Is stress giving you a pain in the neck?

Long days at a desk, hours on your phone, poor sleep, stress, or simply feeling run down can all leave you feeling tight through your neck and shoulders. And the chances are, this isn’t the first time you’ve felt this. Neck pain has a 12-month recurrence rate of 30-50%, highlighting the significant burden of neck pain across the globe.

For some people, this recurring neck tension can contribute to headaches.

A cervicogenic headache (CGH) is a type of secondary headache where the source of the headache is associated with structures in the neck. Symptoms can sometimes include pain that starts around the neck or back of the head and travels towards the forehead, temple or behind the eye. Neck stiffness or reduced movement may also occur.

Importantly, not every headache is cervicogenic. Headaches can have many different causes, including migraine and tension-type headache, which is why an appropriate assessment is important.

So, what can you do?

1. Keep moving your neck

If you've been sitting at a desk or looking down at a screen for a long period, take regular movement breaks. Gentle neck movements within a comfortable range can help prevent you from staying in one position for too long and causing stiffness.

2. Don't rely on stretching alone

Research suggests that targeted neck and upper-back exercises can help reduce headache intensity and frequency in people with cervicogenic headache. Exercises may focus on neck control, endurance, mobility and the muscles around the shoulder blades.

A 2023 systematic review found that multimodal therapeutic exercise was associated with clinically relevant improvements in headache intensity and frequency. To put it plainly - just placing your hand on the sides, front and back of your head and resisting the tension could create positive change. However, for optimal exercises, load and progression, it's best to consult with your physiotherapist.

3. Build strength and endurance

If your neck becomes tired or uncomfortable during prolonged sitting, driving or working, improving the capacity of the neck and upper-back muscles may be more useful than simply trying to "loosen" them.

Your physiotherapist can help identify which specific areas need to improve and prescribe exercises appropriate for you.

4. Manual therapy can be useful, but it's not the whole treatment

Research supports the use of techniques such as cervical mobilisation, manipulation, soft-tissue therapy and even dry needling for some people with cervicogenic headache, particularly in the short term. However, the evidence suggests that combining hands-on treatment with an active exercise program can be a more useful approach than relying on passive treatment alone.

5. Look at the bigger picture

Stress, sleep, physical activity and recovery can all influence how your body responds to pain. If you're feeling run-down and your neck tension keeps returning, addressing these factors alongside your physical symptoms may be an important part of your recovery. At the end of the day, the fundamentals are most important - getting enough hours of sleep, regular exercise and sufficient recovery can reduce the chance of pain.

Still experiencing neck tension or headaches?

If you're regularly experiencing headaches alongside neck pain, stiffness or restricted movement, physiotherapists are your best solution.

Our physiotherapists can assess your neck movement, function and contributing factors to determine whether your symptoms are consistent with a neck-related condition/headache, and whether physiotherapy is appropriate.

Have questions about your headaches or neck tension? Get in touch with our team to see how physiotherapy can help you move, feel, and function better.

Until next time,

The Progress Physio Team

References

1. Fejer, R., Kyvik, K. O., & Hartvigsen, J. (2006). The prevalence of neck pain in the world population: a systematic critical review of the literature. European spine journal, 15(6), 834-848. https://doi.org/10.1007/s00586-004-0864-4
2. Jung, A., Carvalho, G. F., Szikszay, T. M., Pawlowsky, V., Gabler, T., & Luedtke, K. (2024). Physical Therapist Interventions to Reduce Headache Intensity, Frequency, and Duration in Patients With Cervicogenic Headache: A Systematic Review and Network Meta-Analysis. Physical therapy, 104(2), pzad154. https://doi.org/10.1093/ptj/pzad154 
3. Becher, B., Lozano-López, C., Castro-Carletti, E. M., Hoffmann, M., Becher, C., Mesa-Jimenez, J., Fernandez-de-Las-Peñas, C., & Armijo-Olivo, S. (2023). Effectiveness of therapeutic exercise for the management of cervicogenic headache: A systematic review. Musculoskeletal science & practice, 66, 102822. https://doi.org/10.1016/j.msksp.2023.102822
4. Bini, P., Hohenschurz-Schmidt, D., Masullo, V., Pitt, D., & Draper-Rodi, J. (2022). The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis. Chiropractic & manual therapies, 30(1), 49. https://doi.org/10.1186/s12998-022-00459-9