You wake up with a dull ache behind your eyes. By lunchtime it's wrapped around your skull like a vice. You reach for the paracetamol, maybe an ibuprofen chaser, and push through the afternoon. Sound familiar?
Most people treat headaches as a pain problem. Pop a pill, wait it out, get on with life. But here's what we see every week at our Camberwell clinic: the headache is rarely the problem itself. It's the symptom. The actual problem is usually sitting in your neck, your jaw, your upper back, or the way you've been hunching over a laptop since 2020 turned your dining table into an office.
Physiotherapy doesn't just mask the pain. It goes after the source. And for a surprisingly large number of headache and migraine sufferers, that source is mechanical — meaning it's coming from your body's structure, not from something more sinister. The good news? Mechanical problems respond incredibly well to hands-on treatment.
Not every headache is the same, and not every headache responds to physiotherapy. Let's be straight about that from the start. But the ones that do respond? They respond really, really well.
These are the ones that start in your neck and refer pain up into your head. You might feel it behind one eye, across your forehead, or in the base of your skull. They're incredibly common in people who work at desks, drive for long periods, or sleep in awkward positions. The joints and muscles in your upper cervical spine (the top three vertebrae in your neck) are the usual culprits.
What makes cervicogenic headaches tricky is that the pain is felt in your head, so most people never think to look at their neck. They take headache tablets for a neck problem, which is a bit like putting a bandaid on your elbow because your shoulder hurts. It might take the edge off temporarily, but it's not solving anything.
A physiotherapist trained in assessing the cervical spine can identify exactly which joints and muscles are contributing to your headaches — often within the first consultation. From there, treatment typically involves manual therapy (specific joint mobilisation and soft tissue work), combined with exercises to improve the strength and endurance of the deep neck flexor muscles that support your cervical spine.
These are the most common headache type worldwide, and they're the ones most people describe as a "band" or "pressure" around the head. Muscle tension in the neck, shoulders, and jaw is a major driver. Stress, poor posture, teeth clenching, and prolonged screen time are the usual triggers — so basically, modern life.
Physiotherapy addresses tension-type headaches by releasing the overactive muscles (particularly the upper trapezius, suboccipital muscles, and temporalis), improving joint mobility in the thoracic spine and neck, and giving you strategies to manage the postural and lifestyle factors that keep triggering them.
Migraines are complex. They involve neurological, vascular, and sometimes hormonal factors, and we'd never suggest that physiotherapy alone can "cure" a migraine disorder. But research consistently shows that many migraine sufferers have significant musculoskeletal dysfunction in their neck and upper back that acts as a trigger or amplifier.
Think of it this way: if your migraine threshold is a cup, the musculoskeletal tension in your neck is filling that cup partway before any other trigger even arrives. Physiotherapy can lower the level in that cup — meaning you need a bigger trigger to set off a migraine, and the migraines you do get may be less intense and less frequent.
A 2019 systematic review published in Musculoskeletal Science and Practice found that manual therapy was effective in reducing migraine frequency, intensity, and duration. It's not a silver bullet, but it's a meaningful part of a comprehensive management strategy.
If you come to our clinic in Camberwell for headache assessment, here's what you can expect in your first 45-minute consultation:
A proper history. Not a five-minute chat. We want to know when the headaches started, how often they occur, what makes them worse, what makes them better, your sleep quality, your work setup, your stress levels, your jaw habits. Headaches have multiple contributors and we need to understand yours.
A thorough physical assessment. We'll assess the mobility and muscle control of your cervical spine, thoracic spine, and temporomandibular joint (jaw). We're looking for stiff joints, overactive muscles, weak stabilisers, and specific movement patterns that reproduce or aggravate your headache.
Hands-on treatment in the first session. If we identify a clear musculoskeletal contribution to your headaches — which we do in the majority of cases — we'll start treatment immediately. This typically includes gentle joint mobilisation of the upper cervical spine, soft tissue release of the suboccipital muscles, upper trapezius, and levator scapulae, and possibly dry needling if appropriate.
A clear explanation. We'll explain what we found, what we think is driving your headaches, and what the plan looks like moving forward. You'll leave understanding your condition better than when you walked in.
Home exercises. Usually 2-3 specific exercises targeting the areas we've identified. Nothing complicated — we want you to actually do them.
Most patients with cervicogenic or tension-type headaches notice a meaningful change within 3-4 sessions. Some notice improvement after the first session. We're not talking about complete elimination overnight — we're talking about reduced frequency, reduced intensity, and a growing sense that the headaches are becoming manageable rather than controlling your life.
For migraines with a musculoskeletal component, the timeline can be a little longer because there are usually multiple factors at play. But most patients report a noticeable reduction in migraine frequency within 4-6 weeks of starting treatment.
The long-term goal isn't just to treat your headaches — it's to give you the understanding and tools to prevent them from coming back. That's why the exercise and education component is so important.
We always want to be responsible about this. Please see your GP first if you experience any of the following:
A sudden, severe headache that comes on like a thunderclap. A headache accompanied by fever, stiff neck, rash, confusion, or vision changes. A new headache pattern after age 50. Headaches that are progressively getting worse over weeks despite treatment. Headaches associated with recent head trauma.
These presentations need medical investigation first. But if you've had your headaches investigated and nothing sinister has been found — or if your headaches have a clear pattern related to posture, stress, or neck stiffness — physiotherapy is an excellent next step.
Many of our patients at Upwell have been through the GP and specialist pathway, tried various medications, and still haven't found adequate relief. That's because the medications are treating the symptom (pain) but not the underlying mechanical dysfunction. Physiotherapy addresses that missing piece.
At our Camberwell clinic on Burke Road, we take a multi-disciplinary approach to headache management. Your physiotherapist might work alongside our podiatrist (because yes, the way your feet hit the ground can affect your neck), our exercise physiologist (to design a long-term strength program), or our clinical Pilates team (to address postural control in a supervised environment).
That collaborative approach is one of the things that makes a multi-disciplinary clinic different from seeing a standalone practitioner. Your headache doesn't exist in isolation from the rest of your body, and your treatment shouldn't either.
We've been treating headaches at Upwell for nearly a decade. It's one of the most rewarding conditions to treat because the results are often significant and the patient's quality of life improves dramatically. If you've been living with headaches that aren't responding to medication alone, come and see us. You might be surprised at how much your neck has to say about your head.
No. You can book directly with us without a GP referral. However, if you have a chronic disease management plan (formerly Enhanced Primary Care plan) from your GP, you may be eligible for Medicare rebates on your physiotherapy sessions.
Most patients see significant improvement within 3-6 sessions. Some conditions resolve faster, others take longer depending on how long the problem has been present and how many contributing factors are involved.
Yes. If you have extras cover that includes physiotherapy, you can claim your sessions on the spot at our clinic using HICAPS. We accept all major health funds.
Absolutely. Children and teenagers frequently develop headaches related to posture, screen time, sports, and growth. Our physiotherapists are experienced in treating patients of all ages.
Both professions treat headaches, but the approaches differ. Physiotherapy combines manual therapy with exercise prescription, postural education, and lifestyle modification. The focus is on active rehabilitation — giving you the tools to manage and prevent your headaches long-term, not just providing passive treatment.