If you’ve ever experienced a constant, dull ache in your head that never seems to go away, you know how draining chronic headaches can be. For some people, headaches aren’t just an occasional inconvenience; they’re a 24/7 reality. They can affect your focus at work, your ability to enjoy social activities, and even your sleep.
How physiotherapy can treat the root cause
While painkillers may provide short-term relief, they often fail to address the underlying cause of chronic head pain. This is where physiotherapy can play a vital role in long-term management, particularly when the neck may be contributing to the problem.
Persistent, 24/7 headaches are often described as a dull, pressure-like pain, as though the head is ‘caught in a vice’. Sufferers commonly rate the discomfort around 3/10 – 5/10 on the Visual Analog Scale (VAS), with intermittent flares that intensify the pain before it settles back to a constant baseline.
Understanding whether the neck is involved can be an important step toward identifying and treating the root cause, rather than simply masking the symptoms.
Physiotherapists can help to identify what’s really causing your headaches and teach you how to manage and prevent them conservatively. In most 24/7 headache presentations, the upper neck indicates stiffness and restriction, and potentially is the main driver of the pain.
Understanding constant or chronic headaches
Headaches that persist for weeks or months are often classified as chronic daily headaches. They can have several causes, including:
- Tension-type headaches are associated with muscle tightness in the neck, shoulders, or jaw.
- Cervicogenic headaches originate from stiffness and restrictions in the upper neck
- Posture-related headaches, common in people who sit at desks or use screens all day.
- Stress and fatigue can amplify muscle tension and pain sensitivity.
- Previous injuries, such as whiplash or concussions, that leave lingering dysfunction of the neck.
It’s important to rule out medical causes first, but if scans and tests come back normal, the problem might be musculoskeletal and that’s where physiotherapy shines.
How physiotherapy can help chronic headaches
Physiotherapy focuses on restoring movement in your upper cervical spine, posture, and muscle balance. When it comes to constant headaches, your physiotherapist will first perform a comprehensive assessment, looking at your neck, shoulders, upper back, and even how you move throughout the day.
1. Manual Therapy
Using principles from the Watson Headache Approach, hands-on techniques like gentle joint mobilisations and sustained pressure to the upper cervical spine (C0–C3) can reduce headache symptoms. Combined with desensitisation techniques, these methods over several physiotherapy sessions can improve mobility, decrease sensitivity, and relieve chronic head pain.
2. Posture Correction
Many chronic headaches are caused by forward head posture or rounded shoulders common in people who work on computers. Physiotherapists can teach you exercises and ergonomic tips to realign your spine and reduce strain on the neck muscles.
3. Exercise Prescription
Specific strengthening and stretching exercises help restore balance and stability. For example:
- Strengthening deep neck flexors to support the head.
- Stretching the upper trapezius, levator scapulae, and pectoral muscles.
- Improving shoulder blade control for better posture.
4. Relaxation and Breathing Techniques
Stress can amplify pain. Physiotherapists often integrate strategies like combining jaw and neck posture with breathing, as well as mindfulness of the breath, to downregulate the nervous system and muscle tension.
5. Education and Lifestyle Advice
Your physiotherapist will help you understand your triggers, whether it’s screen time, sleep position, or repetitive strain and give you practical tools to manage them day to day.
When to see a physiotherapist
If you’ve been living with a constant headache for more than a few weeks, or if painkillers only provide temporary relief, it’s time to seek help. Physiotherapy offers a safe, drug-free option that focuses on long-term recovery, not just masking symptoms.
Remember: you don’t have to live with constant pain. With the right assessment and a personalised treatment plan, it could be possible to reduce or even eliminate chronic headaches and get back to feeling like yourself again.
In Summary
Chronic headaches are frustrating, exhausting, and can feel hopeless, but they often have a physical, treatable cause. Physiotherapy addresses the underlying tension, posture, and movement problems that keep headaches coming back. If constant head pain is controlling your life, consider booking a physiotherapy assessment. Relief might be closer than you think.
If you suffer from constant or chronic headaches, book an appointment with the Headache Neck and Jaw Clinic’s expert physiotherapists.
Lisa Eisfeld is a trained physiotherapist from Germany. She has also studied advanced Manual therapy and finished her Osteopathy Diploma in 2018 at the School for Manual Medicine Berlin. Lisa has also attained her Watson Headache Institute Level 1 Foundation and Level 2 Consolidation courses. Read more about Lisa.