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Neck Pain and Headaches, What Can I Do About It?

In my years of being a Physical Therapist (PT), I have had multiple patients that had neck pain in conjunction with headaches. The pain starts in the upper back/shoulders and continues into the base of the skull into the head causing a debilitating headache.

There are 3 treatments I have found to give these patients relief: 1) dry needling, 2) manual suboccipital release, and 3) scapular stabilizer musculature strengthening.  The first and second treatments should be done by a Physical Therapist, while the third treatment can be performed at home with an elastic band. I will go through all the treatments and describe them.

Dry needling is a fairly new and valuable adjunct treatment for chronic/acute pain/stiffness, especially neck pain and headaches. With the dry needling technique, a fine, flexible and sterile needle is used. The purpose of the needling is to release shortened bands of muscle caused by abnormal functioning of the nervous system, which is usually caused by injury to the tissue. No drugs are injected, hence the name “dry”. I have found around 6 treatments of dry needling to the patient will essentially eliminate their neck pain/headaches, since they tend to coincide.

Manual suboccipital release is a technique used by a PT where the patient is on their back with their head completely relaxed onto the PT’s hands. The PT then places their fingertips right beneath the skull and gives a slight pull. After a minute or so the patient should experience some type of relief. I found that this technique is not as effective as dry needling, but can be used alternatively if the patient opts out of dry needling or could even be used in addition to the dry needling.

Scapular stabilizer musculature strengthening is gaining strength into your shoulder blade muscles. By doing the following exercises, there will be less tension into the neck, therefore less headaches. I will go over the top 3 exercises that can be performed at home with an elastic band; 1) Rows, 2) Straight Arm Pulldowns (SAP), and 3) Reverse Flys.

Rows – Hold onto the band with thumbs to the sky, now back up until your arms are straight and there is tension felt. Next, while keeping your shoulders down and back, bring the band back at chest level while bending your elbows and keeping them close to your body and squeezing your shoulder blades together. Hold at the spot for a couple of seconds, and then slowly return to starting position. Repeat that motion 20 times.


SAP – Hold onto the band with your palms facing towards you, now back up until your arms are straight and there is tension felt. Next, while keeping your shoulders down and back, keep your arms straight while pulling the band to go past your hips. Be sSAP – Hold onto the band with your palms facing towards you, now back up until your arms are straight and there is tension felt. Next, while keeping your shoulders down and back, keep your arms straight while pulling the band to go past your hips. Be sure to keep your core tight and try to squeeze your shoulder blades together. Hold at the spot for a couple of seconds, and then slowly return to starting position. Repeat that motion 20 times.ure to keep your core tight and try to squeeze your shoulder blades together. Hold at the spot for a couple of seconds, and then slowly return to starting position. Repeat that motion 20 times.


Reverse Flys – Hold onto the band with thumbs to the sky, now back up until your arms are straight and there is tension felt. Next, while keeping your shoulders down and back, bring the band back at chest level while keeping your arms straight with a slight bend and trying to squeeze your shoulder blades together. Hold at the spot for a couple of seconds, and then slowly return to starting position. Repeat that motion 20 times.

Of course these are not the only exercises that can be performed, but are the most common to get the best results.

Not all neck pain patients have headaches and vice versa, but if you are experiencing the deadly combination, give these 3 treatments a try. If you have any other ailments, visit us here at Jones Physical Therapy so we can get you back to living your best life.

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