Headache & Migraine Physiotherapy in Sydney CBD.
Cervicogenic headache, tension-type headache, migraine, jaw-driven headache — not all headaches are the same, and treating them the same way is why so many people are still in pain.
At City Physio & Pilates, headache and migraine management is a dedicated speciality — with Watson Headache trained clinicians, an orofacial pain specialist, and dedicated extended appointment types for complex presentations.
Accurate diagnosis is the entire foundation of effective headache treatment. Get the diagnosis wrong and the treatment will fail — regardless of how well it’s delivered.
Headaches are one of the most common presentations in primary healthcare — and one of the most under-assessed. Many people with cervicogenic or tension-type headaches spend years cycling through medication, chiropractic, and general physio without anyone properly identifying what’s actually driving their pain.
At City Physio, we use dedicated extended appointment types for headache and migraine presentations specifically because these cases require more time, a more detailed history, and a more thorough assessment than a standard physiotherapy consultation allows.
Headaches originating from dysfunction in the upper cervical spine — typically C1, C2, and C3 joints — that refer pain into the head. Extremely common in desk workers, people who spend long hours at screens, and those with a history of neck trauma. Often misdiagnosed as tension headache or migraine. Our Watson Headache trained clinicians are specifically qualified to assess and treat this presentation.
Bilateral, pressing or tightening head pain driven by muscular tension, postural load, stress, and trigger points in the neck, upper back, and jaw musculature. Physiotherapy — particularly manual therapy, dry needling, and postural retraining — is highly effective for tension-type headache and produces lasting results when the muscular drivers are correctly identified and treated.
Migraine is a complex neurological condition — not just a bad headache. Physiotherapy doesn’t cure migraine, but it can significantly reduce frequency and severity by addressing cervical and muscular triggers that contribute to migraine onset. We work collaboratively with GPs and neurologists and maintain referral pathways when further investigation or pharmacological management is indicated.
Headaches driven by TMJ dysfunction, bruxism, jaw muscle tension, or orofacial pain — a presentation that is frequently missed entirely because the jaw is not assessed as part of a standard headache workup. This is one of our most significant clinical differentiators: our Principal Physiotherapist Nicola Michell holds a Masters specialisation in orofacial pain and is one of very few physiotherapists in Australia qualified to assess and treat this complex overlap.
Headaches following head or neck trauma, concussion, or whiplash. A careful, staged approach is required — we assess the cervical spine, vestibular system, and musculature, and manage the rehabilitation pathway in collaboration with your GP or specialist.
Your treatment plan is built around what’s actually causing your headaches — not a generic protocol applied to every patient who walks through the door.
Watson Headache training and a Masters-qualified orofacial pain specialist — in the same clinic.
The Watson Headache Approach is an internationally recognised assessment and treatment methodology for cervicogenic and cervically-driven headache. Our clinicians trained in this approach can determine whether the upper cervical spine is contributing to your headache — and treat it with precision if it is.
For patients whose headaches have a jaw or orofacial component — including bruxism, TMJ dysfunction, jaw muscle tension, and orofacial pain — Nicola Michell, our Principal Physiotherapist, holds a Masters specialisation in orofacial pain with certification in Orofacial Myology. This is a formal academic qualification — not a weekend course or a special interest. She is one of very few physiotherapists in Australia with this level of training in jaw-driven headache.
If you’ve been told your headaches are “just stress” or “just migraine” and previous treatment hasn’t worked, there may be a cervical or orofacial component that hasn’t been properly assessed. Book an extended headache appointment and we’ll work it out.
Book Extended Headache Appointment
Read More — TMJ & Jaw Physio
Headache physio — what you actually want to know.
Can physiotherapy actually help with headaches?
Yes — for headaches that have a musculoskeletal or cervical component. Cervicogenic headache (driven by upper neck dysfunction), tension-type headache (driven by muscle tension and trigger points), and jaw-driven headache all respond well to physiotherapy. Migraine is more complex — physio can reduce frequency by addressing cervical and muscular triggers, but it’s not a standalone treatment for migraine and we work collaboratively with GPs and neurologists for those patients.
How do I know what type of headache I have?
That’s exactly what your initial assessment is for. Many people arrive having been told they have “tension headaches” or “migraines” without a rigorous diagnostic process having taken place. Our extended headache appointments are specifically designed to differentiate between headache types — assessing the upper cervical spine, jaw, posture, trigger points, and symptom patterns to identify what’s actually driving your pain before we treat anything.
What is the Watson Headache Approach?
The Watson Headache Approach is an internationally recognised, evidence-based assessment and treatment methodology for cervicogenic and cervically-driven headache developed by physiotherapist Dean Watson. It involves a systematic assessment of the upper cervical joints (C1–C3) to determine whether spinal dysfunction is contributing to or causing headache — and a specific manual therapy approach to treat it if it is. Our clinicians trained in this method have a significantly higher rate of identifying cervicogenic contributions to headache than standard physiotherapy assessment.
My headaches are in my jaw area — is that a physio problem?
Quite possibly, yes — and it’s one of the most under-recognised presentations in headache management. TMJ dysfunction, bruxism, jaw muscle tension, and orofacial pain can all drive or contribute to headache patterns. Our Principal Physiotherapist Nicola Michell holds a Masters specialisation in orofacial pain and is qualified to assess and treat this complex area. If your headaches involve jaw tension, clicking, face pain, or you grind your teeth, book specifically with Nicola. Read more about TMJ physio.
Do I need a referral or imaging before booking?
No referral is required. Bring any existing imaging (MRI, CT) or letters from your GP or neurologist if you have them — they’re useful context. If we assess you and feel further investigation is warranted, we’ll refer you back to your GP with a clear clinical reason. We maintain collaborative referral pathways with local GPs and neurologists.
How many sessions will I need?
It depends on the type of headache, how long you’ve had it, and how your body responds. Cervicogenic headache often responds well within 4–8 sessions. Chronic or complex presentations take longer. Your physiotherapist will give you a realistic timeline and clear milestones at your initial assessment — not an open-ended treatment plan.
Is headache physiotherapy covered by private health insurance?
Yes — physiotherapy consultations are covered under physiotherapy extras with most major private health funds. Bring your HICAPS card and we’ll process your rebate on the spot. The extended appointment type used for headache presentations attracts a higher fee than a standard consultation — check your specific extras cover if out-of-pocket cost is a consideration.
I’ve had headaches for years and tried everything. Is physio still worth trying?
If you haven’t had a thorough upper cervical assessment and jaw assessment by a clinician trained specifically in headache management — then yes, it’s worth trying. Chronic headache sufferers who’ve been through multiple treatments without resolution frequently have an unidentified cervical or orofacial component. That’s exactly the kind of case we do well with. Book an extended appointment and let us assess properly before you write it off.
Headache treatment often overlaps with these specialities:
The headache you’ve been managing around deserves a proper look.
Book an extended headache appointment online, or call us if you’d like to talk through which clinician is right for your presentation.
hello@cityphysio.com.au · Shop 10, Level 6, 25 Martin Place
— The City Physio team