Not all headaches are treatable by a physiotherapist, and being straight about which are is the most useful thing this page can do.
The ones we can help are cervicogenic headaches, which arise from the joints, muscles and nerves of the upper neck. They typically start at the base of the skull and spread forwards over one side of the head, they are usually one sided and stay on the same side, they are affected by neck position and movement, and they come with a stiff or tender neck. Many people who have them have been treating them as migraines or tension headaches for years.
More information
What we cannot treat
Migraine is a neurological condition and physiotherapy does not treat it directly, though neck treatment sometimes reduces how often attacks are triggered in people who have both. Medication overuse headache, which is common and under-recognised, needs your GP. Cluster headaches need medical management.
We will tell you honestly at the assessment which sort we think you have, and refer you back to your GP if physiotherapy is not the answer.
What treatment involves
Assessment of the upper neck joints, the muscles around them and how your neck behaves under sustained load. Then hands on treatment to the specific segments involved, and exercise for the deep neck muscles, which are commonly weak in people with cervicogenic headache.
Most people who genuinely have neck driven headaches notice a change within a handful of appointments, which also serves as a useful test of the diagnosis.
When a headache is an emergency
A sudden severe headache unlike any you have had, a headache with fever and a stiff neck, one after a head injury, or one with weakness, confusion, visual loss or a first seizure needs emergency attention. Ring 999 or go to hospital.
