Chronic Headaches
Not all headaches come from the head. At Modern Physio we focus on understanding the root-cause of your problem & personalizing your treatment for lasting results.
Understanding Chronic Headaches
Not all headaches come from the head. A substantial proportion of persistent headaches are cervicogenic — driven by the joints and muscles of the upper neck, which refer pain into the back of the head, the temple or behind the eye. These are the headaches physiotherapy can genuinely help, and they are commonly mistaken for migraine or treated indefinitely with painkillers. Tension-type headaches also respond to work on posture, trigger points and workload. Migraine is a different condition requiring medical management, though neck treatment sometimes helps people who have both. The first job at Modern Physio in Jaipur is working out which kind you have, because the answer determines whether physiotherapy is the right treatment at all.
Common Symptoms
- Headache starting at the base of the skull and spreading forward
- Pain usually on one side, in the case of cervicogenic headache
- Headache brought on or worsened by neck positions or movement
- Reduced neck movement, particularly turning to one side
- Tenderness in the upper neck and shoulder muscles
- A band-like tightness around the head, in tension-type headache
- Headaches that worsen through a working day at a screen
- Associated neck or shoulder pain
How Common Is It?
Headache is among the most common reasons people seek healthcare, and neck-related headache makes up a meaningful share of persistent cases. It is under-recognised largely because the pain is felt in the head rather than where it originates.
Causes & Risk Factors
- Dysfunction of the upper cervical joints
- Trigger points in the neck and shoulder muscles referring pain into the head
- Sustained forward-head posture at a desk or on a phone
- Workstation set at the wrong height
- Previous neck injury, including whiplash
- Sleep position and pillow height
- Stress-related muscle tension in the neck and jaw
Our Diagnosis Process
- Detailed history of the pattern — onset, location, duration, and what brings it on
- Screening for the red flags below, and for features suggesting migraine or another medical cause
- Examination of upper cervical joint movement, including whether it reproduces your familiar headache
- Palpation for trigger points that refer into the head
- Assessment of posture, deep neck muscle endurance and workstation setup
- Referral for medical assessment where the presentation is not mechanical
Our Treatment Approach
- Manual therapy to the upper cervical joints where assessment reproduces the headache from there
- Trigger point release in the muscles referring pain into the head
- Deep neck flexor and shoulder blade endurance training — the part that reduces recurrence
- Workstation and screen-height changes, made specific to your actual desk
- Pillow and sleep position advice
- Guidance on medication-overuse headache, where frequent painkiller use has become part of the cycle — for discussion with your doctor
Recovery & Prevention Tips
- Keep a simple headache diary for two weeks: timing, duration, and what preceded it. Patterns emerge quickly
- Set a break timer at a desk — position change beats posture perfection
- Raise your screen so the top of it is at roughly eye level
- Do the neck endurance exercises daily; they are undramatic and they are what holds the gains
- If you are taking painkillers for headache on most days of the week, raise it with your doctor
Products That Can Help
Supports and equipment we fit at the clinic that patients with this condition commonly use alongside treatment — never instead of it.
Evidence & Sources
Tension-type headache is common, often related to muscle tension and posture, and is managed with activity, posture and trigger management rather than painkillers alone.
NHS — Tension headachesPersistent or changing headache patterns should be assessed medically to exclude other causes.
NHS — HeadachesFrequently Asked Questions
How do I know if my headache comes from my neck?
The strongest clue is reproduction: if examining specific upper neck joints brings on your familiar headache, that points to a cervicogenic source. Other clues are headaches triggered by neck positions, restricted neck movement, and pain that starts at the base of the skull.
Can physiotherapy help migraine?
Migraine is a medical condition and needs medical management. Some people with migraine also have a neck contribution, and treating that can reduce overall headache burden — but physiotherapy is not a migraine treatment and should not be sold as one.
I take painkillers most days. Is that a problem?
It can be. Frequent painkiller use can itself perpetuate headaches, a pattern known as medication-overuse headache. That is a medical issue to raise with your doctor; it is worth asking about, because treating the neck rarely works while it is going on.
How long before I notice a difference?
Where the neck is the driver, many people notice a change in headache frequency or intensity within a few sessions. If there is no change at all after a fair trial, that is information — it suggests the source is not mechanical, and it should prompt a rethink rather than more sessions.
Will I need imaging?
Usually not for mechanical headache. Imaging matters when the history suggests something that needs investigating, which is what the red-flag screen is for. Dr. Surabhi Bansal is a physiotherapist, not a physician: the clinic does not prescribe medication and has no imaging on site. Where medication review, investigation or a specialist opinion is the right next step, you will be told so and referred.
Medically Reviewed
This content was reviewed for medical accuracy by Dr. Surabhi Bansal, BPT, MPT (Ortho) with 14+ years of clinical experience.
At Modern Physio, all medical content undergoes a thorough review process to ensure accuracy and alignment with current physiotherapy standards. Our content is created to educate and should not replace professional medical advice. Learn more about our review process.
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