Neck Pain and Headaches: Treatment Tips and Exercises from Physical Therapists

It’s common to think of a headache as just a headache. Maybe you write it off as the result of stress or forgetting to eat lunch or a too-tight ponytail, but sometimes it can be related to neck pain. In fact, headache and neck pain often go together. 

“Headaches are often a reaction to something going on in the neck,” says Samantha Stewart, PT, DPT, a physical therapist at Hinge Health. Much of the time, it can be related to lifestyle habits that strain or stress the neck. Over time, this can lead to irritation and inflammation in the neck that triggers chronic head and neck aches.

While headaches can be uncomfortable and distracting, there's a lot you can do on your own to manage neck pain-related headaches, reassures Dr. Stewart. 

Read on to learn more about how neck pain can contribute to headaches, and how to feel better, especially with tips and exercises recommended by Hinge Health physical therapists.

Why Does Neck Pain Cause Headaches?

Many of the muscles in your neck and shoulders connect to the base of your skull, explains Dr. Stewart. As a result, when these muscles tighten up, they pull on your skull, which can trigger a headache. “I see this a lot in my patients, because they are always leaning forward, whether they spend long periods of time sitting in front of a computer, talking on their phone, or driving in a car,” she says. “Long periods in these positions can put strain on neck muscles and result in headaches.” 

Can a Stiff Neck Cause a Headache? 

Yes, there is a link between stiff neck muscles and headaches. There’s some recent research that links neck muscle inflammation, especially in the trapezius muscle — a kite-shaped muscle that stretches from the back of the neck down to the shoulders — to headaches, including migraines and tension-type headaches. A 2022 review in the journal Cephalalgia found that people with chronic migraines were more likely to experience neck pain than those who had migraines less frequently. “It’s still a bit of a mystery in these cases — we don’t know if headaches cause neck pain, or vice versa, or if it’s a bit of both,” points out Dr. Stewart. 

There are also other causes of headaches related to neck pain. Cervicogenic headaches, for example, are related to joint inflammation in the upper neck (cervical spine). Occipital neuralgia is another condition — in this case the nerves that run from the top of your spinal cord up through your scalp become inflamed. 

While headaches and neck pain can stem from different causes, most of the time, treatment is the same, Dr. Stewart notes. This includes exercise, physical therapy, and lifestyle tweaks such as stress management. If these steps don’t work, you may want to consult with your primary care physician or a neurologist to discuss whether you should consider medical treatments to relieve headache pain. 

Symptoms of Headaches Related to Neck Pain

Your headache symptoms may be different depending on the type of headache you have, notes Dr. Stewart. Common symptoms include:

• A tight sensation and dull pain on both sides of the head. This is usually linked to tension-type headaches, says Dr. Stewart.

• A migraine, that is characterized by severe throbbing pain confined to one side of the head. You may also experience light sensitivity or nausea. 

• A shooting or throbbing pain that starts along the base of your head and spreads along your scalp on one or both sides. 

• Pain on one side of the head that radiates from your neck and back of your head, and is accompanied by neck stiffness. 

Treatment Options

It’s usually fine to occasionally reach for over-the-counter pain relievers like acetaminophen, ibuprofen, or naproxen to treat head and neck pain. (It’s important to make sure that you are safely able to take these medications, based on your medical history.) 

But to get to the root of the problem, it’s a good idea to focus on non-drug based therapies, like regular exercise, physical therapy, and lifestyle tweaks, advises Dr. Stewart. Give the below options recommended by Hinge Health physical therapists a try for a few weeks. If your head and neck pain doesn’t improve, you may want to see a headache specialist.

Physical therapy. It’s often recommended as the first-line treatment for headaches related to neck, according to the International Headache Society. “A physical therapist can teach you exercises to stretch and strengthen your neck, which increases blood flow to the area,” says Dr. Stewart. “These exercises also increase your tolerance to different positions, improve your neck mobility, and help to make sure that you have all the right muscles supporting your head and neck when you move.” You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Heat. A hot shower, moist hot towel, or hot water bottle can relax neck muscles and improve blood flow to the area, which helps to promote healing and reduce the likelihood of tension-type headaches, says Dr. Stewart. 

Regular exercise. “Aerobic exercise, even just brisk walking, helps to bring your shoulders away from your ears,” points out Dr. Stewart. “This helps stretch neck and shoulder muscles.”

Stress relief. When you’re stressed or anxious, you automatically tense up your neck and shoulder muscles, which in turn can strain the base of your skull and trigger a headache, says Dr. Stewart. “I had a patient recently come in with complaints of headache and neck pain,” she recalls. “It turns out they had just had a recent work deadline which caused a lot of tension and stress. They were tensing their neck and tightening their shoulders without realizing it.” 

Mindfulness-based practices, such as deep breathing or yoga, have been shown to help with stress and headaches. A 2019 review in the Journal of General Internal Medicine found that yoga helped to reduce headache frequency.

Tweak your pillow position. If you wake with neck pain or stiffness, Dr. Stewart recommends that you consider trying out a new pillow or tweaking your sleeping position. “Your neck can become sensitive to certain sleep positions if your head is pushed up too high or too low for your comfort,” points out Dr. Stewart. “This may cause tension as you sleep, which can contribute to pain or tightness.”

Stretching and strengthening your neck, shoulder, and upper back muscles can provide the support you need to avoid tension that can contribute to headaches. It’s rarely just one thing that may be contributing to your headache so engaging in exercises that work multiple parts of the body can be helpful. These moves, recommended by Hinge Health physical therapists, are a great place to start.  

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Just Move! 

“As soon as you feel a headache coming on, stand up and do something active,” says Dr. Stewart. “A little bit of movement can go a long way when it comes to preventing a headache.” A 2022 review of 79 clinical trials in the journal Physical Therapy found that exercise was a very effective way to treat and fend off headaches. “Movement helps to relieve muscle tension that can contribute to headache pain,” explains Dr. Stewart. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.  

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Varangot-Reille, C., Suso-Martí, L., Dubuis, V., Cuenca-Martínez, F., Blanco-Díaz, M., Salar-Andreu, C., Casaña, J., & Calatayud, J. (2022). Exercise and Manual Therapy for the Treatment of Primary Headache: An Umbrella and Mapping Review. Physical Therapy, 102(3). doi:10.1093/ptj/pzab308

2. Al-Khazali, H. M., Younis, S., Al-Sayegh, Z., Ashina, S., Ashina, M., & Schytz, H. W. (2022). Prevalence of neck pain in migraine: A systematic review and meta-analysis. Cephalalgia, 42(7):663-673. doi:10.1177/03331024211068073

3. Racicki, S., Gerwin, S., DiClaudio, S., Reinmann, S., & Donaldson, M. (2013). Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. Journal of Manual & Manipulative Therapy, 21(2), 113–124. doi:10.1179/2042618612y.0000000025

4. Anheyer, D., Klose, P., Lauche, R., Saha, F. J., & Cramer, H. (2019). Yoga for Treating Headaches: a Systematic Review and Meta-analysis. Journal of General Internal Medicine, 35(3), 846–854. doi:10.1007/s11606-019-05413-9

5. Watson, J. C. (2023, August 10). Cervicogenic Headache. UpToDate. https://www.uptodate.com/contents/cervicogenic-headache