Tension & Neck Headache Physiotherapy in Amman

What is tension-type headache, and what is a headache from the neck?

Tension-type headache is one of the most common kinds of headache: a pressing or tight feeling, usually on both sides of the head, mild to moderate, that is not made worse by routine daily activity and can also be felt in the face or neck; it is often linked with stress and sleep problems. A headache from the neck (cervicogenic headache) usually starts in the upper neck and spreads to one side of the head, and is brought on or made worse by certain neck movements or by holding the head in one position for a long time, often with a stiff neck. Migraine is a different type that needs a doctor’s diagnosis and treatment.

Common signs

Tension-type: a pressing, band-like tightness across the forehead, the sides or the back of the head
Tension-type: a tender scalp or tight neck and shoulder muscles, usually without nausea or vomiting
From the neck: pain on one side that starts in the neck or at the base of the skull and spreads forwards
From the neck: brought on or made worse by certain neck movements or long periods in one position, with a stiff neck
Signs that point to migraine instead: throbbing pain on one side with nausea or discomfort from light and noise — these need a doctor’s diagnosis

Common misunderstandings

"I need a brain scan to be sure my headache is not serious": when a headache fits the tension-type or neck-related pattern and there are no warning signs, scans are not advised just for reassurance; the doctor requests one when there are signs that call for it
"More painkillers will ease the headache": taking headache painkillers very often can itself make headaches more frequent, which is called medication overuse headache; if you take them often, talk to your doctor before changing anything
"Every headache comes from the neck": many headaches have nothing to do with the neck, so we first check that your headache pattern fits a tension-type or neck-related headache, and refer you to a doctor if it does not

What usually helps?

We start with the everyday factors linked to headaches: stress, poor or disturbed sleep, a lot of caffeine, and long periods in one position without movement breaks; regular physical activity and relaxation may help. For tension-type headache with neck pain, guidelines suggest low-load exercises that build the endurance of the deep neck muscles and the muscles around the shoulder blades; for a headache from the neck, they support specific exercises and manual therapy with mobilisation of the neck joints. The evidence for physiotherapy in tension-type headache is limited, so we see it as one part of the plan, not a promise of results. Medicines, preventive treatment and medication overuse headache are for your doctor to assess and treat, and keeping a headache diary can help your doctor and us understand the pattern.

How we help at Revibe

We listen: where the headache starts, how often it comes, what triggers it, your sleep, stress and work, and the medicines you take
We examine the neck, upper back and shoulders and look for warning signs; if your headache does not fit a tension-type or neck-related pattern, or a sign needs a doctor, we refer you
We identify what may keep the headaches going: long periods in one position, stress, sleep and activity levels
We treat: manual therapy and joint mobilisation of the neck (including Mulligan techniques), release of muscle knots in the neck and shoulders, and exercises for the deep neck and shoulder-blade muscles
We progress with a home programme of exercises, movement breaks and relaxation, and reassess at every session to decide the next step

When do you need urgent medical care?

A sudden, extremely painful headache or neck pain that peaks within minutes or is unlike any you have had before; or a headache with weakness or numbness in the face, arm or leg, a drooping face or eyelid, trouble speaking, swallowing or keeping your balance, double vision or loss of vision, confusion, memory problems, drowsiness, a fit (seizure) or fainting — go to the emergency department or call an ambulance: 911 in Jordan or 122 in Iraq and Kurdistan
A headache with a high temperature, a stiff neck, a rash or eyes that are bothered by bright light; a headache after a head injury or a fall in the past three months; or a severe headache with a red, painful eye — go to the emergency department straight away or call an ambulance
A new headache in someone over 50 with jaw pain when chewing or talking, or a sore or tender scalp or temples — see a doctor the same day, and if your vision changes, go to the emergency department straight away
A headache that keeps getting worse or is clearly different from your usual ones, or one that comes with vomiting or a change in personality, is brought on by coughing, sneezing, bending down or exercise, or changes when you stand up or lie down; or a new headache if you have had cancer or have a weakened immune system — see a doctor the same day
A severe headache in pregnancy or in the days or weeks after giving birth, especially with blurred vision, flashing lights, sudden swelling of the face, hands or feet, or pain below the ribs — contact your doctor or maternity unit straight away or go to the hospital

In these cases go to the nearest emergency department or a doctor straight away — instead of booking physiotherapy.

FAQ

Do I need a brain scan for my headache?

Usually not. When a headache fits the tension-type pattern, scans are not advised just for reassurance; the doctor decides on imaging when there are warning signs or a clear change in the headache.

Can physiotherapy help my headache?

It may help when the headache is linked with the neck, through exercise and manual therapy. For tension-type headache the evidence is more limited, so we combine it with advice on sleep, stress and activity. Physiotherapy does not replace a doctor for migraine or other types of headache.

I take painkillers often — is that a problem?

It can be, because taking headache medicines very often can make headaches more frequent. Talk to your doctor before changing or stopping any medicine; they assess this and plan the next steps.

How many sessions will I need?

It depends on your condition and how long you have had it; after the first assessment we explain the plan and the expected number of sessions.

More common questions: Neck and disc questions — 30 questions