How Physiotherapy can help with Cervicogenic Headaches

Many of us quietly suffer with headaches, taking a pill in order to get on with our day.  For a subset of people, their headache is actually coming from their neck; treating the neck then results in a significant decrease in headache pain, intensity and frequency.

A classic example is the headache that starts at the back of the head, and then radiates to the forehead or eye; these are generally one sided and can present similar to migraines even though the cause is actually in the joints, muscles and nerves of the upper neck.   Headaches that feel like a gripping or pressing tightness through the entire forehead and temple area are also examples of headaches driven by the neck. When we choose to medicate our way out of a headache, especially if we’re taking medication twice a week or more, we can actually develop rebound headaches, leaving us with even more frequent headaches!

Is physiotherapy effective for rebound headaches?


If the cause is in the neck, then you must treat the neck! This is where a functional manual therapy approach comes in. A qualified physio will fully assess the root cause of the headache. If the problem is in the joints of the neck, the physiotherapist will restore natural motion and alignment of those joints. Through a combination of releasing tight and painful muscles and specifically retraining the correct postural muscles of the neck, a physio will help you to alleviate the pain generators driving the headache! Current research continues to demonstrate that this approach is effective for a large proportion of patients with a headache.

A quick checklist to help you start troubleshooting the cause of your headaches:

  1. Do you awaken with headaches? If so, the position that you are sleeping in may be putting too much strain on the neck…. this is especially true for individuals who sleep on the belly. Changing your sleep position and properly supporting the neck will often help immensely.
  2. Do you tend to get headaches after you’ve been at work for sometime? In this case, the posture that you’re in may be contributing to overuse of some of the muscles of the neck.  When these muscles become stiff and tight or even develop knots, the ensuing pain can be felt in the head. Changing the posture and strengthening the proper muscles will diminish headaches.
  3. Did your headaches develop after an injury to the head or neck?  Even a simple rear-end collision that you thought nothing of at the time can essentially “shut off” the stabilizing muscle of the neck.  More significant car accidents or falls can essentially jam up the joints of the neck and create continued headaches if not addressed.

If you find yourself continually reaching into the medicine cabinet to address your headaches, you are likely just perpetuating the cycle as opposed to heeding the warning signals of your body.  A qualified physiotherapist will help you identify the root cause of your headache, treat the joints and muscles that are creating your pain, and show you how to break the habits that have contributed to your headaches.

By Dr Katherine Kulp