Tension-Type & Cervicogenic Headaches — the Neck Connection

If your headaches come with a tight band around the head, an
ache that starts at the base of the skull, or tension in your neck and
jaw, physiotherapy can genuinely help — but only once we know which kind
of headache we’re actually dealing with. Not all headaches
share a cause, and not all of them belong in a physiotherapy clinic
first. This page is built to do the thing that popular “5-minute
headache relief” videos never do: help you tell tension-type and
cervicogenic headache (which respond well to hands-on treatment and
exercise) apart from migraine (where physiotherapy is only ever a
supporting player) — and flag the rare but serious headaches that need a
doctor, not a stretch. At Somalynk in Ixelles, near Place du Luxembourg
and the EU quarter, your physiotherapist is Philippe Tadger — a
musculoskeletal clinician who is also a Cochrane statistical editor and
PhD pain researcher, so “evidence-based” here means honestly telling you
what physiotherapy can and cannot do for your specific headache. Care is
available in French, English and Spanish.

Trust strip: MSc Orthopaedic Manual Therapy,
University of Zaragoza (honours) · Statistical Editor at Cochrane
(Anaesthesia & Emergency) · PhD candidate in chronic pain (Vrije
Universiteit Brussel) · INAMI-conventionné n°5/58395/34/527

👉 Book a consultation
— or read on: What kind of headache do you
have? · Red flags — see a doctor
first

What kind of headache do you have?

This is the question no popular headache video actually answers — and
it changes everything about what treatment should look like.

Many people have more than one type at once, or a
tension-type/cervicogenic component sitting alongside migraine — which
is exactly why a real assessment, not a generic stretch routine,
matters. If you are not sure which category you fall into, that
uncertainty is itself a good reason to get assessed rather than guess
from a video.

Red flags — see a doctor or emergency services
first

Before any exercise or self-care advice, it matters to say plainly:
most headaches are not dangerous, but a small number are, and no
stretch fixes those. Seek urgent medical care if your headache
involves any of the following:

• A “thunderclap” headache — sudden, severe pain that
  reaches maximum intensity within seconds to a couple of minutes, often
  described as “the worst headache of my life”
• Fever together with a stiff neck (with or without a
  rash) — possible meningitis
• New neurological symptoms — weakness, numbness,
  vision loss, slurred speech, confusion, difficulty walking
• Headache that started after a head injury
• A new headache after age 50, or a headache pattern
  that has clearly and progressively changed or worsened
• Headache that wakes you at night, or is worse lying
  down, coughing or straining

None of the popular headache-relief videos we reviewed screen for any
of this beyond a passing “see your doctor if pain persists” — which is
not enough. If any of the above applies to you, this page and any
self-care exercise is the wrong next step; contact a doctor or emergency
services first.

What you may already be trying — and what’s
honestly helpful

If you’ve searched for headache relief online, you’ve likely found
videos recommending chin tucks, self-massage at the base of the skull,
jaw and temple massage, upper trapezius stretches and posture
correction. For tension-type and cervicogenic headache, that
advice is largely reasonable — these are genuine, low-risk
techniques with a plausible mechanism (releasing tension in the muscles
that refer pain into the head) and some are supported by trial evidence,
particularly when combined rather than used in isolation:

• Chin tucks / upper-cervical flexion — a light
  stretch to the base-of-skull muscles
• Suboccipital self-massage — circular pressure at
  the base of the skull for 20–30 seconds
• Temporalis and masseter (jaw muscle) massage —
  relevant if you clench or grind your jaw
• Upper trapezius and levator scapulae stretches —
  for shoulder/neck tension that refers upward
• Posture and screen-time adjustments — reducing
  sustained forward-head postures

If these genuinely ease your symptoms, that is useful information,
not something to abandon. What is missing from every video we reviewed
is knowing which of these actually addresses your
problem — and knowing when to stop self-treating and get
assessed instead.

Where the popular advice oversells or gets it
wrong

A few corrections worth making plainly, because getting them right
changes what you should expect from treatment:

• A claim you may have seen online frames neck-muscle release
  as “fast migraine relief.” Migraine is a distinct neurological
  condition, not simply a build-up of muscle tension. Neck tension can be
  one trigger among several for some migraine sufferers, but
  releasing neck muscles does not treat migraine itself — and framing it
  that way risks people delaying appropriate medical care for a condition
  physiotherapy cannot resolve on its own.
• One muscle is sometimes singled out as “the migraine
  muscle.” No single muscle causes migraine. Muscular tension can
  contribute to head pain in tension-type and cervicogenic headache, but
  migraine’s mechanism is primarily neurovascular and genetic.
• A felt “pop” during a neck stretch is sometimes described as
  the spine “adjusting” or “realigning” itself. That is not what
  is happening — it is gas cavitation in the joint fluid, a harmless side
  effect, not a bone moving back into place.
• Most self-care videos treat all “headache with neck/skull
  tension” as one bucket and hand out the same
  stretch-and-massage routine regardless of cause. In reality your
  tightness could come from a stiff upper-cervical joint, active
  myofascial trigger points, poor deep-neck muscle control, or a jaw (TMJ)
  driver — and the right treatment depends on which it is.

What physiotherapy actually adds

Following the same method used for every condition here: the
first session is a functional and movement diagnosis, plus a test
treatment that probes our first hypothesis — not a generic
protocol.

• We work out why your muscles are tight,
  not just that they are — assessing upper-cervical joint mobility,
  myofascial trigger points, deep-neck flexor motor control, posture, and
  (where relevant) jaw/TMJ involvement.
• Honest evidence by headache type:
  • Cervicogenic headache — evidence: moderate. Manual therapy
    (joint mobilisation) combined with specific neck exercise has reasonable
    trial support for reducing frequency and intensity.
  • Tension-type headache — evidence: moderate. Combined manual
    therapy, exercise and myofascial trigger-point treatment show benefit
    for many patients, particularly when self-care alone has plateaued.
  • Migraine — evidence: adjunct only. Where neck tension is a
    contributing trigger, manual therapy and exercise may reduce that
    trigger load, but physiotherapy is not first-line migraine treatment.
    Medication and lifestyle-trigger management with your GP or a
    neurologist remain the primary approach; we work alongside that, not
    instead of it.
• Acute vs. stable presentation: if your headaches
  are recent or reactive to a specific mechanical trigger, mechanical
  pain-reproduction testing guides treatment directly. If your pattern is
  stable or long-standing, functional evaluation — movement quality,
  posture, deep-neck control — leads, to reduce the risk of
  recurrence.
• Chronic or frequent headache also gets the
  biopsychosocial layer where relevant — sleep, stress and load all
  influence headache frequency, and this ties to Philippe’s PhD research
  in chronic pain (VUB).

Your first visit — step by
step

1. History and your goals. What the headache feels
   like, where it starts, what triggers or eases it, how often it happens,
   and — importantly — screening for the red flags above.
2. Clinical examination. Upper-cervical and cervical
   joint mobility, muscle and trigger-point assessment, deep-neck motor
   control, posture, and jaw/TMJ screening where relevant.
3. A shared plan. Combining hands-on treatment with
   active exercise and self-care guidance, and being explicit if your
   presentation looks more like migraine than tension-type/cervicogenic
   headache — in which case we will say so and coordinate with your GP
   rather than promise something physiotherapy cannot deliver.

Consultations are available in French, English and
Spanish.

Practical info: INAMI, mutuelle, prescription,
booking and access

INAMI-conventionné (n°5/58395/34/527). Philippe is a
conventionné physiotherapist: fees follow the official INAMI schedule,
with no supplements. A standard session costs €31.64, of which your
mutuality reimburses €25.39 — you pay a fixed co-payment of €6.25 (€2.50
with preferential status/BIM), and the one-time intake at your first
session is reimbursed in full. International patients: invoices are
accepted by insurers such as Allianz Care, Cigna Global, Aetna and BUPA.
Full details and the current official tariffs: pricing & insurance · INAMI sources:
official
tariff schedule (PDF), fixed
co-payments.

Do you need a prescription? You do
not need a doctor’s prescription simply to book. A
medical prescription is required for reimbursement (and
treatment must start within two months of the prescription); you can
consult without one, but the session is then fully at your charge. The
number of reimbursed sessions per year depends on your situation — ask
at booking if unsure.

Duration. A session lasts roughly 30 minutes (first
visit longer). No prices are listed here — see the pricing & insurance page for the full
table.

Location and access. The clinic is in
Ixelles, near Place du Luxembourg (Philippe practises
at ESP), in the EU quarter — easily reached by public transport.

Booking and cancellation. Book by contacting the clinic. Please give reasonable
notice to cancel.

About Philippe Tadger

Philippe Tadger is a musculoskeletal physiotherapist with 15+
years of international experience across Venezuela, Colombia,
Spain, France and Belgium.

• MSc in Orthopaedic Manual Therapy, University of
  Zaragoza — graduated with honours.
• Statistical Editor at Cochrane (Anaesthesia &
  Emergency) — the appraisal skills behind the honest
  evidence-by-headache-type claims on this page.
• PhD candidate in chronic pain and lifestyle
  interventions (Vrije Universiteit Brussel).
• Hands-on training in Maitland, Mulligan, Kinetic Control, Clinical
  Neurodynamics, myofascial pain treatment (Travell & Simons), and
  contemporary pain science.

Languages: French, English and Spanish (native) — so
both francophone Bruxellois and the international/expat community near
the EU institutions are equally at home here.

Frequently asked questions

How do I know if my headache is tension-type, cervicogenic,
or migraine? Tension-type headache usually feels like a dull
band around the head; cervicogenic headache starts at the base of the
skull/neck and spreads forward, often triggered by neck movement;
migraine is typically one-sided, throbbing, and often comes with nausea
or light sensitivity. Many people have overlapping patterns — a proper
assessment is the reliable way to know, not self-diagnosis from a
video.

When should I see a doctor instead of a
physiotherapist? Immediately if you have a sudden “worst
headache of my life,” fever with a stiff neck, new neurological symptoms
(weakness, vision loss, slurred speech, confusion), a headache after a
head injury, a new headache after age 50, or a headache that is
progressively worsening or wakes you at night.

Can physiotherapy help my migraines? Only as an
adjunct. If neck tension is one of your migraine triggers, manual
therapy and exercise may help reduce that trigger load, but medical
management with your GP or a neurologist should lead migraine treatment
— physiotherapy works alongside that, not instead of it.

Is the “migraine muscle” claim I saw online true? No
single muscle causes migraine — migraine is primarily a neurological,
neurovascular condition. Muscle tension can contribute to tension-type
and cervicogenic headache, and can be a trigger for some migraine
sufferers, but releasing a muscle does not treat migraine.

Are chin tucks and neck stretches actually useful?
For tension-type and cervicogenic headache, yes — they are reasonable,
low-risk self-care with a plausible mechanism, and some evidence
supports them, particularly combined with other treatment rather than
alone. They are not a treatment for migraine.

Is the “pop” I feel during a neck stretch my spine
realigning? No. It is gas cavitation in the joint fluid — a
harmless side effect, not a bone moving back into place.

What happens during the first consultation? Your
history and goals (including red-flag screening), a clinical examination
of your neck, muscles and posture, and a shared plan combining hands-on
treatment with active exercise — with an honest steer toward your GP if
your pattern looks more like migraine.

Is Philippe conventionné with INAMI, and will my mutuelle
reimburse me? Yes — INAMI-conventionné (n°5/58395/34/527): fees
follow the official INAMI schedule with no supplements. Your mutuality
reimburses €25.39 of the €31.64 standard session, leaving a fixed
co-payment of €6.25 (€2.50 with preferential status/BIM). International
insurers such as Allianz Care, Cigna Global, Aetna and BUPA accept the
invoices — full details on the pricing
& insurance page.

Can I be treated in English or Spanish? Yes.
Consultations are available in French, English and Spanish.

Where is the clinic and how do I get there by public
transport? Ixelles, near Place du Luxembourg (Philippe
practises at ESP), in the EU quarter — easily reached via
Bruxelles-Luxembourg station and nearby bus/tram lines.

👉 Ready to find out which kind of headache you actually
have? Book a consultation.

References

1. International Headache Society — ICHD-3 diagnostic criteria for
   tension-type headache, cervicogenic headache and migraine. https://ichd-3.org/
2. NICE Guideline CG150 — Headaches in over 16s: diagnosis and
   management, including red-flag (“red flag”) criteria for urgent
   referral. https://www.nice.org.uk/guidance/cg150
3. Núñez-Cabaleiro P & Leirós-Rodríguez R. Effectiveness of manual
   therapy and exercise for cervicogenic headache — systematic review.
   J Manipulative Physiol Ther 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9682850/
4. Falsiroli Maistrello L et al. Manual therapy / trigger-point
   treatment for tension-type headache — evidence review. Front
   Neurol 2018;9:254. https://pmc.ncbi.nlm.nih.gov/articles/PMC5928320/
5. Rist PM et al. Manual therapy for migraine — evidence
   limited/adjunct role, medical management remains first-line.
   Headache 2019;59(4):532-542. https://pubmed.ncbi.nlm.nih.gov/30973196/

Internal link ideas: Neck Pain, “Tech
Neck” & Posture (shared muscle mechanics — link both
directions), Manual
Therapy (evidence-appraisal differentiator, INAMI/mutuelle
mechanics), About Philippe Tadger, Book an appointment / contact the
Ixelles clinic.