Why Your Headaches Might Actually Start in Your Neck

You've probably called it a "stress headache" or a "screen headache" — that dull ache that builds behind your eyes or wraps around your temples by mid-afternoon. You reach for paracetamol, rub your temples, maybe try to dim the lights. But if this happens most days, and it tends to arrive alongside a stiff neck or aching shoulders, the real source might not be stress or your eyes at all. It might be the muscles and joints in your neck.

This type of headache has a name: cervicogenic headache, meaning it originates in the cervical spine (the neck). It's extremely common in people who spend long hours at a desk, drive frequently, or carry tension in their upper body — which describes a huge number of people working in London. The good news is that because the cause is mechanical, it usually responds well to the right kind of physiotherapy, rather than needing to be managed with painkillers indefinitely.

How to tell if your neck is the culprit

Tension-type headaches and cervicogenic headaches can feel similar, but there are some useful clues. Neck-driven headaches often:

• Start at the base of the skull and spread forward to one side of the head, the temple, or behind an eye
• Feel worse after long periods sitting still, especially looking at a screen
• Come with a stiff, achy, or "heavy" feeling in the neck and shoulders
• Ease slightly when you move or stretch your neck, and worsen with certain neck positions
• Are often one-sided, rather than a band of pressure across the whole head

By contrast, a classic tension headache tends to feel like an even, gripping pressure on both sides, without a strong link to neck movement. The overlap is significant, though, and many people have a mix of both — which is exactly why treating the neck often improves things even when the headache doesn't feel obviously "neck-related."

Why the neck causes head pain at all

The top three joints of your neck sit remarkably close to the nerves that also supply sensation to parts of your scalp and face. When those upper neck joints become stiff — often from sustained poor posture, a previous whiplash injury, or simply hours of forward head position at a laptop — the nerves can become irritated and refer pain upward into the head. Add tight, overworked muscles like the upper trapezius and suboccipitals (the small muscles right at the base of the skull), and you have a reliable headache generator.

This is also why headaches often cluster around stressful periods or heavy workloads — not because stress directly causes head pain, but because stress tends to show up physically as raised shoulders, a jutted-forward chin, and shallow breathing, all of which load the neck.

What actually helps

Painkillers can take the edge off, but they don't address why the headaches keep coming back. A physiotherapy assessment looks at how your neck joints move, which muscles are tight or weak, and what postures or habits are feeding the problem. Treatment for cervicogenic headaches typically combines:

• Hands-on treatment to restore movement in stiff upper neck joints and ease muscle tension
• Targeted exercises for deep neck flexor and postural muscles, which often become weak and underused in desk-based lifestyles
• Practical ergonomic advice — screen height, chair setup, and simple habit changes that reduce sustained strain
• A gradual return to normal activity without fear of movement making things worse

If your job involves long screen hours, this is where a broader look at your movement patterns through physiotherapy can make a real difference, since headaches rarely exist in isolation from shoulder and upper back stiffness. And if the neck pain itself is a significant part of the picture — not just the headache it triggers — our pain relief for back, neck and joint pain approach is designed to get to the root of that discomfort rather than just calming a flare-up.

Don't ignore the shoulders

It's easy to focus entirely on the neck and forget the shoulders, but they're part of the same system. Rounded, elevated shoulders pull on the same muscles that attach to the base of the skull, and weak shoulder blade control makes it harder to hold a good neck position through the day. Building some shoulder and upper back strength — even a few minutes of targeted exercise a few times a week — can meaningfully reduce how often headaches show up. This is often a natural fit alongside general strength and conditioning work, particularly if you're already active and want a plan that supports your training rather than working against it.

It's also worth mentioning that headaches like this aren't reserved for office workers. Runners training through London with poor upper body posture, and gym-goers who neglect the upper back in favour of pushing exercises, see the same pattern.

When to get it checked out

Occasional headaches after a bad night's sleep or a stressful week are normal and usually nothing to worry about. But if you're getting them multiple times a week, relying on painkillers regularly, or noticing your neck feels permanently tight, it's worth having it properly assessed rather than accepting it as your new normal.

A physiotherapist can quickly tell whether your neck is contributing, identify which specific joints or muscles are involved, and give you a clear plan to address it — usually a combination of hands-on treatment and exercises you can do yourself. If this sounds familiar, we'd be happy to take a proper look at our Vauxhall clinic and help you get to the bottom of it.