Headache & Neck Pain: What You Need to Know (From a Physiotherapy Perspective)
Headache and neck pain often show up together—and for many people, they can become persistent, frustrating, and confusing. The good news? Understanding why they happen and how to manage them can make a huge difference.
This guide breaks down the common causes, how physiotherapy can help, key stretches for self-management, and how to tell the difference between major types of headaches.
1. Why Do Headache and Neck Pain Occur Together?
Headache and neck pain share overlapping structures: muscles, joints, nerves, and connective tissues. When these become irritated, they can refer pain upward into the head.
Common Causes
Muscle tension or trigger points in the upper trapezius, scalene, and levator scapulae
Poor posture, especially prolonged head-down tilt (phones, laptops, tablets)
Cervical joint dysfunction, especially in the upper neck (C1–C3)
Stress leading to jaw clenching and increased muscle tension
Previous injury, such as whiplash
Repetitive or sustained load, e.g., long desk hours, cycling position
When these factors accumulate, they can overload the structures of the neck and trigger headache patterns.
2. Physiotherapy Treatment for Headache & Neck Pain
A physiotherapist typically uses a combination of:
Manual therapy
Joint mobilization of the upper cervical spine
Soft tissue release of tight or overactive muscles
Posture and movement retraining
Learning how to move efficiently reduces unnecessary strain on the neck.
Strengthening
Especially the deep neck flexors, scapular stabilizers, and postural muscles.
Education
Understanding your triggers and habits is often the most powerful intervention.
Exercise program
Targeted stretches, mobility exercises, and strengthening work to reduce recurrence.
3. Self-Management: Key Stretches for Neck-Related Headaches
Below are three of the stretches for tension-related neck pain.
Upper Trapezius Stretch
How to do it
Sit tall.
Hold the side of the chair with one hand.
Gently tilt your head to the opposite side.
Hold 20–30 seconds, repeat 2–3 times each side.
Levator Scapulae Stretch
How to do it
Turn your head 45° toward one armpit.
Gently pull your head downward toward that armpit.
Hold 20–30 seconds, repeat 2–3 times.
Scalene Muscle Stretch
How to do it
Sit tall and put one hand behind your back.
Tilt your head away from that side.
Slightly rotate your head up to stretch the front neck muscles.
Hold 20–30 seconds.
4. Differentiating the Main Types of Headaches
Understanding your headache type helps determine the best treatment
Migraine
Throbbing or pulsating
Often one-sided
May include nausea, sensitivity to light/sound
Attacks last hours to days
Can be triggered by hormones, stress, sleep changes, certain foods
Physiotherapy helps by reducing neck-related triggers and improving muscle tension.
Tension-Type Headache
Dull, tight, pressure-like pain around the forehead, temples, or back of head
Often linked to muscle tension and stress
Usually mild to moderate
Physiotherapy is very effective—stretches, manual therapy, and posture training help significantly.
Cervicogenic Headache
Starts in the neck, then radiates to the head
Typically one-sided
Triggered by certain neck movements or sustained postures
Often accompanied by neck stiffness
This is where physiotherapy shines: joint mobilization, strengthening, and movement retraining are key.
5. Head-Down Tilt & Cervical Spine Load: Why Posture Matters
Modern lifestyle puts the neck under more load than ever.
How much load does head tilt create?
Neutral (0°): ~4.5–5 kg
30° head tilt: ~18 kg
45° head tilt: ~22 kg
60° head tilt: up to 27 kg
This means that texting, looking down at your phone, or leaning over a laptop for hours can triple or quadruple the forces on your neck muscles and joints.
Practical tips
Raise screens to eye level
Keep phones at chest/eye height
Take movement breaks every 30–45 minutes
Support your lower back to keep your neck upright
6. Takeaway
Headache and neck pain often share a common origin. With the right combination of physiotherapy treatment, self-management exercises, and posture strategies, many people experience dramatic relief.
If your headaches are persistent, worsening, or affecting your daily function, a physiotherapist can assess your movement patterns and design a personalized plan.
