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Can a Physiotherapist help with your headache?

It might surprise you that a physiotherapist can help you with certain types of headache!

Headaches are one of the most common yet debilitating pain that many feel frustrated about. Many are familiar with the term “Migraine”, but not all headache are migraines! Cervicogenic headache is the most common type of headache that a physiotherapist can treat.

Cervicogenic headache

Cervicogenic headache is caused by tightness, tension, and/or stiffness from the neck, especially in the upper cervical(neck) joints.

Here are some signs and symptoms to look out for:

  • Pain that originates from the neck, radiating to the back of the head, forehead, behind the eyes and ears, or face

  • Triggered by neck movements, and/or prolonged positioning in an awkward or uncomfortable neck posture

  • Headache tends to be on one side of the head and rarely changes side

  • Limited neck range and movements

  • Tight and tensioned neck muscles

Causes of cervicogenic headaches

  • Prolonged sitting in an incorrect posture

  • Whiplash, car accident, concussion

What to expect in a physiotherapy session

  • Assessment to determine the source of the headache

  • Manual therapy (soft tissue release, joint mobilizations)

  • Stretching exercises

  • Strengthening exercises for the neck and shoulder region

  • Ergonomic advice

Tips for managing cervicogenic headaches on your own

Other treatment methods (requires a visit to the GP or Specialist)

  • Simple analgesics (paracetamol, NSAIDs, COX-2 inhibitors)

  • Other medications like Muscle relaxants, or tricyclic antidepressants

  • Nerve blocks

  • Trigger point injections

  • Botulinum toxin (Botox)

  • Surgical interventions (often only provide temporary relief with the possibility of longer intensification of pain)

What about Migraines?

Migraines are chronic episodic headache, that appears to be influenced by genetics and environmental factors. They may be caused by changes to the brainstem and its interaction with the trigeminal nerve, and imbalances in brain chemicals.

Signs and symptoms

  • Typically last 4 to 72 hours

  • May be severe

  • Often but not always one-sided throbbing pain

  • Worse with exertion

  • May be accompanied by nausea; sensitivity to light, sound, or odours


  • Hormonal changes in women

  • Food, and/or food additives

  • Alcoholic drinks

  • Stress

  • Sensory stimuli – bright lights, loud sounds, strong smells

  • Changes in wake-sleep pattern

  • Physical exertion

  • Medications – oral contraceptives and vasodilators


Pharmacological treatment

  • Symptomatic treatment – for immediate relief of pain, to be taken when symptoms occur

  • Prophylactic treatment – to prevent or reduce the frequency of headache, usually taken regularly whether symptoms are present or not

Lifestyle modifications

  • Regular sleep

  • Regular and balanced diet

  • Moderate amount of routine exercise

  • Adequate amount of water

  • Reduce caffeine, alcohol intake

  • Stress management

  • Smoking cessation

  • Avoid known triggers

Not all headaches are migraines, and there are other common types of headaches such as cluster headache, tension headache, sinus headache. If you suspect that you are suffering from cervicogenic headache, seeking help from a physiotherapist can be beneficial. However, if you are uncertain about the type of headache that you have, a physiotherapist can assist in referring you to the right healthcare professional.

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