A tension headache is often brought on due to stress and can be posturally related.

It may also be referred to as a cervicogenic hadache.

Signs & Symptoms

A tension headache is one that:

  • Has a gradual onset

  • Presents as a dull ache

  • Tends to be one sided, but can be both

  • Can refer to the shoulder or scapula regions

  • Has associated symptoms such as neck pain or reduced neck range of movement

  • Is common following a trauma such as whiplash

  • If often posturally related (forward head posture, rounded shoulders, upper cervical extension)

  • Causes discomfort, but does not prevent daily function like a migraine can.

What Causes It?

  • Dysfunction or stiffness of the cervical and thoracic joints

  • Tight neck muscles

  • Poor posture (especially at the computer, or with prolonged sitting)

  • Physical and emotional stress

  • Nerve compression

  • Trigger point referral

  • Weak deep cervical flexors

  • Inadequate rest

  • Anxiety

  • Fatigue

How to Self Manage

  • Use of a heat bag or hot water bottle

  • Stress reduction

  • Neck stretches

  • Postural awareness


  • Conservative management should ease the symptoms of a cervical or tension headache.

  • If pain persists GP referral may be necessary to organise investigation for other causes (e.g. spondylosis, osteoarthritis, rheumatoid arthritis etc)

How Physio Helps

  • Joint mobilisation or manipulation

  • Massage

  • Muscle and neural stretches

  • Acupuncture or dry needling

  • Pilates exercises and deep cervical flexor education

  • Ergonomic advice (e.g. - workstation setup; correct pillow height)Joint mobilisation or manipulation

  • Posture awareness and advice

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Disclaimer: Information made available by AskPhysio (Sammy Margo Physiotherapy) is provided for guidance only and should not be considered as medical recommendations or advice.  AskPhysio is not responsible for errors or omissions in the information. Please consider what the best options for your healthcare are, based on the urgency of your condition and nature of your condition. Please consult a GP or Healthcare Specialist to discuss any specific concerns that exist prior to using the information provided.