Understanding Tension Headaches: Can Neck Pain Be the Cause?

If you've ever had a headache that seems to start at the base of your skull and spread towards your forehead or behind your eyes, you may have wondered whether it's really your head that's causing the problem.
For many people, the answer is actually the neck.

At Better Bodies Physiotherapy, it's common to see people who book an appointment for headaches, only to discover that their neck is playing a significant role in their symptoms.
While not every headache is caused by the neck, understanding the connection can help you get the right treatment.

Can neck pain cause headaches?
Yes.
The muscles, joints, and nerves in your neck are closely connected to the structures involved in headaches.
When these tissues become irritated or sensitive, pain can sometimes be felt in the head rather than just the neck. This is known as a cervicogenic headache, meaning a headache that originates from the neck.
Neck pain can also contribute to tension-type headaches, where increased muscle tension and sensitivity may play a role.

What do neck-related headaches feel like?
Everyone experiences headaches differently, but neck-related headaches often include:

• Pain that starts at the base of the skull
• Pain that spreads towards the forehead, temple, or behind one eye
• A stiff or sore neck
• Headaches that become worse after long periods sitting or looking at a screen
• Pain that is aggravated by certain neck movements or positions

Some people notice that they wake up with both neck stiffness and a headache, while others find their symptoms build throughout the day.

Is it a migraine or a neck headache?
This is one of the most common questions people ask.
Migraines and cervicogenic headaches can sometimes feel similar, but they are different conditions.
Migraines often involve symptoms such as:

• Nausea
• Sensitivity to light or sound
• Visual disturbances (such as flashing lights or blurred vision)
• Headache that may not change with neck movement

Neck-related headaches are more likely to:

• Be associated with neck pain or stiffness
• Be aggravated by certain neck movements
• Improve as neck movement improves

Sometimes people experience both migraines and neck pain, which is why a thorough assessment is important.

Why does my headache get worse after sitting at a computer?
Many people spend several hours each day looking at a computer, laptop, or phone.
Remaining in one position for a long time can increase the demands on the muscles and joints around your neck. If these tissues become tired or sensitive, they may contribute to both neck pain and headaches.
Interestingly, it isn't usually about having "perfect posture."
Our bodies cope best with movement and variety, rather than staying in one position all day.
Changing positions regularly, taking movement breaks, and improving the strength and endurance of your neck and upper back can often make a significant difference.

Can physiotherapy help headaches?
If your headaches are coming from your neck, physiotherapy may help.
Treatment may include:
Understanding your symptoms
The first step is identifying whether your neck is likely contributing to your headaches.
Improving movement
Restoring normal movement in your neck can help reduce stiffness and improve your confidence with movement.
Strengthening the neck and upper back
Building strength and endurance can improve your neck's ability to cope with everyday activities, whether that's working at a computer, driving, or exercising.
Advice for work and daily activities
Small changes to your routine, combined with regular movement, may help reduce the frequency of headaches.

When should I seek medical attention?
Although many headaches are not caused by serious conditions, you should seek urgent medical assessment if you experience:

• A sudden, severe headache unlike anything you've had before
• Headaches following a significant head injury
• Headaches accompanied by fever, confusion, difficulty speaking, weakness, or changes in vision
• Persistent headaches that are becoming progressively worse

If you're unsure, it's always best to seek medical advice.

When should I see a physiotherapist?
Consider booking an appointment if:

• Your headaches are occurring regularly.
• You often have neck pain and headaches together.
• Sitting at a computer or driving seems to trigger your symptoms.
• Pain is affecting your work, sleep, or daily life.
• You're relying on pain relief medication more often than you'd like.

A physiotherapist can assess your neck, identify contributing factors, and help you develop a plan to reduce your symptoms.

The bottom line
Not every headache starts in your head.
For many people, the neck plays a significant role in recurring headaches, particularly when symptoms are associated with stiffness, prolonged sitting, or certain neck movements.
The good news is that, with the right assessment and management, many people can reduce both the frequency and severity of their headaches.

At Better Bodies Physiotherapy, we help people understand the cause of their neck pain and headaches so they can return to work, exercise, and everyday life with greater confidence.
If recurring headaches or neck pain are affecting your quality of life, we'd love to help.

Further reading:
​Neck Pain Physiotherapy
Shoulder Pain Physiotherapy
Sports Physiotherapy
Why does my neck hurt when I wake up?
Why does my neck click?