Headaches and osteopathy: when the neck is part of the picture

I have spent more than twenty years focusing on back pain and headache in osteopathic practice. That experience makes me more cautious, not less. A sudden worst-ever headache, headache with fever or rash, headache after a head injury, or headache with visual or speech change is a medical emergency, not an osteopathy booking.

Where the history and examination point to a mechanical contribution — stiff upper cervical joints, marked muscle tone, a clear link to desk posture or jaw clenching — hands-on treatment and advice can be a useful part of care for some people.

I will ask about frequency, triggers, sleep, screens, and whether a GP or neurologist is already involved. Examination includes the neck, upper back and, where relevant, the jaw. Techniques are chosen for you: they may be very gentle. Cranial osteopathy is one option when a lighter approach suits the person in the room.

Osteopathy can sit alongside prescribed medication. It is not a reason to stop a migraine preventer or to skip a GP review. If your pattern is changing, go back to your doctor. My job is the musculoskeletal piece, honestly scoped.