Headaches and Migraines.
Can physiotherapy help with headaches?
Yes — for a significant proportion of headache sufferers, physiotherapy is one of the most effective treatments available. The key is accurate identification of the headache type, because the treatment for a cervicogenic headache is fundamentally different from that for migraine, tension-type headache, or TMJ-related headache. Many people with chronic headaches that haven't responded to medication are living with an unrecognised structural or musculoskeletal component that physiotherapy can directly address.
Types of headache — and which respond to physiotherapy
Headaches are classified by the International Headache Society into primary headaches — where the headache itself is the condition — and secondary headaches, where the headache is a symptom of an underlying condition. This distinction matters for physiotherapy because the assessment approach and treatment targets differ significantly.
Tension-type headache — the most common headache type, affecting approximately 40% of the population — produces a bilateral pressing or tightening sensation, typically described as a band around the head, without the nausea, photophobia or phonophobia characteristic of migraine. Episodic tension headache is strongly associated with stress, poor posture and muscular tension — particularly in the suboccipital, upper trapezius, temporalis and masseter muscles. Physiotherapy addressing these muscular contributors — trigger point release, dry needling, manual therapy and postural correction — is highly effective for episodic tension headache. Chronic tension headache (more than 15 headache days per month) has a more complex multifactorial basis and benefits from a broader approach combining physiotherapy with pain psychology and lifestyle intervention.
Migraine — affecting approximately 15% of the population with a strong female predominance — is a primary neurological condition characterised by recurrent attacks of moderate to severe unilateral throbbing headache with nausea, photophobia and phonophobia, often preceded by an aura. Migraine is driven by cortical spreading depression and trigeminovascular sensitisation and is primarily managed medically — with acute treatments (triptans, anti-emetics) and preventive medications (beta-blockers, topiramate, CGRP antagonists) — rather than by physiotherapy addressing the migraine mechanism directly. However physiotherapy plays an important role in migraine management by addressing the musculoskeletal triggers that precipitate attacks in many migraineurs. Upper cervical joint dysfunction, masticatory muscle tension and forward head posture are all recognised migraine triggers that physiotherapy can reduce, decreasing attack frequency in responsive patients. If you identify that your migraines are consistently triggered by neck stiffness or specific neck positions, a physiotherapy assessment is appropriate.
Cervicogenic headache — headache arising from dysfunction in the upper cervical spine — is one of the most important and most commonly missed headache presentations in physiotherapy practice, affecting approximately 15 to 20% of chronic headache sufferers. Cervicogenic headaches are those related to problems in the neck — caused by things like poor posture, whiplash, previous injuries to the head or neck, or repetitive strain. The symptoms include pain on one side of the head that can radiate from the back of the head, triggered or worsened by certain neck positions or movements, and sometimes accompanied by nausea, sensitivity to light or sound, or blurred vision. Cervicogenic headache is highly responsive to physiotherapy — see our dedicated cervicogenic headache page for the full assessment and treatment detail.
TMJ-related headache — headache arising from the masticatory muscles, particularly the temporalis — produces temple and forehead pain that closely mimics tension headache and migraine. The temporalis muscle, when loaded with trigger points from jaw clenching, teeth grinding or masticatory overload, refers pain in a characteristic temporal pattern. Dry needling of the temporalis and masseter, TMJ manual therapy, and management of parafunctional habits can produce rapid and significant headache relief in this population.
Post-traumatic headache — headache developing after head or neck injury, including whiplash — is one of the most common presentations in physiotherapy. The upper cervical facet joints at C2-3 and C5-6 are the most commonly injured structures in whiplash and are a primary source of post-traumatic headache. Manual therapy targeting these joints alongside deep cervical flexor retraining produces meaningful headache reduction in post-whiplash populations.
Exertional and activity-related headache — where headache is triggered by physical exertion — may reflect underlying musculoskeletal contributors to headache that are unmasked by increased cervical loading during exercise, or in some cases represent more serious pathology requiring medical assessment.
When to see a GP or specialist
Red flags that warrant further medical assessment include headaches that get worse over time, sudden onset of severe head pain, headaches in combination with high fever, rash and neck stiffness, headache following a head injury, and profound dizziness and visual disturbances. Any new headache in an older adult, a headache that wakes you from sleep, headache with personality change, or the worst headache of your life are also red flags requiring urgent medical assessment. Physiotherapy is appropriate after serious causes have been excluded.
How can physiotherapy help?
Treatment for cervicogenic and musculoskeletal headaches depends on the underlying causes. Your physiotherapist will assess your muscle length, joint movement, and postural alignment to develop a personalised treatment plan that may include manual therapy, exercise, and advice on posture and ergonomics.
Manual therapy — cervical joint mobilisation targeting the upper cervical segments — is the most evidence-based intervention for cervicogenic headache and significantly reduces both headache frequency and intensity. Deep cervical flexor retraining rebuilds the muscular support of the upper cervical spine and reduces the recurring joint stress that perpetuates headache. Real time ultrasound makes this retraining precise and teachable.
Dry needling of the suboccipital muscles, upper trapezius, temporalis and masseter addresses the myofascial trigger point component that contributes to both tension-type and cervicogenic headache. Thoracic spine mobilisation and scapular control work addresses the postural contributors — the forward head posture and thoracic kyphosis that increase upper cervical joint loading and masticatory muscle tension.
Clinical Pilates provides structured thoracic extension, scapular control and deep cervical stabiliser training that addresses the postural contributors to headache in a sustainable, progressive way.
Ergonomic advice — workstation setup, device use habits, sleeping position — addresses the environmental factors that will perpetuate the problem if not modified alongside clinical treatment.
Our physiotherapists Yulia Khasyanova and Mauricio Bara both have experience in headache and cervical spine conditions and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Yes — for a significant proportion of headache sufferers, physiotherapy is one of the most effective treatments available. The key is accurate identification of the headache type, because the treatment for a cervicogenic headache is fundamentally different from that for migraine, tension-type headache, or TMJ-related headache. Many people with chronic headaches that haven't responded to medication are living with an unrecognised structural or musculoskeletal component that physiotherapy can directly address.
Types of headache — and which respond to physiotherapy
Headaches are classified by the International Headache Society into primary headaches — where the headache itself is the condition — and secondary headaches, where the headache is a symptom of an underlying condition. This distinction matters for physiotherapy because the assessment approach and treatment targets differ significantly.
Tension-type headache — the most common headache type, affecting approximately 40% of the population — produces a bilateral pressing or tightening sensation, typically described as a band around the head, without the nausea, photophobia or phonophobia characteristic of migraine. Episodic tension headache is strongly associated with stress, poor posture and muscular tension — particularly in the suboccipital, upper trapezius, temporalis and masseter muscles. Physiotherapy addressing these muscular contributors — trigger point release, dry needling, manual therapy and postural correction — is highly effective for episodic tension headache. Chronic tension headache (more than 15 headache days per month) has a more complex multifactorial basis and benefits from a broader approach combining physiotherapy with pain psychology and lifestyle intervention.
Migraine — affecting approximately 15% of the population with a strong female predominance — is a primary neurological condition characterised by recurrent attacks of moderate to severe unilateral throbbing headache with nausea, photophobia and phonophobia, often preceded by an aura. Migraine is driven by cortical spreading depression and trigeminovascular sensitisation and is primarily managed medically — with acute treatments (triptans, anti-emetics) and preventive medications (beta-blockers, topiramate, CGRP antagonists) — rather than by physiotherapy addressing the migraine mechanism directly. However physiotherapy plays an important role in migraine management by addressing the musculoskeletal triggers that precipitate attacks in many migraineurs. Upper cervical joint dysfunction, masticatory muscle tension and forward head posture are all recognised migraine triggers that physiotherapy can reduce, decreasing attack frequency in responsive patients. If you identify that your migraines are consistently triggered by neck stiffness or specific neck positions, a physiotherapy assessment is appropriate.
Cervicogenic headache — headache arising from dysfunction in the upper cervical spine — is one of the most important and most commonly missed headache presentations in physiotherapy practice, affecting approximately 15 to 20% of chronic headache sufferers. Cervicogenic headaches are those related to problems in the neck — caused by things like poor posture, whiplash, previous injuries to the head or neck, or repetitive strain. The symptoms include pain on one side of the head that can radiate from the back of the head, triggered or worsened by certain neck positions or movements, and sometimes accompanied by nausea, sensitivity to light or sound, or blurred vision. Cervicogenic headache is highly responsive to physiotherapy — see our dedicated cervicogenic headache page for the full assessment and treatment detail.
TMJ-related headache — headache arising from the masticatory muscles, particularly the temporalis — produces temple and forehead pain that closely mimics tension headache and migraine. The temporalis muscle, when loaded with trigger points from jaw clenching, teeth grinding or masticatory overload, refers pain in a characteristic temporal pattern. Dry needling of the temporalis and masseter, TMJ manual therapy, and management of parafunctional habits can produce rapid and significant headache relief in this population.
Post-traumatic headache — headache developing after head or neck injury, including whiplash — is one of the most common presentations in physiotherapy. The upper cervical facet joints at C2-3 and C5-6 are the most commonly injured structures in whiplash and are a primary source of post-traumatic headache. Manual therapy targeting these joints alongside deep cervical flexor retraining produces meaningful headache reduction in post-whiplash populations.
Exertional and activity-related headache — where headache is triggered by physical exertion — may reflect underlying musculoskeletal contributors to headache that are unmasked by increased cervical loading during exercise, or in some cases represent more serious pathology requiring medical assessment.
When to see a GP or specialist
Red flags that warrant further medical assessment include headaches that get worse over time, sudden onset of severe head pain, headaches in combination with high fever, rash and neck stiffness, headache following a head injury, and profound dizziness and visual disturbances. Any new headache in an older adult, a headache that wakes you from sleep, headache with personality change, or the worst headache of your life are also red flags requiring urgent medical assessment. Physiotherapy is appropriate after serious causes have been excluded.
How can physiotherapy help?
Treatment for cervicogenic and musculoskeletal headaches depends on the underlying causes. Your physiotherapist will assess your muscle length, joint movement, and postural alignment to develop a personalised treatment plan that may include manual therapy, exercise, and advice on posture and ergonomics.
Manual therapy — cervical joint mobilisation targeting the upper cervical segments — is the most evidence-based intervention for cervicogenic headache and significantly reduces both headache frequency and intensity. Deep cervical flexor retraining rebuilds the muscular support of the upper cervical spine and reduces the recurring joint stress that perpetuates headache. Real time ultrasound makes this retraining precise and teachable.
Dry needling of the suboccipital muscles, upper trapezius, temporalis and masseter addresses the myofascial trigger point component that contributes to both tension-type and cervicogenic headache. Thoracic spine mobilisation and scapular control work addresses the postural contributors — the forward head posture and thoracic kyphosis that increase upper cervical joint loading and masticatory muscle tension.
Clinical Pilates provides structured thoracic extension, scapular control and deep cervical stabiliser training that addresses the postural contributors to headache in a sustainable, progressive way.
Ergonomic advice — workstation setup, device use habits, sleeping position — addresses the environmental factors that will perpetuate the problem if not modified alongside clinical treatment.
Our physiotherapists Yulia Khasyanova and Mauricio Bara both have experience in headache and cervical spine conditions and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
