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Tension headaches are the most common type of headache in the world. They are often described as a tight band around the forehead, a heavy pressure behind the eyes, or a dull ache at the base of the skull. Because they are common, they are often dismissed as “normal” or simply a result of stress. Patients are told to take paracetamol, drink water, and relax.
However, for those suffering from chronic tension headaches, “relaxing” is impossible. The pain is constant and draining. It affects concentration, mood, and sleep. It is often accompanied by neck stiffness and shoulder tightness that no amount of massage seems to fix permanently.
At Breakthrough Pain & Performance, we distinguish between a true tension headache and a Cervicogenic Headache. A cervicogenic headache is pain that is perceived in the head but originates in the neck. The brain is making a mapping error. It mistakes neck signals for head pain. By correcting this error and treating the specific structures in the neck that are feeding the pain loop, we can resolve headaches that have persisted for years.
To understand why your neck hurts your head, you must understand the anatomy of the brainstem. Specifically, the Trigemino-Cervical Nucleus (TCN).
The TCN is a cluster of nerves in the lower brainstem. It acts like a busy train station. It receives trains (signals) from two main lines:
1. The Trigeminal Nerve: This supplies sensation to the face, forehead, jaw, and the meninges (covering of the brain).
2. The Upper Cervical Nerves (C1, C2, C3): These supply sensation to the top of the neck and the base of the skull.
Crucially, these two tracks merge onto the same platform. The signals mix together. When the signals arrive at the cortex (the conscious brain), the brain cannot always tell which track the train came from.
If you have a stiff joint at C2 or a tight suboccipital muscle, it sends a constant stream of “danger” signals into the TCN. The TCN gets overwhelmed. It passes this signal up to the brain. The brain interprets this as pain in the forehead or behind the eye. This is Referred Pain. You feel the pain in your head, but the problem is in your neck. Treating the head will never work because the source is lower down. We treat the neck to clear the station.
For decades, anatomists believed the muscles of the neck were separate from the brain. We now know this is incorrect. There is a direct physical connection called the Myodural Bridge.
The small muscles at the base of the skull (Rectus Capitis Posterior Minor) have connective tissue fibres that pass directly through the gap between the skull and the spine. They attach to the Dura Mater, the sensitive protective covering of the brain.
If these muscles are tight or in spasm (perhaps due to poor posture or stress), they physically pull on the Dura Mater. This traction on the brain’s covering causes vague, diffuse headaches and a feeling of “brain fog.”
We use specific release techniques for the suboccipital muscles. We do not just rub them. We use eye movements to relax them via the neurological connection (the cervico-ocular reflex). By releasing the tension in these muscles, we stop the tugging on the Dura, often providing instant relief from the “heavy head” sensation.
Many people associate tension headaches with computer use. They blame the blue light or the screen glare. While these contribute, the primary driver is often Oculomotor Strain.
The muscles that move your eyes are hardwired to the muscles of your neck. When your eyes strain to focus (convergence) or hold a steady gaze on a pixelated screen, the brain reflexively tightens the neck muscles to stabilise the head.
If you have a minor visual deficit, such as Convergence Insufficiency (difficulty turning the eyes inwards), your brain has to work harder to prevent double vision. This effort creates massive tension in the suboccipital muscles. By 3pm, your neck is rock hard and your head is pounding.
We test your eyes as part of your headache assessment. We look for hidden strains in the visual system. We prescribe simple “eye push-ups” or tracking drills. By making the eyes stronger and more efficient, we remove the need for the neck to lock up, resolving the headache at the neurological source.
Do you have pain across the top of your shoulders and up the neck (the coat hanger area)? This is often driven by Apical Breathing.
When you are stressed, you breathe into your upper chest using the “emergency” breathing muscles. These are the Upper Trapezius, the Levator Scapulae, and the Scalenes. These muscles all attach to the neck vertebrae.
If you take 20,000 breaths a day using these muscles, they become exhausted and tight. They compress the cervical joints and the nerves, feeding into the TCN and causing headaches.
We retrain Diaphragmatic Breathing. We teach you how to breathe without lifting your shoulders. This allows the neck muscles to rest. Often, chronic daily headaches vanish simply by changing the respiratory mechanics.
1. The Diagnosis: We determine if it is a true tension headache or a cervicogenic referral.
2. The Release: We use P-DTR to switch off the protective spasms in the upper neck muscles.
3. The Mobilisation: We gently restore movement to the C1 and C2 vertebrae (often responsible for rotation headaches).
4. The Retrain: We give you visual and breathing drills to prevent the tension from rebuilding during the work day.
This clinic is for you if:
We provide a drug-free, mechanical solution to head pain.
