Can Neck Problems Cause Headaches?
Senior Physiotherapist, Founder and Director · Registered with the Australian Health Practitioner Regulation Agency (PHY0002060505);
Kenny Merlevede is a Senior Physiotherapist with 18 years of experience in private practice, with a focus on complex cervical presentations and persistent musculoskeletal conditions
Last reviewed: 2 November 2026
Some headaches are linked to problems in the neck, jaw, posture or muscle tension. Cervicogenic headache (pain referred from the neck) is one example, and tension-type headache (often involving heightened sensitivity and muscle tenderness) can also involve the neck and shoulders. Both may respond to physiotherapy. Migraine is different: it is a neurological condition that usually needs medical care alongside strategies to manage triggers, but physiotherapy may still help when neck or jaw factors contribute.
Key Takeaways
Headaches have different causes: cervicogenic headache comes from the neck, tension-type involves muscle tenderness and sensitivity, and migraine is a neurological condition with distinct features like nausea and light sensitivity
Neck stiffness, headache that changes with neck movement, and pain at the base of the skull or behind the eyes often point to a neck-related cause
Physiotherapy may help reduce headache frequency and intensity through manual therapy, exercise, posture and movement retraining, and addressing contributing factors like stress, jaw clenching and screen habits
A headache diary tracking timing, triggers, sleep, meals and medication helps identify patterns and guides treatment
Seek urgent medical care for a sudden severe or “worst-ever” headache, new weakness or speech difficulty, confusion, fever with neck stiffness, visual loss, headache after significant injury, or a new and rapidly worsening pattern
What Causes Different Types of Headaches?
Headaches fall into two broad groups: primary headaches where the headache itself is the condition, and secondary headaches caused by another problem such as infection or injury.
Migraine typically causes moderate to severe pain, often on one side of the head, with a throbbing or pulsating quality. According to the International Classification of Headache Disorders, 3rd edition, published in 2018, untreated migraine attacks commonly last 4 to 72 hours and may be accompanied by nausea, vomiting, and sensitivity to light or sound. Some people experience aura (temporary visual, sensory or speech changes) before or during an attack.
Tension-type headache usually feels like a band of pressure across the forehead or around the head. It involves heightened sensitivity and tenderness around the head, neck and shoulders. The pain is not always caused by tight muscles alone: the nervous system's sensitivity plays a role.
Cervicogenic headache is pain referred from structures in the neck. It is usually linked with neck pain or stiffness, restricted neck movement, and headache that can be reproduced by specific neck positions or pressure. The pain often sits at the base of the skull or behind the eyes, and moving your neck may change the intensity.
"The biggest misconception is that people think they have migraines," says Kenny Merlevede, Senior Physiotherapist. "They've heard the word a lot from friends or online, so it becomes the label for any bad headache. But often what I see is a neck-related or tension-type headache, not a migraine. They can feel quite similar to the person, which is why the mix up is so common."
Secondary headaches result from another condition. A sudden "thunderclap" headache, new neurological symptoms such as weakness or speech difficulty, fever with neck stiffness, confusion, visual loss, headache after significant injury, or a new and rapidly worsening pattern requires urgent medical assessment.
How Can Neck Problems Cause Headaches?
The upper neck joints, particularly those near the base of the skull, share nerve pathways with parts of the head and face. When these joints become stiff or irritated, pain can be felt in the head, temples, behind the eyes, or even around the ears (a process called referred pain).
Muscles around the neck and shoulders can become overworked from sustained postures, stress, or repetitive movements. When these muscles are overloaded, they can develop tender points and contribute to headache, particularly when combined with reduced neck movement.
Forward head posture, where your head sits forward of your shoulders, is common in people who spend long hours at a desk or looking at screens. This position increases the load on the neck and upper back, and may be associated with neck pain and headache in some people.
Jaw clenching and grinding, especially during sleep, can also contribute. The jaw and neck are closely connected, and tension in one area often affects the other. Sleep quality, stress levels, work habits and training load can all add to the overall strain.
What Does the Research Show?
A 2023 systematic review and meta-analysis published in PM&R found that manual therapy may improve cervicogenic headache in the short term, while exercise-based physiotherapy may provide longer-term benefit (PM R. 2023;15(5):613-628). This review looked at cervicogenic headache only, and the authors note that more high-quality research is needed.
The International Classification of Headache Disorders, 3rd edition provides the diagnostic framework that helps clinicians distinguish between different headache types, including migraine, tension-type headache and cervicogenic headache.
Physiotherapy is most likely to help when the neck, jaw, posture, movement or muscle function contributes to the headache, and when the person is willing to work on the factors driving the problem.
How Do We Work Out Where Your Headache Is Coming From?
At the first appointment, we ask about your headache pattern, when it started, what makes it better or worse, and whether you have any other symptoms like neck pain, jaw tension, dizziness or nausea. We also ask about your work setup, sleep, stress levels, and any recent changes in your routine or training.
We then assess how your neck moves, check the joints at the top of your spine, and test the strength and control of the muscles that support your head and neck. We look at your posture while sitting and standing, and check whether certain positions or movements bring on your headache. Pressing on specific areas of your neck or shoulders may reproduce your headache, which helps confirm whether the neck is involved.
"The question I hear most is, 'How do I know if my headache is coming from my neck?'" says Kenny. "The internet gives long lists of headache types, but it's hard for someone to match that to their own head. What I usually look at is whether the neck is stiff or sore, whether moving the neck changes the headache, and whether the headache sits at the back of the head or behind the eyes. It's hard to work out alone, which is why people keep asking."
This assessment helps us work out whether your headache is likely to respond to physiotherapy, or whether you need medical review first.
What Does Physiotherapy Treatment Involve?
Treatment is tailored to what we find in your assessment. It usually includes a combination of hands-on therapy, exercise, education, and strategies to address the factors contributing to your headache. Results vary from person to person.
Manual therapy may include gentle joint mobilisation to improve movement in stiff areas of your neck and upper back, soft tissue work to ease overloaded muscles, and techniques to reduce sensitivity. These techniques may help reduce pain in the short term and make it easier for you to move and exercise.
Exercise focuses on retraining the deep muscles in your neck that help keep your head stable, and strengthening your upper back and shoulder muscles so they can support your posture throughout the day. We start with simple movements and gradually build up as your control and strength improve.
In some cases, dry needling or trigger point therapy may be used to help ease persistent muscle tension, particularly around the back of your neck, shoulders or jaw.
We also discuss your work setup, sleep habits, stress management, and any other factors that may be contributing. Small changes, such as adjusting your screen height, taking regular breaks, or improving your sleep routine, may help over time.
What Can You Do to Help?
Keep a headache diary for at least four weeks. Record the timing, duration, what the pain feels like, any other symptoms, your sleep quality, meals, hydration, medication use, and what you were doing when the headache started. This helps identify patterns and guides treatment.
Maintain regular meals, stay hydrated, and aim for consistent sleep. Avoid cutting out large numbers of foods without professional guidance, as this can increase stress and create nutritional problems.
If you are taking pain relief frequently, discuss this with your doctor or pharmacist. Overusing medication can actually make headaches worse over time, a condition called medication overuse headache.
Seek urgent medical care if you experience a sudden severe or “worst-ever” headache, new weakness or speech difficulty, confusion, fever with neck stiffness, visual loss, headache after significant injury, or a new and rapidly worsening pattern. These are warning signs that need immediate assessment.
Arrange a physiotherapy assessment if your headache occurs with neck pain, restricted neck movement or jaw symptoms, or if it isn’t settling. Early assessment can help identify what’s contributing and guide your next steps.
Common Questions
How do I know if my headache is coming from my neck?
Cervicogenic headache often sits at the base of the skull or behind the eyes, is linked with neck pain or stiffness, and changes when you move your neck. If your neck is stiff or sore, or if moving your neck changes the headache, the neck may be involved. An assessment can help work out whether your headache is likely to respond to physiotherapy.
What happens during a physiotherapy session for headaches?
We assess how your neck moves, check the joints at the top of your spine, and test the strength and control of the muscles that support your head and neck. Treatment may include gentle joint mobilisation, soft tissue work, dry needling, and exercises to retrain your neck and upper back muscles. We also discuss your work setup, sleep habits, and stress management.
How long does treatment take?
Recovery depends on how long you've had the headache, how severe it is, and what you're able to do between sessions. Some people notice improvement within a few sessions, but this varies from person to person. The goal is to reduce pain, understand why it happened, and build enough strength, movement, and resilience that it is less likely to keep coming back.
Reviewed by Maria Josefina Cánepa Bustos. She is a Senior Musculoskeletal Physiotherapist with a focus on sports and paediatric musculoskeletal rehabilitation, with eight years of clinical experienwith a focus once across private practice, sports clubs, and academic settings. Holds a Master of Science in Advanced Professional Practice in Paediatric Musculoskeletal Health, alongside postgraduate qualifications in therapeutic exercise and university teaching, working with young athletes, injury prevention, and performance-based rehabilitation in sport settings. Registered with the with the Australian Health Practitioner Regulation Agency (PHY0002918524)
This article is for general information only and is not a substitute for personal medical advice. If you have concerns about your health, please consult a qualified clinician or your GP.
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