Chronic Headache? Try Physiotherapy Treatment!



Do you always carry Advil around in case a headache strikes during your work day? Do you experience a lot of tension in your shoulders and neck? Is your massage therapist your best friend?


If any of these questions relate to your life, you may be suffering from cervicogenic headaches. Cervicogenic headache refers to a headache caused by neck pain that progresses to a headache. The joints of the neck need to move freely for movement to be pain free. If stiffness develops in the joints or if muscles surrounding the joints become too stiff, the movement is impaired which can lead to pain. Nerves that supply the head, jaw, forehead and ears come from your neck which is why reduced movement and stiffness in the neck can lead to pain in any of those areas.


What causes cervicogenic headaches?

The first step is to determine the cause of your headache. A thorough assessment by a physiotherapist is a good place to start. Your physiotherapist will assess:

  • Your head, neck and shoulder movement to determine if there are limitations

  • The mobility of your neck and upper back joints to screen for any restrictions or impingements

  • Your neck and shoulder muscles to determine if they have increased tension


Movement restriction or muscle tightness can be cause by a variety of factors from poor posture, overuse, previous injuries, or even genetics. In cases of chronic headaches, persistent pain can lead to the nervous system becoming more sensitive to pain signals and trigger a pain response more rapidly. This is referred to as sensitization and leads to a vicious cycle of repeated symptoms, emphasizing the need to find the root cause of your headaches and treat it adequately.

Your physiotherapist at Reach may also consult an occupational therapist if they think that your environment might be contributing to your headache. An occupational therapist can make recommendations on the ergonomics of your work station, sleeping postures or other modifications to your home or work environment to minimize strain on your neck and shoulders.


Common headache symptoms

Cervicogenic headaches can have different patterns for different individuals depending on the root cause and the specific area of the neck that is affected. The most common symptoms are:

  • Headache on one side of the head

  • Headache that starts at the upper neck or base of the skull

  • Headache that worsens as the day goes on

  • Headache often felt with prolonged sitting or time on the computer

  • Stiffness or restricted neck movement

  • Light-headedness or dizziness


How can physiotherapy help with headaches?

Once your physiotherapist has determined the cause(s) of your headache, they will discuss treatment options with you and make a plan using a variety of treatment approaches that may include:

  • Manual therapy/joint mobilization: this is hands-on physiotherapy aimed at regaining joint glide to improve movement.

  • Dry needling: this technique uses acupuncture needles aimed at relieving trigger points (areas of increased muscle tone) to reduce muscular tightness in your shoulders and neck. For more information on this technique, go check out our blog post on dry needling

  • Soft tissue release: manual or instrument assisted soft tissue release to reduce muscle tightness

  • Active stretches: your therapist will give you specific stretches to do in therapy and at home to maintain and improve muscle length

  • Postural correction exercises: if poor posture appears to a contributing factor to your headaches, you will be provided with specific exercises to improve your posture and correct muscle imbalances. If needed, this is also where our occupational therapist can help by making your environment more appropriate to the needs of your daily activities and specifics of your body.

  • Strengthening: exercises are also frequently used to strengthen your neck and/or back muscles which can help improve posture and correct muscle imbalances.


It’s time to quit the band-aid solutions. Come see Reach’s interdisciplinary team to put an end to this headache!

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