Why your headache might start in your shoulders

You take a paracetamol. The headache eases. A few hours later it is back. You take another one. It eases again. By the end of the week you have been managing the same headache on and off for days, and you have got through half a box of painkillers without ever asking where the headache is actually coming from.

Image by Aarón Blanco Tejedor

This is something I see regularly in clinic. People come in with neck or shoulder tension and mention almost as an afterthought that they have been getting headaches too. When I ask how long, the answer is usually weeks. Sometimes months. They have been treating the symptom with painkillers without looking at what is driving it.

Where tension headaches actually come from

Not every headache is a head problem. Tension headaches are driven by tight muscles, and those muscles are often nowhere near your head. The neck is the most common culprit, particularly the muscles at the front and sides that hold your head up when you lean forward or tilt down. If you spend your day looking at a screen, looking at your phone, or working with your head in any position other than neutral, those muscles are working constantly.

Your shoulders are involved too. When tension builds across the upper trapezius and into the base of the skull, it creates a pulling sensation that wraps around the head. Many people describe it as a band of pressure or a dull ache that sits behind the eyes or across the forehead. That is often muscular tension referring upward, not a problem inside the head.

And then there is the jaw. This is the one most people do not think about, but it is a significant driver of headaches. Clenching, grinding, holding your teeth together during a stressful video call without realising. The muscles around the jaw are powerful, and when they are tight they refer pain directly into the temples, the sides of the head, and behind the eyes. If your headaches sit in those areas, your jaw is worth looking at.

The stress connection

Tension headaches are often called that for a reason. They are linked to physical tension, and physical tension is linked to stress. A stressful day at work does not just make you feel mentally drained. It keeps your shoulders elevated, your jaw clenched, your neck braced. Your body holds that tension for hours, and by the evening your head is pounding.

The pattern builds over time. You might not notice the jaw clenching during a difficult call. You might not feel your shoulders creeping up toward your ears while you work through a deadline. But your muscles notice, and they respond by tightening and staying tight. That sustained contraction is what creates the headache, and it is why painkillers only offer temporary relief. They dull the pain without releasing the tension that caused it.

What I look at when someone comes in with headaches

I do not just work on the head. I look at the whole chain. What the neck muscles are doing, especially the front of the neck where people rarely think to look. Whether the upper back is stiff through the thoracic spine, because restriction where the thoracic meets the lumbar spine can contribute to tension that travels upward. What the shoulders and upper traps are doing. And what the jaw is doing.

The jaw is a big one for me. I use a device called the TEND Focus, which is designed for precise, targeted work on small muscle groups. It allows me to work the muscles around the jaw and the temporomandibular joint in a way that hands alone sometimes cannot. For clients with TMJ issues or persistent jaw clenching, it can make a real difference.

I will also ask whether you have seen a dentist. Jaw tension is sometimes linked to teeth alignment, grinding at night, or dental issues that need addressing alongside the soft tissue work. If I think there is something else going on, I will tell you. That is always how I work.

Why painkillers are not the answer

Painkillers have their place. If you have a headache and you need to get through the day, taking something to manage it is reasonable. But if you are reaching for them several times a week, that is a pattern worth questioning.

Photo by Towfiqu Barbhuiya

Painkillers manage the pain. They do not address the tension in your neck that is causing it. They do not release the muscles in your jaw that are clenching during every stressful moment. They do not change the fact that your shoulders have been up around your ears for six hours.

Treatment works differently because it targets the source. Releasing the neck, working the jaw, freeing up the thoracic spine, and settling the nervous system so your body stops holding on so tightly. Most clients with tension headaches notice a significant reduction after even one or two sessions, because once the muscular driver is addressed, the headache loses its fuel.

When to take it seriously

I should be clear. Not all headaches are muscular. If your headaches are sudden, severe, or different from anything you have experienced before, see your GP. If they come with visual changes, dizziness, or nausea, that needs medical assessment. Tension headaches are common and treatable, but ruling out anything else is always the right first step.

If your headaches are persistent, dull, linked to stress, and tend to sit across your forehead, temples, or the back of your head, there is a good chance they are being driven by muscular tension. And that is something I can help with.

I am based in Sissinghurst, just outside Cranbrook, and I work with people from across the Weald of Kent. Book a massage