Neck Pain and Headache, Part Two: Seeing a Doctor

Migraine Symptoms | 4 Min. Read
Author: Nicole Spare, DO

Dr. Spare is Clinical Assistant Professor of Neurology at the Jefferson Headache Center.

Reviewed by: Ctrl M Health Medical Directors


  • Neck and head pain can be intimately linked. They also tend to compound with time, so seek medical advice sooner rather than later.
  • In a routine evaluation, a physician will ask about events related to your head or neck that span your entire life, to understand how your muscles and supporting structures have developed over time. Be sure to mention any previous head and neck traumas, including falls, sports injuries, car crashes, or physical abuse.
  • After identifying areas of soft tissue restriction and musculoskeletal dysfunction, the medical team will often recommend physical therapy. The physical therapist will then come up with an individualized program of exercise and manual therapy.
  • Because the relationship between neck pain and headache is not just mechanical, but also neurovascular, your comprehensive treatment plan will also address any other headache symptoms you experience.

Full Article

Is your neck pain becoming a problem? Neck and shoulder pain are among the most prevalent musculoskeletal disorders and can be seriously disabling. According to the 2016 Global Burden of Diseases report, which ranks disorders according to the years of disability it creates in people’s lives, neck pain came in at No.6. (Not to be outdone, migraine nearly topped the list at No.2.)

An African American woman on couch has severe neck pain and headache, holding her neck in pain.

Neck pain and head pain can be intimately linked. If you are having head or neck pain, including severe neck pain and headache at the base of the skull, it’s important to seek medical advice sooner rather than later as part of a comprehensive headache treatment program. A multidisciplinary approach will allow you to achieve your functional goals and a better quality of life. But, early intervention is always best, because neck and head issues compound over time.

Be sure to see a doctor right away if you experience any of the following, which could be signs of a serious condition:

    • New onset of weakness
    • Sensation disturbance such as pins and needles or numbness in a new area
    • Your worst headache or neck pain ever

Medical Professionals’ Evaluation

During a routine medical appointment, the physician will ask questions to create a timeline of the events related to your head or neck symptoms. Believe it or not, this timeline will go back over the course of your entire lifetime, because they’ll need to understand how and why your muscles and supporting structures have developed over time. Some earlier conditions may be a secondary contributing reason for head and neck pain later on, including torticollis in early infancy and scoliosis in early adolescence.

It is also imperative to discuss previous head and neck traumas, including but not limited to any trauma you may have experienced from:

    • Falls
    • Sports-related injuries
    • Motor vehicle collisions, including whiplash
    • Physical abuse to the head and/or neck

To make the process easier, before your appointment, think about minor and major contributors that may be related to your head and neck symptoms. Ask a family or friend for help recalling past events.

Next, the physician will gently examine you and identify areas of soft tissue restriction and musculoskeletal dysfunction. The medical team will then often recommend a referral to a physical therapist to perform a comprehensive functional evaluation.

However, your treatment plan likely won’t end there, because the relationship between neck pain and headache is not strictly a mechanical issue. Headache is a “neurovascular pain syndrome.” This means that in addition to the physical headache symptoms like pressure and pain from structures in the head and neck, there are often a variety of other symptoms to address. For example:

    • Cognitive symptoms, such as difficulty concentrating or having brain fog
    • Emotional-behavioral response to how your brain interprets and responds to pain, which can amplify the pain experience

A better understanding of how your brain, spinal cord, nerves, and their supporting structures function together will help you to better understand your pain experience and your treatment plan.

Reducing Pain Through Physical Therapy

If you’ve been referred to a physical therapist, their comprehensive functional evaluation comes next. Physical therapists (often referred to as “PTs”) are trained experts who help people restore movement and manage pain through exercise programs and hands-on care. Your physical therapist will assess the strength and range of motion in your neck and shoulders. Based on the analysis of these movement patterns, your physical therapist will then determine the potential causes of your symptoms, discuss them with you, and then implement an individualized program

That might include:

Exercise. Programs are typically designed around stretching and strengthening the muscles that need them, with warm-ups and cool-downs. Your appointments might involve hand weights, resistance bands, or exercise balls, while your “homework” may not require any props.

Manual therapy. The physical therapist uses their hands to apply pressure on muscle tissue and manipulate joints.

Physical therapists monitor you throughout the program to ensure it’s challenging enough to move forward your progress, but not so challenging as to be painful. A growing body of research shows that this combination of hands-on techniques, coupled with exercise, is most beneficial for patients who experience neck pain. By maintaining a full active range of motion, working on strength and stability training, and being mindful of your posture, you will improve your body mechanics in the long run.

Want to know more about what to do about neck and head pain? Read “Bad Posture and Migraine: Your Work-From-Home Ergonomic Tuneup.”

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