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Are Your Headaches Neck-Related? How to Self-Diagnose and Find Relief

Are Your Headaches Neck-Related? How to Self-Diagnose and Find Relief

Do you suffer from headaches?

More importantly, do you feel like they’re under control?

If, like many, you experience regular headaches you’ll know how debilitating they can be.

Particularly when they create such a handbrake on your capacity to think, be social and happy.

So it goes without saying how important it is to try and understand the cause of your headaches.

From what I’ve come to learn as a Physiotherapist, neck dysfunction may cause, or at least heavily contribute to, the majority of headaches. This isn’t to say all headaches are neck-related, but it suggests there’s a strong chance you can do something about them.

So if you’re looking to better understand your headaches and how to conquer them, here’s some professional advice to consider.

Headaches

For many, a headache represents an often unexpected or unpredictable ache, pain or tension somewhere on the face, head or top of the neck.

Staggeringly, almost half the adult population has had a headache within the last year.

In 2013, the International Headache Society released an in-depth classification system for headaches, which helps distinguish between the sheer volume of headache types.

And these types fit in to two major categories depending on the source of the headache:

  1. Primary Headaches
  2. Secondary Headaches

Primary Headaches

Primary headaches are headaches which are the primary concern. These include the most common headaches like tension headaches, migraines and cluster headaches.

  • Tension headaches or stress headaches are the most common type of headache. These are usually characterized by feelings of tightness and pressure around the forehead and base of the skull. Tension headaches can appear on one or both sides.
  • Migraines often present as a one-sided throbbing or pulsing sensation. They may also associate with Aura – reversible, usually visual neurological symptoms. In some cases we confuse severe tension headaches with migraines.
  • Cluster headaches are cyclical headache attacks that usually occur behind the eye. Often considered some of the most intense and uncomfortable headaches, cluster headaches can last for a short amount of time before disappearing and returning later on.

Secondary Headaches

Secondary headaches are not considered the primary medical condition. Headaches associated with structural neck dysfunction (Cervico-genic headaches), infections, head trauma and substance abuse are considered secondary headaches.

Interestingly, those hard-earned hangover headaches as well as “ice-cream” headaches fall squarely in this category as well.

Neck-Related Headaches

Interestingly, despite these specific classifications, neck dysfunction may be a common attribute with many of these.

So with this in mind I’d like to give you enough information to quickly work out whether your headaches are caused – or at the very least influenced by the neck.

Symptoms of Neck-Related Headaches

Clinically, neck-related headaches can present in the following ways:

  • Vague, hard to localize ache
  • Sharper, more specific pain

These symptoms can occur in a number of areas (one-sided or both):

  • Behind the eyes
  • Base of the skull
  • Temples
  • Forehead
  • Top of the head
  • Sinuses
  • Ear
  • Jaw
  • Teeth

They can also create the following associated symptoms:

  • Pressure
  • Feeling of tightness
  • Dizziness
  • Light-Headedness
  • Ringing in your ears (Tinnitus)
  • Mild loss of balance
  • Nausea
  • Lazy eye
  • Eyelid “tick”
  • Light-sensitivity
  • Blurred vision
  • Brain fog
  • Skin Sensitivity
  • Sensation of blocked sinus

Now many of the above symptoms can relate to other issues including medical conditions, but it’s important to understand they have the potential to be neck-related as well.

Symptoms of Serious Headaches

Despite many symptoms indicating a non-serious neck-related headache, it’s still vitally important to keep an eye out for more serious symptoms.

If you have any of these symptoms seek medical assistance immediately – even just as a precaution.

  • Sudden, severe headache
  • Slurred speech
  • Severe loss of balance
  • Memory loss
  • Confusion
  • Trouble moving extremities
  • Seizures
  • Vomitting
  • Fever

These may indicate more sinister causes of headaches like a brain aneurysm or brain tumor. Again, these are not to be taken lightly.

Cause of Neck-Related Headaches

To put things simply, many headaches (and facial symptoms) are referred from stiff, overloaded and irritated tissue in the upper neck and base of the skull.

Interestingly, this is often an easy connection to highlight.

By pressing through any upper neck joint stiffness, muscle tightness or spasm we can often reproduce relevant headache symptoms.

Furthermore, we can reduce these symptoms by successfully freeing up and/or settling the problematic areas.

So if you’re looking to better understand the potential cause of your headaches, it’s important to know where to look.

The Upper Neck

The spine has a far greater influence over our head, arm and leg function than we realize.

The upper neck in particular has neural connections to the head and face. And when challenged, these areas can express themselves symptomatically.

Clinically, the O/C1, C2 and C3 levels of the spine seem best at reproducing and influencing headache symptoms – particularly when stiff and surrounded by muscle tightness.

Anatomically, these strong neural connections between the head, face and neck are called dermatomes.

Dermatomes of the head, face and neck

Dermatomes are areas of skin supplied by singular nerve roots and formed during early fetal development. They’re also vitally important to appreciate if trying to understand referral pain patterns.

Interestingly, the diagnosis of most neck-related headaches is complicated by something simple – most have no awareness of any neck dysfunction at the time.

The upper neck may not feel stiff or tight and most certainly may not hurt. If you were a magician it would be a classic misdirect.

And this is why it’s crucial to have an awareness of the neck’s potential role in most headaches. To correctly diagnose and treat your headaches, you (or a health professional you trust) will often have to go looking for these specific areas. Many of which feel asymptomatic until touched.

The Role of Posture

If looking to truly understand the cause of your headaches, we need to ask why perfectly healthy and normal neck tissue has become stiff, tight and overloaded in the first place.

Headaches can certainly appear in an instant but the neck-related ones are often the last straw rather than the start of something new.

Consider the moment your headache began as the moment you breached your tissue’s threshold for dysfunction.

It may not be a linear progression, but is one often uninterrupted thanks to the covert nature of its progression.

pain threshold graph

And when looking to understand why the upper neck gradually becomes dysfunctional and irritated, we can start by analyzing the things we do most often.

The following are common situations that gradually overload an otherwise healthy upper neck:

  • Using your phone or laptop
  • Reading a book
  • Watching TV
  • Working on a computer
  • Doing school work
  • Arts and crafts
  • Playing an instrument
  • Cooking and cleaning

The key here is that each commonly involves bending the neck to look down, up or off to one side for hours a day. You may not do any one of these for too long but there’s a strong chance many do more than one each day.

It all adds up over time.

Our tissue is brilliant at buffering less than ideal shapes, but only for so long. Eventually we’ll creep closer to its threshold for pain until that threshold is breached. This is of course unless we do something about it.

But again, it’s hard to know what to look for without the right perspective.

Triggers for Headaches

One of the distracting features of many neck-related headaches are the triggers. The things that – on the surface – feel like they give us the headache.

Some typical triggers include:

  • Exercise
  • Alcohol
  • Stress
  • Lack of Sleep
  • Certain Foods
  • Certain Smells
  • Changes in Temperature

Again, it’s worth reinforcing we may associate many of these trigggers with other types of headaches and migraines. Just be aware they may also trigger a neck-related headache as well.

On the surface these triggers make perfect sense. You come in close contact with them and suddenly you have a headache.

However, it’s important to state that many triggers for neck-related headaches are inherently normal. Things like stress and a lack of sleep aren’t ideal, but they’re a part of being human.

Instead, it’s become clear that many triggers (as the title implies) may just expose underlying upper-neck dysfunction that’s already there. As mentioned above, consider these the last straw, not the first.

Furthermore, if we can improve the health, function and daily positioning of these already dysfunctional areas, these triggers should no longer contribute to the onset of a headache.

It’s clearly still possible for your body to have an unhealthy reaction to these stimuli, but it’s almost impossible to know for sure unless we remove your upper-neck dysfunction. Otherwise we’re just guessing.

The Role of Stress in Headaches

With any pain-related issue it’s important to understand the role of stress. This becomes even more important when talking chronic pain and headaches.

On its own, stress is unlikely to cause a headache. After all stress – for the most part, is normal.

It does however lower our threshold for pain and heightening our pain experience. And in the case of chronic headaches, stress can further amplify any symptoms and force them to hang around.

graph of stress lowering threshold to onset of pain

The reason for this comes back to the body’s innate fight or flight response.

It may surprise many to know that pain is not damage-specific. The amount of pain we feel is not related to the amount or severity of our dysfunction.

Instead, it relates to our brain and nervous system’s perception of threat – something stress directly influences.

So while stress should never cause a headache on its own, its presence may certainly bring forward and amplify your headache symptoms.

Treatment of Neck-Related Headaches

Treating neck-related headaches is best performed by a well-trained and experienced health professional. They can use their experience and clinical judgement to figure out the best course of action.

Typical treatment may involve the following:

  • Massage
  • Trigger-point therapy
  • Neck joint mobilization
  • Heat application
  • Pain relief
  • Deep Neck Flexor strength training
  • Postural correction
  • Neck Stretches

Thankfully, there are also a number of things you can do at home to try and improve neck-related headaches yourself.

Some of the most effective options involve a lacrosse ball (like this) or massage ball.

Self-Neck Mobilizations

There are a number of exercises you may have seen or be given by your therapist that attempt to regain mobility in your upper neck.

By far the best, fastest and most effective in my experience is a simple lacrosse ball exercise.

lacrosse ball neck mobility exercise lying down

How to Self-Mobilize Your Neck

Time needed: 10 mins

  1. Find a lacrosse ball (tennis ball, baseball or massage ball) and lie down.
  2. Gently let the ball press in to one side of your neck. Go looking for anything that feels tight, stiff or tender. Pay attention to anything that reproduces your headache or associated symptoms. Compare both sides.
  3. Prioritize areas that feel the most stiff and tight and relax. Let the ball sink in to what you feel needs attention. Then move on to the next spot.

This exercise can be used to preemptively scan and reduce the upper neck restriction associated with neck-related headaches. More importantly, it can be used mid-headache to self-assess and treat.

Postural Correction

Mobilizing the upper neck is crucial to quickly conquering your symptoms but correcting your posture gives you a chance to solve them for good.

Improving your posture is equal parts mental (fostering an awareness of your posture) and physical (maintaining and constantly reclaiming a good shape).

keanu reeves in a good neck posture vs a bad neck posture
Keanu Reeves showing the subtle difference between a good neck and head posture (L) and a less than perfect one (R)

Characteristics of correct head and neck posture:

  • Chin not poking out, up or down
  • Symmetry, no sideways tilt
  • Face pointing straight ahead

In order to make this easier try to improve your environment.

  • Raise the height of your laptop or computer screen
  • Hold your phone higher, lie on your side to use it
  • Adjust your car’s rearview mirror to suit an upright shape

Hot/Cold Showers

A useful way to try and short-circuit headaches is with a hot/cold contrasting shower.

The onset of pain with a headache is usually accompanied by a heightening of the nervous system and an increased perception of threat.

Contrasting hot/cold showers are a fantastic way to down-regulate and desensitize a threatened nervous system, positively impacting your pain.

Deep Breathing

If you’re a fellow Your Wellness Nerd nerd you’ll know how underrated deep breathing is for pain management.

We’ve covered this in great depth via the Wim Hof Method and our article on Fibromyalgia but the idea is simple.

Breathing techniques like Box Breathing can cue your brain and nervous system to relax in the same way as a hot/cold shower.

A few cycles is often enough to see a shift in your symptoms.

Conclusion

There are many different headache classifications. Some are very serious but thankfully many are not. From what can be seen clinically, a number of everyday headaches are neck-related despite the broad classification system.

A thourough assessment and treatment of the upper neck can usually account for many headache symptoms. You just need to know where to look. Feel free to go hunting for yourself with a lacrosse ball or tennis ball to see what you can find.

For lasting results make sure to reflect on your everyday neck postures and positions. Remember, those neck-related headaches don’t cause themselves.

So if you or someone you know struggles with headaches have a good look at your neck. You may be pleasantly surprised at what you find.

Are your headaches neck-related? Let me know how you’re managing your symptoms below in the comments.

Alternatively, why not consider booking an online Physiotherapy consultation with us? We can work out whether your headaches are neck-related and direct you appropriately.

your wellness nerd online physiotherapy consultation



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