had had no headaches since this date. Although this man’’s headaches may return, at least he now realises that they can be treated manually and successfully without drugs. He checks back in for treatment now and again when he needs it. Now that’s a patient that brings a smile to my face!

Jenny’s Story.

A young Mum called Jenny recently came to me complaining of pain at the base of her skull and over the right side of her forehead. It was a constant ache but was significantly worse at the end of the day and when she was sitting down.

When I questioned Jenny, she remembered knocking her forehead on the frame of a door some weeks previously - Jenny is over six foot tall! Although she felt no neck or head pain at the time her headache started two days later, so she correctly associated her headaches with this accident.

When I assessed Jenny’s neck she had a restriction in her movement when turning to the right. Looking at Jenny’s sitting posture - she sat with her chin poked up slightly and her shoulders rounded too much. I am never happy with poor posture!

I palpated Jenny’s neck and noticed that a facet joint at the top right side of her neck was very stiff and the muscles around the base of her neck were very tight. I was able to intensify her headache when I palpated the stiffened joint. This helped me confirm my diagnosis.

At this stage my impression was that Jenny had knocked her neck out of alignment when she hit her head off the wall. Secondary to that her neck muscles had become overactive and tight in response to it. Because Jenny’s sitting posture was bad, when she was sitting more pressure was being placed on her injured neck and hence her pain worsened. By the end of the day her neck was tired - and as a result was unable to hold her head effectively so her symptoms appeared worse.

I treated Jenny on three occasions to loosen her neck and soften her overactive muscles. Her headache had disappeared after the first session. However, I encouraged Jenny to have two more sessions to ensure the cause of her headache had been fully removed. Removing the cause of pain is always the key to a lasting success. Jenny attends a weekly Pilates class as she is keen to improve her posture. Well done Jenny!

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Check if your headache is neck related.

Ultimately, If you suffer from frequent or chronic headaches, then I suggest that you seek the advice of an open-minded doctor, physiotherapist or dentist and see if the cause is neck related. It is helpful to do consult with them before deciding on the long term management (or just putting up with it!). This will ensure that you will find the least invasive approach to the management of your neck pain headaches.


While the content and materials contained in the articles on this website have been written & researched by Sally Ann Quirke, a professional, practising & fully qualified Chartered Physiotherapist (Physical Therapist) based in Ireland, they are provided for general information and educational purposes only. They do not constitute medical advice on any particular individual situation. Please see your Chartered Physiotherapist or other medical practitioner for full and individual consultation.

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