HEADACHE & MIGRAINES
Frequent headaches and migraines can seriously disrupt your day-to-day life. Many headaches originate from tension in the neck, jaw and upper back — areas our osteopaths and remedial massage therapists specialise in treating. At Dingley Health Hub, we take a whole-body approach to understanding your triggers and addressing the underlying causes, helping to reduce the frequency, intensity and duration of your headaches so you can get back to feeling like yourself.
Common Headache & Migraine Conditions
Tension headaches
Tension-type headache is the most common headache disorder, affecting up to 78% of the population. It is characterised by bilateral pressing or band-like head pain of mild-to-moderate intensity. The primary musculoskeletal contributors are cervical and upper thoracic joint dysfunction and myofascial trigger points in the suboccipital, trapezius, sternocleidomastoid and temporalis muscles. While often dismissed as "just stress", recurrent tension headaches significantly impact quality of life and respond very well to osteopathic and massage treatment.
Symptoms include:
Bilateral pressing or tightening pain (not throbbing), mild-to-moderate intensity not aggravated by routine physical activity, possible mild light or sound sensitivity but not both simultaneously, and episodes lasting anywhere from 30 minutes to 7 days. Pain is typically felt across the forehead, temples or back of the head like a tight band.
How we treat it:
Osteopathic mobilisation and manipulation of the cervical and upper thoracic spine provides immediate relief by restoring joint movement and reducing pressure on the structures that refer pain to the head. Trigger point dry needling and deep tissue massage of the pericranial muscles — the trapezius, suboccipitals, temporalis and sternocleidomastoid — is highly effective for stubborn tension headaches. Postural correction addresses the forward head posture that chronically overloads the upper cervical joints. Where stress is a significant driver, our onsite counsellor Stephan Koutsonas works concurrently on psychological contributors, producing far more durable results than physical treatment alone.
Stress-related headaches
Psychological stress is one of the most commonly reported headache triggers. Stress activates the body's threat response, causing subconscious muscle bracing in the neck, jaw and shoulders and lowering central pain thresholds — a perfect storm for headache. When stress becomes chronic, so too can the headaches. Dingley Health Hub offers a uniquely integrated approach, combining osteopathic and massage care with onsite counselling to address both the physical and psychological contributors simultaneously.
Symptoms include:
Headaches correlating with periods of high stress or anxiety, associated neck and shoulder tightness, jaw clenching or teeth grinding (bruxism), disturbed sleep, fatigue, and sometimes associated digestive symptoms such as nausea or appetite changes. Headaches may be present daily during particularly stressful periods.
How we treat it:
Our osteopaths and massage therapists treat the physical manifestations of chronic stress — releasing the tight scalenes, suboccipitals, temporalis and masseter muscles that accumulate tension during stressful periods. Jaw and TMJ (temporomandibular joint) release is incorporated where clenching and grinding contribute to headache. Our counsellor Stephan Koutsonas works concurrently on the psychological drivers of chronic stress — including anxiety, sleep disruption and nervous system dysregulation. This combination addresses both the cause (stress) and the physical output (muscular tension and headache), producing far more durable results than either approach in isolation.
Headaches from eye strain and screen use
Digital eye strain (computer vision syndrome) from prolonged screen use drives frontal headaches through a combination of accommodative muscle fatigue in the eyes, forward head posture and reduced blink rate causing dry eyes. As screen time increases across all age groups and occupations, this headache type is increasingly common and often underdiagnosed as a treatable musculoskeletal problem. Many patients are surprised to find that treating the neck — not the eyes — resolves their screen-related headaches.
Symptoms include:
Frontal or retro-orbital headache (behind the eyes) that builds progressively over a screen-heavy day, eye fatigue and blurring at distance after prolonged near work, neck and upper back stiffness, dry or irritated eyes, and headaches that reliably resolve on weekends or holidays when screen time is reduced.
How we treat it:
We address the cervical and thoracic postural dysfunction that prolonged screen use promotes. The forward head posture adopted at screens places sustained compressive load on the suboccipital and upper cervical structures — treating these joints and muscles directly relieves screen-related headache quickly and effectively. A comprehensive ergonomic assessment covers screen height and distance, chair setup, lighting conditions and break frequency, often identifying straightforward adjustments that dramatically reduce symptoms. For persistent cases, ophthalmology review for blue light filtering lenses or dedicated computer glasses is recommended alongside our treatment.
Headaches from neck joint dysfunction
Cervicogenic headache (CGH) arises from pathology in the upper cervical spine — specifically the C0, C1, C2 and C3 levels — where the trigeminal and cervical nerve pathways converge at the trigeminocervical nucleus. Dysfunction or irritation at these levels refers pain to the head in a characteristic pattern. CGH is frequently misdiagnosed as migraine or tension-type headache, as the symptoms can overlap significantly. Correct differentiation is critical, because the treatment is entirely different — and highly effective when applied to the right diagnosis.
Symptoms include:
Unilateral headache that is always on the same side (side-locked), starting in the neck or suboccipital region and radiating forward to the forehead, temple or behind the eye. Neck stiffness and restricted cervical movement accompany the headache. The headache can be reproduced by applying sustained pressure to the upper cervical joints on the affected side — a reliable diagnostic finding. Nausea and light sensitivity can occur, mimicking migraine.
How we treat it:
Upper cervical joint mobilisation and manipulation is the most evidence-supported treatment for cervicogenic headache. A landmark randomised controlled trial (Jull et al.) demonstrated that specific cervical manipulation combined with therapeutic exercise reduced CGH frequency by more than 50% — superior to either approach alone. Our osteopaths are trained in precise upper cervical assessment and treatment techniques. Deep neck flexor endurance training — exercises targeting the longus colli and longus capitis — maintains improvement between sessions and reduces recurrence. Dry needling of the suboccipital muscles provides additional symptomatic relief for patients with significant muscular involvement.
Headaches following whiplash or neck injury
Headache is one of the most common and persistent symptoms following whiplash injury, present in over 80% of acute whiplash cases. Post-traumatic headache following whiplash most commonly resembles tension-type or cervicogenic headache in character, arising from the disruption to cervical joints, ligaments, muscles and nerves caused by the sudden acceleration-deceleration force. Inadequate treatment of the underlying cervical dysfunction is one of the main reasons post-whiplash headache persists for months or years after an injury.
Symptoms include:
Headache onset within 7 days of a neck injury (a diagnostic criterion for post-traumatic headache), accompanying neck pain and stiffness, possible dizziness or visual disturbances, cognitive fog or difficulty concentrating, fatigue, and in some cases anxiety about movement or driving following a vehicle accident.
How we treat it:
A graded active rehabilitation approach — combining early gentle cervical mobilisation and soft tissue therapy with progressive exercise and pain education — produces superior outcomes to passive rest and immobilisation alone. This is well supported by current whiplash clinical guidelines. Neural mobilisation addresses sensitised cervical nerve roots that contribute to persistent head pain after whiplash. Where fear of movement, anxiety or post-traumatic stress is contributing to recovery, our onsite counsellor provides concurrent psychological support. TAC (Transport Accident Commission) patients are welcome and managed with appropriate documentation throughout.
Migraine without aura
Migraine without aura is the most common form of migraine, characterised by recurrent attacks of moderate-to-severe unilateral throbbing head pain accompanied by nausea, photophobia and phonophobia. It has a strong neurobiological basis involving cortical spreading depression and trigeminal nerve sensitisation, but musculoskeletal and lifestyle factors significantly modulate how frequently and severely attacks occur — and these are highly amenable to osteopathic and lifestyle intervention alongside medical management.
Symptoms include:
Moderate-to-severe unilateral pulsating or throbbing head pain lasting 4–72 hours untreated, nausea and/or vomiting, significant photophobia (light sensitivity) and phonophobia (sound sensitivity), and functional impairment severe enough to interrupt daily activities. Attacks may be preceded by a prodrome of fatigue, mood change or food cravings hours before the headache begins.
How we treat it:
Upper cervical mobilisation reduces the sensitivity of the trigeminocervical complex — the key neurological pathway through which migraine attacks are initiated and amplified — making attacks less frequent and less severe. Soft tissue treatment of the neck and jaw reduces the musculoskeletal triggers that can initiate attacks in susceptible individuals. We work alongside your GP or neurologist: our role is complementary to medical prophylaxis and acute medications, targeting the modifiable musculoskeletal and lifestyle contributors that pharmacotherapy alone does not address. Trigger identification and management — covering sleep, hydration, dietary triggers, screen exposure and hormonal patterns — is incorporated into every migraine treatment plan.
Migraine with aura
Migraine with aura involves transient, fully reversible neurological symptoms — most commonly visual disturbances such as scintillating scotoma (shimmering blind spots) or zigzag lines, but also sensory, language or rarely motor disturbances — that precede the headache phase by 20–60 minutes. The underlying mechanism is cortical spreading depression, a wave of electrical activity followed by suppression that moves across the brain's cortex. Migraine with aura carries a slightly elevated cardiovascular risk, particularly in women who smoke or use oestrogen-containing contraception, which should be discussed with a GP.
Symptoms include:
Fully reversible visual aura (zigzag lines, shimmering scotoma, temporary vision loss) or sensory aura (tingling or numbness moving across the face or hand) or speech disturbance, developing gradually over 5 or more minutes and lasting up to 60 minutes, followed within 60 minutes by moderate-to-severe unilateral throbbing headache with nausea and light and sound sensitivity.
How we treat it:
Our approach for migraine with aura closely parallels that for migraine without aura — osteopathic cervical care, trigger identification and lifestyle modification — working in coordination with the prescribing medical team. We pay particular attention to sleep quality and regularity, screen exposure and blue light, dietary triggers (especially tyramine-rich foods, caffeine rebound and meal skipping), and hormonal triggers across the menstrual cycle. We help patients develop an early-warning recognition system — identifying their individual prodrome and aura signals — and implement effective responses before a full migraine attack develops. This proactive approach reduces both the frequency and severity of attacks over time.
Vertigo
Vertigo — the illusion that you or your environment is spinning — ranges from briefly disconcerting to severely debilitating, affecting balance, confidence and the ability to carry out everyday tasks. Benign paroxysmal positional vertigo (BPPV) is the most common cause, accounting for approximately 50% of all vertigo cases, and is highly treatable with specific repositioning manoeuvres that our osteopaths are trained to perform. Cervicogenic dizziness arising from upper cervical joint and muscle dysfunction is the second most common cause treated in allied health settings and responds well to manual therapy.
Symptoms include:
Episodic spinning sensation triggered by specific head position changes — rolling over in bed, looking up, bending down — with each episode typically lasting less than one minute (BPPV). Alternatively, a more constant background unsteadiness or dizziness that worsens with neck movement (cervicogenic dizziness). Associated nausea, nystagmus (involuntary eye movement) during episodes, and in severe cases difficulty walking or falls. Tinnitus and hearing loss accompanying vertigo warrant ENT review.
How we treat it:
For BPPV, the Epley manoeuvre (for posterior semicircular canal involvement, the most common type) or Semont manoeuvre (for anterior canal involvement) physically moves the displaced calcium carbonate crystals (otoconia) back into the utricle where they no longer cause symptoms. This resolves vertigo in the majority of cases within one to three treatment sessions. Our osteopaths are trained and experienced in performing these repositioning procedures accurately. For cervicogenic dizziness, upper cervical joint mobilisation directly addresses the proprioceptive dysfunction in the neck that is generating the false dizziness signal. Vestibular rehabilitation exercises improve the brain's central compensation mechanisms and restore confidence in movement. Persistent, atypical or progressive vertigo is co-managed with ENT or neurology to exclude inner ear pathology or central causes.
Frequently asked Questions
Can osteopathy help with headaches and migraines?
Answer:
Yes. Osteopathy is highly effective for many types of headache, particularly those with a musculoskeletal component — including tension-type headaches, cervicogenic headaches, post-whiplash headaches and headaches associated with jaw tension and screen use. Our osteopaths restore movement in the cervical and thoracic spine, release tight muscles in the neck, jaw and upper shoulders, and address the postural patterns that chronically overload the upper cervical joints. For migraines, osteopathic care plays an important preventive role by reducing the sensitivity of the trigeminocervical complex — the neurological pathway through which attacks are amplified. We work alongside your GP or neurologist for migraine management rather than replacing medical care.
What is a cervicogenic headache and how is it different from a tension headache?
Answer:
A cervicogenic headache originates from dysfunction in the upper cervical spine — specifically the C0, C1, C2 and C3 joints — where the cervical and trigeminal nerve pathways converge. The headache is referred from these joints to the head in a characteristic pattern: starting at the base of the skull and radiating to the forehead, temple or behind the eye. It is always on the same side, accompanied by neck stiffness, and can be reproduced by pressing on the upper cervical joints. A tension-type headache, by contrast, is typically bilateral — felt on both sides — described as a pressing or tightening band, and is driven primarily by myofascial trigger points in the pericranial muscles rather than joint dysfunction. The distinction is clinically important because cervicogenic headache responds best to upper cervical joint mobilisation and manipulation, whereas tension headache responds best to trigger point therapy and muscle release.
Why do I get headaches from sitting at a computer all day?
Answer:
Screen-related headaches develop from a combination of forward head posture and eye muscle fatigue. When the head drifts forward during screen use, the upper cervical joints and suboccipital muscles are placed under sustained compressive and tensile load — the same structures that refer pain to the head in cervicogenic and tension-type headaches. At the same time, the eye muscles work harder to maintain focus on a near screen for prolonged periods, contributing to frontal headache. Treating the upper cervical joint dysfunction and tight suboccipital muscles relieves these headaches very effectively. Equally important is correcting screen height — raising the monitor so the top of the screen is at or just below eye level removes the main driver of forward head posture and is one of the most impactful single changes a desk worker can make.
Can neck tension cause headaches?
Answer:
Yes — and this is one of the most common and most under-appreciated causes of recurrent headache. The muscles of the neck and upper shoulders — particularly the trapezius, sternocleidomastoid, suboccipitals and scalenes — are densely innervated and contain highly active myofascial trigger points in most people who experience regular headaches. When these trigger points are active, they refer pain in predictable patterns to the head, forehead and temples. Additionally, the upper cervical joints that become restricted from postural loading or stress bracing directly irritate the cervical nerve roots that converge with the trigeminal pathway — producing referred head pain. Releasing the neck muscles with soft tissue therapy and dry needling, combined with upper cervical joint mobilisation, is one of the most reliably effective treatments for recurrent headache.
How is vertigo treated at Dingley Health Hub?
Answer:
The treatment depends on the specific cause of the vertigo. Benign paroxysmal positional vertigo (BPPV) — the most common form, where displaced calcium crystals in the inner ear cause brief spinning episodes with head position changes — is treated with specific repositioning manoeuvres performed in-clinic. The Epley manoeuvre for posterior canal BPPV and the Semont manoeuvre for anterior canal BPPV physically move the displaced crystals back to where they can no longer cause symptoms. These procedures are highly effective and resolve BPPV in the majority of cases within one to three sessions. Cervicogenic dizziness — a constant background unsteadiness arising from upper cervical joint and muscle dysfunction — is treated with upper cervical mobilisation and vestibular rehabilitation exercises. Vertigo with associated hearing changes or tinnitus is referred to ENT for further assessmeent.
How many sessions will I need for my headaches to improve?
Answer:
Most patients with tension-type or cervicogenic headaches notice meaningful improvement in frequency and intensity within three to five sessions. Chronic daily headache or long-standing migraines typically require a longer course of care — six to ten sessions — combined with lifestyle and trigger modifications, before sustained improvement is established. BPPV often resolves in one to three sessions. The factors that most influence how quickly headaches improve are how long they have been present, how consistently the prescribed exercises and postural changes are implemented, and whether lifestyle triggers — sleep, stress, hydration, screen time — are addressed alongside clinical treatment. We will give you a realistic and honest estimate of what to expect after your initial assessment.
Can stress cause headaches and migraines?
Answer:
Yes. Stress is one of the most commonly reported triggers for both tension-type headaches and migraines. Psychological stress causes subconscious bracing and tension in the muscles of the neck, jaw and upper shoulders — directly loading the structures that generate and amplify headache. Stress also lowers central pain thresholds, disrupts sleep and contributes to dehydration and poor diet habits, all of which independently increase headache risk. At Dingley Health Hub, we take an integrated approach to stress-related headache. Our osteopaths address the physical manifestations, while our onsite counsellor Stephan Koutsonas addresses the psychological drivers — producing more complete and durable results than treating the physical symptoms alone.
Is it safe to have osteopathic treatment during a migraine or headache?
Answer:
During an active migraine attack, most patients are unable to tolerate hands-on treatment and benefit most from rest in a quiet, dark environment. Treatment is most effective in the period between attacks — when we can address the cervical and muscular contributors that lower the attack threshold, without the heightened sensitivity of the migraine state. For tension-type and cervicogenic headaches, gentle treatment during a moderate headache episode is often well tolerated and can provide significant immediate relief. Your osteopath will always tailor the approach to your current state on the day of each appointment.
Do I need a referral to see an osteopath for headaches?
Answer:
No referral is needed. You can book directly online or by calling (03) 9551 7110. Same-week appointments are usually available. Osteopathy for headache and migraine is covered by most Australian private health insurance funds with extras cover — we have HICAPS on-site for immediate claiming. If neurological assessment or brain imaging is clinically indicated following your assessment, we will advise you and arrange a GP referral. Most headache presentations do not require imaging.
What triggers migraines and can they be prevented?
Answer:
Migraines are triggered by a combination of neurobiological susceptibility and identifiable external triggers. Common triggers include disrupted or insufficient sleep, dehydration, skipped meals, caffeine withdrawal, specific foods (tyramine-rich foods such as aged cheese and red wine, artificial sweeteners, processed meats), hormonal fluctuations across the menstrual cycle, high psychological stress and excessive screen exposure. No two people share exactly the same trigger profile. Keeping a migraine diary — noting sleep, food, hydration, stress, activity and hormonal timing around each attack — is the most effective way to identify your personal triggers. At Dingley Health Hub, we work through trigger identification with every migraine patient and develop a practical, sustainable management plan that addresses both the modifiable lifestyle contributors and the musculoskeletal factors that lower the threshold for attacks.