Can a Stronger Neck Mean Fewer Headaches?
- Sam Kelokates
- Jul 1
- 7 min read
If you’re someone who deals with frequent headaches, whether it’s migraine, tension-type, or cervicogenic headache, you’ve probably wondered...
Could this be coming from my neck?
You might notice neck tightness at the end of the day, or that familiar ache starting between your shoulders before the headache sets in.
And you’ve likely tried stretching, posture fixes, maybe even physical therapy with mixed results.
But here’s the thing: when done the right way, strengthening your neck can actually reduce how often you get headaches.
The key is understanding how your neck and shoulder muscles interact with your nervous system and how to train them properly.
Let’s break it down.
The link between neck weakness, muscle endurance, and headache triggers
Can strengthening your neck really reduce how often you get headaches?
The short answer? Yes, strengthening your neck can reduce how often you get headaches.
We now have solid evidence that addressing musculoskeletal impairments in the neck, particularly the upper cervical spine, can positively impact people living with chronic headache conditions.
This is especially true for those with cervicogenic headache, but it also applies to tension-type headache and migraine, if your neck plays a role in triggering your attacks.
Here’s what’s happening: If your neck muscles are weak, tight, or just not working well together, it can create stress on the joints and soft tissue of the neck, especially when you're stuck in the same position for hours, like sitting at a desk or looking down at a screen.
Over time, this contributes to what’s called sensitization: your nervous system becomes more reactive, and even minor stress or muscle fatigue can set off a headache or migraine attack.
Recent studies support this. In one observational study of individuals with chronic migraine, researchers found atrophy and reduced function in deep neck stabilizers, including the longus colli and multifidus muscles.
These muscles are crucial for holding the head upright and maintaining proper neck posture throughout the day.
When they’re underperforming, other muscles, like the upper traps and suboccipitals, start to overwork, becoming painful and contributing to trigger sensitivity.
This leads to a pattern you might recognize: the dull neck ache by early afternoon, the feeling of your head being too heavy to hold up, or constantly propping your head with your hand or a pillow while sitting.
Some people describe it as a “bobblehead” sensation. Not quite dizziness, but a real challenge to keep their head stable.
We often refer to this as cervical instability, and it's a common complaint in people with chronic headache disorders.
Over time, this instability and fatigue can increase the frequency of your headache episodes, particularly later in the day when those deep stabilizers are just worn out.
But the good news is that targeted strengthening exercises can help reverse this cycle.
By restoring endurance and control to the right muscles, you reduce the load on irritated tissues and decrease one of the common triggers of both migraine and tension-type headache.
How Long Does It Take to Strengthen Your Neck Enough to See Fewer Headaches?
This is one of the most common questions I get: “How long will it take for physical therapy or exercise to help with my headaches?”
The answer depends on two key pieces, manual therapy and exercise, and they each follow very different timelines.
Manual therapy (hands-on treatment for the joints and soft tissues of your neck) is typically short-term. Most people see improvements within 6 to 10 sessions, especially when manual therapy is paired with targeted education and exercises specific to your headaches.
But when it comes to strengthening the neck and shoulders, things take more time — because we're building endurance, restoring control, and desensitizing the system.
For long-term relief from migraine, tension-type headache, or cervicogenic headache, research shows we need a structured plan that lasts 3 to 6 months. It takes time to gradually rebuild strength in the right muscles, especially if they’ve been underused or overworked for years.
That’s the timeline where we start to see meaningful changes in headache frequency, pain intensity, and overall stability.
But here’s something most people don’t realize: Even after that initial 3–6 months, the work isn’t done. Just like any form of exercise or physical activity, maintenance matters.
If you stop completely, the neck muscles can lose endurance again, and symptoms may return. Long-term consistency — even just 10–15 minutes a few times a week — helps keep those gains.
What does a good strengthening plan look like? The research points to a simple but effective benchmark: 60 minutes per week of neck and shoulder–specific exercise.
That could be one longer session, or 3–5 shorter sessions spread across the week. Studies show it doesn’t matter how you split it, as long as you’re hitting the total dose needed.
One clinical trial found that even when participants broke up the hour into daily 9-minute sessions, they saw significant reductions in headache intensity and frequency. What really mattered was consistency over time and sticking to the plan.
That said, progress isn’t always linear. As we introduce new, more challenging exercises, some people might experience a short flare-up of neck pain or a mild increase in headaches.
That doesn’t mean the program isn’t working. It just means we need to make thoughtful adjustments. If symptoms don't settle after 2–3 sessions, it's a signal to scale things back and modify the plan.
Ultimately, neck strengthening shouldn’t feel like a punishment. If you're getting a headache every time you do your exercises, the program probably isn’t the right fit for your current sensitivity level.
This doesn't mean exercise won't work for you. It means that routine, at that point in time, wasn't the right one for you. Keep looking for what works!
That’s exactly where individualized support makes all the difference.
What Types of Neck Exercises Are Best for Headache Relief?
A common question I get is: “What’s the best exercise for neck-related headaches?”
The truth is, there isn’t one single exercise that works for everyone. And it’s not just about the neck. The best results come from working the neck and shoulder muscles together.
Here’s why: Your neck and shoulders don’t operate in isolation. The deep muscles in your neck (like the longus colli, longus capitis, and rectus capitis anterior) help with small, precise movements and stabilizing your head.
These are often weak or overactive in people with headache disorders, and strengthening them can improve both postural endurance and motor control.
But these deeper muscles are only part of the story. Many neck muscles also connect to the shoulder blades, upper back, chest, and even the ribs.
So when we talk about exercise for headache relief, we’re really talking about improving the function of an interconnected system. This is called regional interdependence, and if we ignore one part, the whole system suffers.
So what types of exercises make the most impact?
Deep cervical flexor strengthening
Posterior stabilizers like the multifidi and splenius capitis
Scapular stabilizers like rhomboids, serratus anterior, and levator scapulae
Motor control and posture-focused movements
Here’s the good news: it doesn’t have to be a long routine.
Most people benefit from just 10–12 minutes a day, doing 3 to 5 exercises. That’s enough to build consistency without overwhelming your system. Especially if you're dealing with fatigue or sensitivity.
That said, the best exercises for you depend on your specific situation. Someone with restricted neck mobility may need range-of-motion work, while someone with joint hypermobility (like Ehlers-Danlos Syndrome) might benefit more from deep stabilization exercises.
If your neck feels unstable or your head feels “too heavy” by mid-afternoon, you likely need a very different plan than someone who’s just tight and stiff.
If generic one-size-fits-all programs aren't working for you then you may need something more specific. A more effective program that is tailored to your clinical presentation, designed to challenge the right muscles without flaring up symptoms. That’s exactly what we focus on in the next section.
Tried Physical Therapy or Neck Exercises Before — and It Didn’t Work? Here’s What Might Have Been Missing
If you’ve tried physical therapy for your headaches in the past and didn’t get results, you’re not alone — and it’s not your fault.
A national survey of U.S. physical therapists found that only 41.7% could correctly classify migraine, 32.3% got tension-type headache right, and just 54.8% correctly identified cervicogenic headache. Even more concerning? Only 26.4% were familiar with the International Headache Society's criteria for classifying headache disorders (Dale et al., 2020).
When a headache is misclassified, everything downstream suffers: Wrong diagnosis → Wrong treatment plan → Poor outcomes
That’s why generic neck exercises or standard PT protocols often fall short. The plan wasn’t designed for your specific headache type, triggers, or musculoskeletal impairments.
Why Kelos Physical Therapy’s approach is different — and designed to work
At Kelos Physical Therapy, we do things differently. Our approach is grounded in:
Accurate assessment of headache type and cervical involvement
Evidence-informed treatment plans tailored to each person’s presentation
A deep understanding of how migraine, tension-type, and cervicogenic headaches intersect with the neck, nervous system, and daily life
Our Active Headache Recovery Program is built for people just like you! Individuals who need a more specialized, headache-informed plan.
Whether you’ve tried PT before or you’re just getting started, we meet you where you are and help you move forward safely and effectively.
Ready to try something that’s actually designed for your headache? Schedule a free consultation or send us a message to learn more.
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