Have you ever woken up with a splitting headache that does not seem to shift? Feeling hopeless and unable to think clearly? You are not alone. 50% of people will suffer from headaches in a given year and 90% will suffer headaches in their lifetime.

They can affect everyone very differently with some only experiencing a mild ache at the back of the head and some suffering debilitating pain with associated symptoms such as nausea, vomiting and sensitivity to light and sound. Nearly all of those with migraines and about 60% of those with tension type headaches will experience reductions in social activity and work capacity.

Headaches and migraines can have many triggers or driving factors. One thing they all have in common is, when you are having an episode there is increased nervous system activity in the brainstem (specifically the Trigemino-Cervical Complex or TCC). Understanding this is key to understanding the various management strategies of headaches and migraines.

The TCC has nerve fibres connecting to it that come from the upper three joints of the neck, the TMJ (Jaw Joint), the head and face. Due to this amazing convergence of nerves, a stimulus in one or more of these areas can contribute to sensitivity amongst all of them.

You can think of your headache or migraine-like a bucket of water and when that bucket overflows you get a headache. If there is pain, stiffness or dysfunction coming from the upper neck joints, the jaw, the head, or face this will start to fill the bucket up. So when there is increased tension or stiffness in the neck, you are more likely to overflow the bucket and get a headache. If you have jaw joint stiffness, pain, or even have had recent dental work performed, this can also lead to increased information heading toward the TCC, further filling up the bucket.

On the other hand, some systemic factors can reduce the size of the bucket. For example, if you are stressed, anxious, experiencing poor sleep, smoke or have a poor diet, these can all increase your nervous system sensitivity, therefore reducing the size of the bucket. This means it does not take as much to fill up the bucket and you may find yourself more prone to experiencing migraines and headaches. There are other rare medical conditions that could be the primary cause of the migraine or headache and your GP, a Neurologist and your health care team should be able to identify these if that is the case.

The positive aspect of having so many contributing factors is that this means there is a range of treatments that could be utilised. These health practitioners could all have something to add:

  • Physiotherapist: Can treat the cervical spine, the jaw or other contributing musculoskeletal issues
  • Dentist: Can treat the jaw and bite (if you clench or grind the teeth)
  • Dietitian: Can help you optimise your diet which can help with sleep, weight management, inflammation, and wellbeing
  • Psychologist: Can help you if you are feeling stressed, anxious or depressed
  • Neurologist: If you experience persistent or severe headaches, a Neurologist can help diagnose more complex causes or suggest a range of treatments such as medication or botox injections to reduce the tone in the muscles and block chemicals called neurotransmitters that carry signals from your brain that are perceived as pain.

If you would like more information and guidance, talk to our Physiotherapists or Dietitians for advice about how to best plan the management of your headaches or migraines.


Written by Shoulder, Neck and Headache Physiotherapist Adam Horwitz

Adam graduated from The University of Sydney with an applied science degree in Exercise and Sports Science followed by a Masters of Physiotherapy. He has undergone further training in Western Acupuncture and Dry Needling as well as attended a range of courses for the management of shoulder pain, headaches, TMJ Disorders (Jaw Joint) and spinal pathologies.

Adam developed a keen interest in Physiotherapy and injury management through competing in Football, Brazilian Jiu-Jitsu and Squash over the years. He uses a variety of techniques to help diagnose and treat his client’s injuries. His effective treatment planning includes easy to understand advice and education, soft tissue therapy, joint mobilisations and exercise prescription.

His inpatient hospital training gave him an in-depth knowledge of medical management of a variety of conditions and the effect hospitalisation can have on the body after discharge. Adam is fortunate to have worked with some of the leading hip, knee, shoulder and spinal specialists in the country. He is well experienced rehabilitating patients following joint replacements, including; Total Knee Replacements, Total Hip Replacements and Total Shoulder Replacements.

Through further training in Pilates and his involvement with Brazilian Jiu-jitsu, Adam has a deep understanding of human movement, biomechanics and how to use exercise to stimulate adaptation and recovery.

Adam is available for Physiotherapy appointments at our Chermside location.