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Headaches

Headaches can have many different causes, including tension and problems associated with the neck. Physiotherapy may help identify musculoskeletal factors that could be contributing to certain types of headache and provide appropriate treatment and management strategies.

Overview

Headaches are extremely common and can vary considerably in their cause, location, intensity and frequency. While some headaches occur independently of the muscles and joints, others may be associated with tension, posture or problems involving the neck and upper back.

Cervicogenic headaches, for example, originate from structures within the neck and may cause pain that travels into the head. Physiotherapists can assess whether musculoskeletal factors may be contributing to your symptoms and, where appropriate, develop a treatment and management plan tailored to you.

Symptoms

Headache symptoms can differ depending on their underlying cause. Symptoms associated with neck-related headaches may include:

  • Pain beginning in the neck or base of the skull and extending into the head
  • Headache predominantly affecting one side
  • Neck pain or stiffness
  • Reduced or uncomfortable neck movement
  • Headaches aggravated by certain neck movements or prolonged positions
  • Tenderness or tightness around the neck and upper shoulders

These symptoms can also occur with other types of headache, so an appropriate assessment is important rather than assuming the headache originates from the neck.

Causes

Headaches can have many different causes and are not always related to a musculoskeletal problem.

For some people, structures within the neck may contribute to headache symptoms. Factors can include joint or muscle irritation, reduced neck mobility, prolonged or repetitive postures, previous neck injuries, or increased muscular tension.

Other common headache types, including migraine and tension-type headaches, may have different or multiple contributing factors. A physiotherapy assessment can help determine whether there appears to be a musculoskeletal component to your symptoms and whether physiotherapy is appropriate.

Assessment

Your physiotherapist will begin by discussing your symptoms, including when your headaches occur, where you experience pain, how long symptoms last and whether particular movements, activities or positions affect them.

Where appropriate, your assessment may include examining neck movement, joint mobility, muscle function, posture and other relevant physical factors.

Importantly, your physiotherapist will also consider whether your symptoms are appropriate for physiotherapy management. If your presentation suggests that further medical assessment is required, you may be referred to your GP or another appropriate healthcare professional.

Treatment Options

Treatment will depend on the findings of your assessment and whether musculoskeletal factors appear to be contributing to your headaches.

Where physiotherapy is appropriate, treatment may include:

  • Manual therapy to the neck and surrounding areas
  • Exercises to improve neck mobility, strength and control
  • Advice regarding posture, movement and workplace or daily activities
  • Strategies for managing muscular tension
  • Education about factors that may contribute to your symptoms
  • A personalised home exercise and self-management program

Your physiotherapist will tailor treatment to your individual presentation rather than applying the same approach to every type of headache.

When to Seek Professional Advice

Consider seeking professional advice if headaches are persistent, recurring, changing in pattern or interfering with your everyday activities.

Some headaches require urgent medical assessment rather than physiotherapy. Seek urgent medical care for a sudden and extremely severe headache, or a headache accompanied by symptoms such as weakness or numbness, difficulty speaking, confusion, fainting, significant vision changes, fever with neck stiffness, or following a significant head injury.

If you are unsure about the cause of a new or unusual headache, speak with your GP or another appropriate healthcare professional.

Frequently Asked Questions

Do I need a referral to see a physiotherapist?

No. You can book directly with a physiotherapist without a referral. If your treatment is part of a specific insurance, workers' compensation or Medicare program, a referral may be required.

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