Understanding Tension Headaches

If you’ve ever felt a dull ache that starts at the base of your skull and wraps around your head like a tight band, you’re not alone. Tension headaches are one of the most common types of headaches—and often, they aren’t just “in your head.” In many cases, they start in your neck and shoulders.

Poor posture, stress, and muscle imbalances can cause tightness in the upper neck, jaw, and shoulder muscles. These muscles attach near the base of the skull, so when they stay tense, they can irritate the surrounding nerves and trigger headache pain.

Common Causes Behind the Pain

Physical therapists often see tension headaches connected to:

• Forward head posture from computer or phone use

• Tight neck and shoulder muscles (especially the upper traps and suboccipitals)

• Weak deep neck flexors that fail to support the head properly

• Jaw clenching or grinding (TMJ issues)

• Stress-related muscle tension

• Old whiplash or neck injuries that changed how your muscles move

Even small daily habits—like sleeping with too many pillows or carrying a heavy bag on one shoulder—can contribute over time.

How Physical Therapy Can Help

Physical therapy doesn’t just mask the pain; it addresses the root cause. A PT can help identify which muscles or movement patterns are contributing to your headaches and build a plan to restore proper function.

Here’s what that often includes:

• Postural assessment: Learning how your head, neck, and shoulders align throughout the day.

• Manual therapy: Gentle hands-on techniques to release tight muscles and improve mobility.

• Targeted exercises: Strengthening weak muscles and stretching overactive ones.

• Ergonomic coaching: Setting up your workspace or daily habits to reduce neck strain.

• Stress and breathing techniques: Reducing tension and improving oxygen flow to neck muscles.

Over time, many people notice fewer headaches, less neck tightness, and better posture—without relying on medication.

When to See a PT

If you notice your headaches are frequent, triggered by neck movement, or worsened by stress or poor posture, it’s time to check in with us at Defiance. Early intervention can prevent the pain from becoming chronic and help you get back to feeling clear-headed and comfortable.

Tension headaches often start where you least expect—your neck. Physical therapy helps by releasing tight muscles, retraining posture, and preventing future flare-ups.