Neck pain is very common in the U.S. with some estimates suggesting that 70% of the population will experience neck pain at some point.  Though not as common, 1 in 6 Americans are likely to suffer from severe headache or migraines. 

We commonly see clients who suffer from both neck pain and headaches.  It turns out that these two seem to go hand in hand.  Studies have shown that 90% of people with tension type headaches have neck pain, 75% of people with migraines have neck pain, and 84% of people with self reported sinus headaches have neck pain(1,2,3).

 None of the epidemiological studies referenced above chose to delve into the driver of the headache. Is the headache coming from the neck pain or is the neck pain being driven by the headache? The answer; it depends.

There have been numerous studies, based on the work of Janet Travel, that have looked at myofascial (muscular) origins of headaches. Similarly, there is research that links upper cervical joint dysfunction to headache symptoms(4).  Conversely, with the theory of central sensitization one could speculate that chronic migraines and headaches may eventually drive neck pain.

It’s not so easy, especially in a blog post, to be definitive of the origin of every headache or neck pain.  The best bet is to have a skilled PT perform a thorough evaluation to look for all possible contributing factors to your headaches.

The take home message is this: If you thought that there was nothing else you could do for your sinus headache, migraine, or tension type headache besides rest and medication, you were wrong.  A good physical therapist can find the cause or contributing factors to your headaches and help to ease your pain.


1.      Ashina, S., Bendtsen, L., Lyngberg, A. C., Lipton, R. B., Hajiyeva, N., & Jensen, R. (2015). Prevalence of neck pain in migraine and tension-type headache: A population study. Cephalalgia, 35(3), 211–219.

2.      Burch, R., Rizzoli, P., & Loder, E. (2018). The prevalence and impact of migraine and severe headach in the united states: Figures and trends from government health studies. Headache, 58(4), 496-505.

3.      Malo-Urries, M., Tricas-Moreno, JM., Estebanez-de-Miguel, E. et al. (2017). Immediate effects of upper cervical translatoric mobilization on cervical mobility and pressure pain threshold I patients with cervicogenic headache: A randomized controlled trial. Journal of Manipulative and Physiological Therapeutics, 40(9), 649-658.

4.      Shannon M. Petersen, Gwendolen A. Jull & Kenneth E. Learman (2019) Self-reported sinus headaches are associated with neck pain and cervical musculoskeletal dysfunction: a preliminary observational case control study, Journal of Manual & Manipulative Therapy, DOI: 10.1080/10669817.2019.1572987