There are many causes of headaches, some of which are harmless and some may be life-threatening. Broadly these can be classified as primary headaches and secondary headaches.
Primary headaches are benign, recurrent headaches which are not caused by underlying disease processes. The most common form of this is migraine or headache from a cold or excess alcohol.
Secondary headaches however develop as a secondary symptom to an underlying disease process or anatomical structure. Examples of this include infection, head injury, tumor or cervicogenic headache.
A physiotherapist's role in headache care is to differentiate the likely cause of headache through thorough questioning and examination, and then refer to the correct health professional or attempt to treat the headaches if appropriate. The cervical spine (neck) tissues share common nerve structures to other parts of the head and can refer pain into the head causing secondary headaches. If these are thought to be responsible for a headache then treatment of these structures with manual therapy and exercise may help in the management of reducing cervicogenic headache.
In relation to cervicogenic headaches, research has demonstrated that physiotherapy for 6 weeks comprising both exercise and manual therapy in addition to a combined approach of the 2 interventions can significantly reduce headache frequency, intensity and neck pain 6 weeks of treatment. We also have clinicians trained in the Watson Headache technique in order to assess the upper neck and treat with manual therapy.
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If you have suffered from Headaches for a long time and standard Physiotherapy has not worked, you may want to look at our Headache Treatment Clinic.
There are many types of headaches, but the most common are tension‑type headaches, migraines, and cervicogenic (neck‑related) headaches. Tension‑type headaches often feel like a tight band or pressure across both sides of the head and are frequently linked to muscle tension, stress, and prolonged sitting, while migraines usually cause throbbing pain, often on one side, with possible nausea and sensitivity to light or sound.
Cervicogenic headaches come from irritation or dysfunction in the joints and soft tissues of the upper neck and can refer pain into the back of the head, temples, or behind the eyes, often worsening with certain postures or neck movements. At Auckland Physiotherapy, your physiotherapist uses the Watson Headache® Approach to determine whether your neck and brainstem sensitisation are driving your pain and to identify which specific joints and structures are involved so that treatment can be precisely targeted.
For mild headaches, simple steps like taking regular breaks from screens, gently moving your neck and shoulders, staying well‑hydrated, and using over‑the‑counter pain relief as directed by your GP or pharmacist can often settle symptoms. Short‑term strategies such as applying a warm pack to tight neck muscles or a cool pack to the forehead, practising relaxed breathing, and checking your work‑from‑home set‑up can also help reduce strain.
However, quick fixes alone rarely solve recurring headaches, especially when they are driven by upper neck dysfunction or a sensitised brainstem. Auckland Physiotherapy offers targeted, gentle manual therapy using the Watson Headache® Approach to reproduce and then ease your usual pain during treatment, followed by tailored exercises, posture and ergonomic advice, and lifestyle strategies to address the underlying cause rather than only masking symptoms.
You should see a clinician if your headaches are happening more than a few times a month, are changing in pattern, need frequent pain medication, or are starting to interfere with your work, sport, or family life. A GP visit is essential if your headaches are new and severe, occur after a significant injury, are associated with other neurological symptoms, or wake you from sleep, so serious medical causes can be ruled out.
Physiotherapy is appropriate when headaches are recurrent or long‑standing, especially if they are linked with neck stiffness, postural strain (for example desk or device use), or pain that changes with neck position. At Auckland Physiotherapy, your Master Physiotherapist will perform a detailed assessment of your neck, posture, and movement, explain whether your cervical spine is contributing to your headaches, and coordinate with your GP or specialist if further medical investigations are needed.
Migraines and recurring headaches often have a combination of triggers such as stress, poor sleep, hormonal changes, skipped meals, dehydration, certain foods or drinks, bright light and screens, and prolonged or awkward postures. For many people, a sensitised brainstem and irritated upper neck joints make them more vulnerable to these triggers, so episodes are more frequent or intense.
Prevention usually involves a mix of lifestyle strategies and targeted physical treatment: keeping regular sleep and meal routines, staying hydrated, moderating alcohol and caffeine, managing stress, and moving regularly during desk‑based work can reduce trigger load. At Auckland Physiotherapy, your physiotherapist can help identify neck and posture‑related triggers, apply the Watson Headache® Approach to desensitise your upper neck and brainstem, and give you specific exercises, ergonomic changes, and activity modifications so you can return to the things you enjoy without constantly worrying about your next headache.
Headache and migraine treatment at Auckland Physiotherapy focuses on finding and treating the underlying neck‑related drivers of your pain rather than relying only on medication. Your first appointment includes a thorough assessment of your headache history, neck and upper back joints, muscles, posture, and aggravating positions so your physiotherapist can confirm whether your cervical spine and a sensitised brainstem are contributing.
If your headache is suitable for physiotherapy, your treatment may include gentle, specific manual therapy techniques to the upper neck using the Watson Headache® Approach, postural and ergonomic advice, and a tailored exercise programme to improve strength and control around your neck and shoulders. Many people notice meaningful changes within the first one to five sessions, even if they have lived with headaches or migraines for years, and your physio will work alongside your GP or specialist to ensure you have a joined‑up plan for long‑term relief.
