Migraine — and where physiotherapy fits
Migraine is a complex neurological condition, not just "a bad headache." It involves changes in nervous system activity, sensitivity to triggers, and a characteristic pattern of symptoms — often including nausea, light and sound sensitivity, and sometimes visual disturbance. Medical management (often involving a GP, neurologist, or headache specialist) is the foundation of migraine care.
So where does physiotherapy come in?
Physiotherapy isn't a treatment for migraine in the sense of replacing medical care. But for many people with migraine, there's a musculoskeletal component — neck stiffness, upper back tension, jaw tightness, posture-related factors — that can contribute to migraine frequency or intensity. Addressing this side of the picture is where physiotherapy can play a role.
The cervicogenic vs migraine distinction
Some headaches are primarily related to neck structures — these are called cervicogenic headaches. Migraine is a separate condition, though the two can coexist. A skilled physiotherapy assessment can help differentiate, and identify when neck issues are contributing meaningfully to a headache picture.
What a physiotherapy assessment for headache or migraine includes
- Detailed headache history — frequency, pattern, triggers, associated symptoms
- Neck examination — range, joint stiffness, muscle tension
- Posture and movement assessment
- Identification of trigger points that may refer pain to the head
- Discussion of whether neck issues are likely contributing
- Coordination with your GP or specialist where appropriate
What physiotherapy treatment may involve
Manual therapy
Joint mobilisation and soft tissue work targeting upper cervical structures, suboccipital muscles and upper trapezius. Used selectively, often alongside other interventions.
Exercise
Specific exercises for deep neck flexors, scapular control, and general thoracic mobility have evidence in cervicogenic headache management and may help in migraine where there's a neck contribution.
Education
Understanding triggers, pacing, sleep hygiene, ergonomics. Often as important as physical treatment.
Dry needling
Used selectively for trigger points contributing to the headache pattern.
Lifestyle factors
Sleep, stress management, hydration, screen breaks, ergonomic setup. These often have a meaningful impact on migraine frequency.
What physiotherapy isn't for in migraine
- Replacing medical migraine management
- Acute treatment of a migraine in progress (medication-based, by your GP or specialist)
- Diagnosis of new or changing headache patterns (this needs medical assessment)
Any new headache, sudden severe headache, or significant change in pattern warrants prompt medical assessment — not a physiotherapy appointment.
The role of multidisciplinary care
For chronic migraine, evidence supports a multidisciplinary approach:
- GP or neurologist for medical management
- Physiotherapy for musculoskeletal contributors
- Psychology for stress, sleep and coping strategies
- Dietitian for trigger-related dietary considerations where relevant
The combination tends to be more effective than any single approach alone for chronic patterns.
Realistic expectations
Physiotherapy isn't a cure for migraine — but for the subset of people whose migraine pattern includes meaningful musculoskeletal contributors, addressing those contributors can reduce frequency or intensity over time. Outcomes vary between individuals.
What you can do alongside care
- Track your migraines — frequency, intensity, possible triggers (a simple diary helps)
- Pay attention to sleep, hydration, screen breaks, and stress
- Address neck and shoulder tension if you've noticed it accompanies your headaches
- Stay on top of medical management with your GP
Booking
Our team includes physiotherapists experienced in cervical (neck) assessment and headache-related musculoskeletal contributors. Suitability of physiotherapy input depends on the specific headache picture. The starting point is usually a phone enquiry, and we may suggest you also liaise with your GP about overall migraine management.
Reviewed by Joseph Louka, AHPRA-registered Physiotherapist (Principal Physiotherapist) · Last reviewed 2026-05-27
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