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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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