Headaches

Characteristics / Clinical Presentation 

Common features seen in headaches that respond well to physiotherapy include:

• Pain that starts in the neck or base of the skull and may spread to the head, temples, or behind the eyes
• Tightness or aching in the neck, shoulders, or upper back
• Headache triggered or worsened by poor posture, prolonged sitting, screen use, or stress
• Reduced neck movement or stiffness
• Tenderness in neck or shoulder muscles

Some people may also experience:

• Light sensitivity
• Mild nausea or dizziness (more common with migraine-type headaches)
• Fatigue or difficulty concentrating

Physiotherapists also screen carefully for red flag symptoms (such as sudden severe headache, neurological changes, or systemic illness) to ensure appropriate medical referral when needed.

Treatment

Treatment depends on your type of headache but normally includes:

• Education and advice on posture, activity modification, pacing and headache triggers
• Manual therapy such as joint mobilisation or soft tissue techniques to redice stiffness and muscle tension in the neck and upper back.
• Exercise therapy  to improve neck strength, flexibility and control particularly of the deep neck and shoulder muscles
• Movement and ergonomic advice for desk work, screen use and sleep positions
• Relaxation and breathing techniques to help manage stress-related muscle tension.
• Self-management strategies to reduce headache frequency and improve long-term symptom control

Physiotherapy aims not only to reduce pain but also to address contributing factors and empower individuals to manage their headaches independently.