Services · Headaches & migraine
Headaches and migraine
The short answer
Headaches that arise from the upper neck, cervicogenic headache, are what we assess for, and they are more common than most people expect. Headaches with other causes are a job for someone else, and we refer those on rather than treating them. If an approach is not helping, we will say so and change it or refer you on, rather than keep booking you in.
Which headaches we can help with
Broadly: the ones where the neck is the driver. Typical features are pain starting at the base of the skull and travelling forward, usually one-sided, often worse after a long stint at a desk or after a poor night's sleep, and reproducible when we examine the upper cervical joints.
Tension-type headache with a significant muscular component may also be worth assessing. Migraine is more complicated. We will tell you what we think after the first visit.
Which headaches we refer on
This is the honest part, and the reason this page exists. Headaches can be caused by blood pressure changes, medication, sinus infection, eye strain, hormonal shifts, dental problems, and occasionally by things that need urgent attention. None of those are helped by a manual therapist, and treating them delays the thing that would help.
Some headache enquiries here end in a referral rather than an appointment, because many headaches are not a manual therapy problem.
How many visits will I need?
We give the number of visits at the start. Not at the end, and not one visit at a time. Where we can't estimate it honestly, and sometimes we can't, we say that instead of picking a figure.
When this is not a job for an osteopath
Please book with a GP, or go to an emergency department, rather than with us, if any of the following apply:
- A sudden, severe headache that peaked within seconds to a minute, the "worst ever" headache. Emergency department, today.
- Headache with fever, neck stiffness and light sensitivity.
- Headache with new confusion, weakness, speech difficulty or visual loss. Call 000.
- A headache that is new and progressively worsening over days or weeks, particularly over the age of 50.
- Headache that is worse lying down, worse in the morning, or wakes you from sleep.
If any of these apply, see a GP or go to an emergency department first. The symptom check asks about the most serious warning signs, but it does not cover everything.
Exercises we commonly prescribe for this
Pulled from the library. Which of these you get, at what dose and in what order depends on your assessment, this is what the shortlist usually looks like, not a plan for you.
Common questions
How do I know if my headache is coming from my neck?
The reliable test is examination rather than description. If pressing on specific upper cervical joints reproduces your familiar headache, that is a strong sign. We can usually tell you within the first appointment.
Will you treat my migraine?
We will assess it. If there is a clear neck component we will treat that and measure whether frequency changes. If there isn't, we will say so and you should be under a GP or a neurologist rather than us.
How will I know if it is working?
We agree at the first visit what change we are looking for, usually headache frequency. If it is not shifting, we will say so and refer you on.
Can I keep taking my medication?
Yes, and please don't change anything on our advice, that is a conversation for your GP or pharmacist. Do mention it, though: frequent use of pain relief can itself cause a headache pattern, and that is worth knowing about.