Headache starting in the neck: when both hurt together
The screen day ends, the neck is stiff, the shoulders creep up towards the ears, and pain settles at the back of the head, sometimes spreading to the forehead or temples. This picture is common and rarely a sign of serious disease, but it can become a real burden when it returns several times a week.
What is tension-type headache?
Tension-type headache is the most common primary headache, meaning a headache not caused by another disease. According to the Swiss Headache Society, up to 80% of people have it at some point in their life.
How to recognise it
According to the NICE headache guideline, tension-type headache typically:
- affects both sides of the head, pressing or tightening rather than throbbing;
- is mild to moderate;
- is not made worse by routine activities such as walking or climbing stairs;
- has no other marked symptoms (unlike migraine, which often comes with nausea or sensitivity to light and sound).
It is called chronic when it occurs on 15 or more days a month for more than three months. It then falls within chronic pain.
Neck pain and headache: tension-type or cervicogenic headache?
The Geneva University Hospitals (HUG) describe tension-type headache as accompanied by tension in the neck and trapezius muscles. The muscles around the skull and neck become more sensitive, and over time the nervous system itself can amplify the pain. Reported triggers include physical or psychological stress, dehydration and changes in routine.
Neck pain and tension-type headache often keep each other going: a tight neck keeps the pain going, and the pain keeps the neck tight. Read more about neck pain in Fribourg on our dedicated page.
There is also a so-called cervicogenic headache, caused by a problem in the neck itself: it is a separate diagnosis, made by a doctor.
Beware of taking painkillers too often
NICE warns of medication-overuse headache when paracetamol, aspirin or an anti-inflammatory is taken on 15 or more days a month for at least three months. If you take painkillers almost every day, talk to your doctor.
Warning signs: when to see a doctor without delay
Most neck-related headaches are benign. The following signs, however, need prompt or urgent medical attention:
Go to an emergency department immediately if you have:
- a sudden, very severe headache that peaks within seconds to a few minutes;
- headache with fever, or a stiff neck that hurts when you bend your head forward;
- new neurological signs: weakness of an arm or leg, speech or vision problems, confusion, balance problems;
- headache after a blow to the head or an accident.
See your doctor promptly if:
- a new type of headache appears after age 50;
- your headache clearly changes in character or gets progressively worse;
- it is triggered by coughing or exertion, or changes with posture;
- it comes with unexplained vomiting, or you have weakened immunity or a history of cancer.
In the vast majority of cases, none of these signs is present.
Recommended first steps
Once warning signs are ruled out, the basics are simple: move your neck and shoulders regularly, take breaks from screen work, drink enough, keep regular sleep and identify your triggers. NICE suggests keeping a headache diary for at least eight weeks, noting frequency, duration, severity, triggers and medication taken.
What does the research say?
For an attack, NICE mentions aspirin, paracetamol or an anti-inflammatory, to be discussed according to your situation, and advises against opioids. NICE also mentions acupuncture for chronic forms. Medication is always discussed with your doctor or pharmacist.
The first consultation lasts 1 h 30 to 2 h. Bring your medical file, your examinations (MRI, reports) and a list of your medicines; a headache diary can help. We review your situation and build your plan together. We work alongside your GP and the other professionals who follow you.
Which approaches can fit at Centre Algos?
Depending on your situation, several approaches can be combined, alongside medical follow-up:
- Naturopathy: sleep, stress management, hydration and diet, to work on the lifestyle habits that can influence pain.
- Cupping: applied to the neck, shoulders and upper back, it can help release muscle tension.
- Breuss massage: a gentle massage along the spine that can support relaxation of the back and neck.
- Percutaneous hydrotomy: subcutaneous micro-injections; it may be considered where appropriate, after assessment, once warning signs have been ruled out and in agreement with your medical follow-up. Price on quotation, set at the first consultation according to your situation.
Everyone responds differently: the aim is to space out attacks and regain comfort, without promising a result.
When to seek advice
What is going on in your case
This text describes general mechanisms. What explains your neck pain and headaches, in your own situation, deserves a real conversation rather than a generic answer.
A question before you decide? Book a free 10-minute call to see whether our approach suits you.
