For people living with chronic migraines, finding lasting relief can be frustrating. Medications, neurologist appointments, diet changes, supplements and scans may all form part of migraine management, but one potential contributor can sometimes be overlooked: the neck.
Neck pain, stiffness and dysfunction in the cervical spine can occur alongside migraine and, for some people, may contribute to or amplify headache symptoms. Understanding the relationship between chronic migraines and the neck can help determine whether physiotherapy has a role alongside your broader migraine management.
At BeFit Training Physiotherapy, our physiotherapists assess neck-related headache presentations, including cervicogenic headache, at our Edgecliff and Coogee clinics.
What Is a Cervicogenic Headache?
A cervicogenic headache is a headache that originates from structures within the neck, such as the cervical joints, muscles or surrounding tissues.
Unlike migraine, which is a primary neurological headache disorder, a cervicogenic headache is considered a secondary headache because the source of the pain is related to another structure — in this case, the neck.
Common signs of a cervicogenic headache can include:
- Pain that begins in the neck or at the base of the skull
- Headaches that worsen with certain neck movements
- Headaches associated with prolonged sitting or sustained posture
- Stiffness or restricted movement through the neck
- Pain travelling from the back of the head towards the forehead or behind the eyes
- Tenderness through the upper neck and surrounding muscles
The symptoms can overlap with migraine, which is why determining what is contributing to your headaches is not always straightforward.
What Is the Connection Between Chronic Migraines and the Neck?
People with chronic migraines commonly experience neck pain or stiffness alongside their headaches. However, having neck pain during a migraine does not necessarily mean the neck is causing the migraine.
There is a neurological connection between the upper cervical spine and the trigeminal system, which plays an important role in headache and migraine pain. This shared pathway is often referred to as the trigeminocervical complex.
Because signals from the upper neck and head interact within this system, problems affecting the cervical spine may contribute to headache symptoms in some people.
This is where a physiotherapy assessment can be useful. Rather than assuming every migraine is coming from the neck, your physiotherapist can assess whether neck movement, joint mobility, muscle function and other physical factors appear to be contributing to your individual headache pattern.
Signs Your Neck May Be Contributing to Your Headaches
Everyone’s headache presentation is different, but there are some patterns that may suggest the neck deserves closer assessment.
These can include:
- Your headache regularly begins with neck pain or stiffness
- Pain starts around the base of your skull
- Your headaches worsen after long periods at a desk or using screens
- Turning or tilting your neck can reproduce or aggravate your headache
- You regularly experience tightness around the upper neck or shoulders
- Your neck movement feels restricted
- Massage, movement or changing position temporarily changes your symptoms
These signs do not automatically mean that your neck is the cause of your migraines. They may, however, provide useful clues that a musculoskeletal assessment is worthwhile.
Can Physiotherapy Help With Chronic Migraines?
Physiotherapy does not treat every cause of chronic migraines, and migraine management may involve input from your GP, neurologist or other healthcare professionals.
Where neck dysfunction is contributing to headache symptoms, physiotherapy can address the musculoskeletal factors that may be adding to the overall problem.
At BeFit, a headache and migraine physiotherapy assessment may look at:
- Cervical spine movement
- Upper neck joint mobility
- Muscle tension and sensitivity
- Neck strength and control
- Posture and sustained positions
- Workstation or screen-related loading
- Movements or activities associated with your headaches
The aim is to understand whether there is a physical component to your symptoms and, if so, what can be done about it.
What Does Physiotherapy for Neck-Related Headaches Involve?
Treatment depends on what your assessment identifies. There is no single treatment program that is appropriate for everyone experiencing headaches or migraines.
Manual Therapy
Hands-on treatment may be used to address stiffness or movement restrictions within the cervical spine and surrounding tissues.
Targeted Neck Exercises
Exercise may focus on improving the strength, endurance and control of the muscles supporting your neck, particularly where sustained positions or particular movements are contributing to symptoms.
Posture and Movement Strategies
If your headaches tend to appear after prolonged desk work, screen use or particular activities, your physiotherapist can help identify ways to change how your neck is being loaded throughout the day.
Muscle and Soft Tissue Treatment
Where appropriate, treatment may include soft tissue techniques or dry needling to address muscular tension and sensitivity around the neck and shoulders.
Self-Management
Understanding your own headache patterns can be an important part of management. Your physiotherapist can help you identify relevant physical triggers and give you strategies and exercises to manage them outside the clinic.
Why Can Neck-Related Headaches Be Difficult to Recognise?
Migraine is a complex neurological condition, and appropriate medical management remains important. The difficulty is that migraine and neck-related headache symptoms can overlap.
Someone experiencing chronic migraines may have migraine as their primary diagnosis while also experiencing neck dysfunction that contributes to their overall symptoms.
That does not mean the neck is responsible for every migraine. It means there may be more than one factor worth considering.
If you regularly experience neck pain or stiffness with your headaches, or notice that particular neck movements and positions influence your symptoms, a physiotherapy assessment may help clarify whether there is a musculoskeletal component that can be addressed.
Common Questions About Migraines, Headaches and Neck Pain
How do I know if my migraines are coming from my neck?
It can be difficult to tell based on symptoms alone. Headaches associated with neck stiffness, restricted neck movement, pain at the base of the skull or symptoms influenced by neck position may suggest a cervical component. A physiotherapy assessment can help determine whether neck dysfunction appears to be contributing to your headaches.
Can physiotherapy reduce migraine frequency?
If neck dysfunction is contributing to your headache presentation, physiotherapy may help manage that component of your symptoms. Migraine itself is a complex neurological condition, so physiotherapy is often best considered as one part of a broader management approach rather than a replacement for medical migraine treatment.
Can neck pain cause headaches?
Yes. Headaches arising from structures within the cervical spine are known as cervicogenic headaches. They can sometimes produce symptoms that overlap with other headache types, which is why an appropriate assessment is important.
Do I need a referral to see a physiotherapist for migraines or headaches?
No. You do not need a referral to see a physiotherapist at BeFit Training Physiotherapy. If you have relevant imaging, neurologist correspondence or other medical information relating to your headaches, you are welcome to bring it to your appointment.
Is dry needling used for headaches?
Dry needling may be used where appropriate to address muscular tension or sensitivity associated with a neck-related headache presentation. It is only one possible treatment technique and is not required or appropriate for everyone. Your physiotherapist can discuss whether it is relevant to you.
How many physiotherapy sessions will I need?
There is no set number. It depends on what is contributing to your symptoms, how long you have been experiencing them and how you respond to treatment. After your initial assessment, your physiotherapist can discuss an appropriate treatment and management plan with you.
When Should You See a Physiotherapist About Chronic Migraines?
If you experience chronic migraines alongside recurring neck pain, stiffness or headaches that appear to change with neck movement or posture, it may be worth having your neck assessed.
Physiotherapy is not intended to replace appropriate medical or neurological migraine care. Instead, it can help determine whether there is a treatable musculoskeletal component contributing to your symptoms.
If your headache is new, unusually severe, rapidly worsening or significantly different from your normal headache pattern, seek appropriate medical assessment rather than assuming it is related to your neck.
How BeFit Can Help
At BeFit Training Physiotherapy, we assess and manage neck-related headache presentations at our Edgecliff and Coogee clinics.
If you are living with chronic migraines and regularly experience neck pain or stiffness alongside your headaches, we can assess how your neck moves and functions and determine whether musculoskeletal factors may be contributing to your symptoms.
No referral is required to book an initial physiotherapy assessment.
Book an appointment at BeFit Training Physiotherapy — no referral needed.
Edgecliff: (02) 9327 7749 | Coogee: (02) 7205 2805
