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Beyond the Headache: A Physiotherapist's Perspective on Migraine Awareness Week

  • SMARTPHYSIO
  • Aug 14, 2025
  • 2 min read

Updated: Feb 1

As we mark Migraine Awareness Week, I'm reminded of how often patients apologise when mentioning their headaches during consultations. "It's probably nothing," they say, yet migraine affects 1 in 7 people globally and is the third most common disease worldwide. From a physiotherapist's perspective, the musculoskeletal connections to migraine are both fascinating and treatable.


More Than Just a Headache

Migraine isn't simply a severe headache – it's a complex neurological condition with significant physical components. Research shows strong links between neck dysfunction, postural abnormalities, and migraine frequency. Studies indicate that up to 87% of migraine sufferers also experience cervicogenic symptoms, suggesting a clear role for physiotherapy intervention.

The modern workplace hasn't helped matters. Hours spent hunched over computers create the perfect storm: forward head posture, rounded shoulders, and increased tension through the suboccipital muscles. These postural changes can trigger or perpetuate migraine patterns through complex neurovascular mechanisms.


The Evidence Base

Recent systematic reviews demonstrate that manual therapy and targeted exercise can significantly reduce migraine frequency and intensity. A randomised controlled trial published in Cephalalgia found that cervical spine treatment reduced migraine days by an average of 2.5 days per month – a clinically meaningful improvement for sufferers.

What's particularly encouraging is research showing that addressing cervical joint dysfunction and muscle imbalances can break the cycle of recurrent migraines. The upper cervical spine shares neural pathways with trigeminal nerve structures, explaining why neck treatment can influence head pain patterns.


Practical Interventions

In practice, I've seen remarkable improvements when addressing:

Cervical mobility restrictions – particularly at the upper cervical segments Postural correction – reducing forward head posture and thoracic kyphosis Muscle imbalances – strengthening deep neck flexors whilst releasing tight suboccipitalsWorkplace ergonomics – optimising computer setup and regular movement breaks

The key is individualised assessment. Not every migraine has a musculoskeletal component, but when present, targeted physiotherapy can be transformative.


A Collaborative Approach

Effective migraine management requires multidisciplinary care. Physiotherapy works brilliantly alongside medical management, addressing the physical contributors whilst doctors manage the neurological aspects. I frequently collaborate with neurologists, providing valuable insights into cervical dysfunction patterns.

Patients often report that physiotherapy helps not just with pain reduction, but also with improved sleep quality, reduced medication dependence, and enhanced overall function – outcomes that matter enormously to quality of life.


Hope and Help

This Migraine Awareness Week, let's challenge the misconception that migraines are "just headaches" to be endured. For many sufferers, addressing the musculoskeletal components can provide significant relief and reduce the burden of this debilitating condition.

If you're experiencing frequent headaches, don't dismiss the potential role of neck dysfunction. A thorough assessment might reveal treatable contributing factors.


How We Can Help With Headache and Migraine Physiotherapy

To find out how we can support people experiencing migraine and recurring headaches through physiotherapy services in London, including care for headaches and neurological conditions or home visit physiotherapy, contact SMARTPHYSIO to discuss the most appropriate support.



 
 

About Our Expert

Sammy Margo, Chartered Physiotherapist and Founder of SmartPhysio

Sammy Margo

​Founder and Director of Physiotherapy Services
Chartered Physiotherapist
MSc, MMACP, AACP, MCSP, HCPC

 

Sammy Margo is a Chartered Physiotherapist with over 30 years’ clinical experience. She has worked across the NHS, professional sport, and private practice, and was England’s first female physiotherapist to work in professional football.

Her areas of clinical expertise include:

  • Senior care and complex rehabilitation

  • Home visit and community-based physiotherapy

  • Sleep, recovery, and performance

  • Musculoskeletal and neurological rehabilitation


Sammy is a recognised sleep expert, a former spokesperson for the Chartered Society of Physiotherapy, and a regular contributor to national media including The Telegraph, The Guardian, Daily Mail, and Stylist. She is the author of The Good Sleep Guide.

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