Functional neurological disorder can cause very real symptoms, even when scans and tests look normal.
If you live with headaches, dizziness, weakness, brain fog or unexplained neurological symptoms, it can be incredibly frustrating to be told that your medical tests are “normal”.
For many people, this is where functional neurological disorder becomes part of the conversation. Functional neurological disorder, often shortened to FND, is a condition where the brain and body have difficulty communicating clearly. The symptoms are real, but they are usually caused by changes in how the nervous system functions rather than visible structural damage.
Many people with FND also experience headaches. These headaches can be confusing, especially when they overlap with neck pain, fatigue, stress, dizziness or sensory sensitivity. This article explains how functional neurological disorder may relate to headaches, why the neck can sometimes play a role, and how physiotherapy may help as part of a broader care plan.
What Is Functional Neurological Disorder?
Functional neurological disorder is a condition affecting how the nervous system sends, receives and processes signals.
A helpful way to understand it is to think of the nervous system as having both “hardware” and “software”. In FND, the hardware, such as the brain, spinal cord and nerves, may look structurally normal on scans. The problem is more like a software issue, where the system is not processing information as smoothly as it should.
This does not mean the symptoms are imagined. FND symptoms are genuine and can significantly affect daily life. FND Australia describes the condition as involving changes in nervous system function, and Australian physiotherapy resources also recognise the role physiotherapists can play in helping people manage movement, function and participation in daily activities.
Functional neurological disorder can be influenced by many factors. For some people, symptoms begin after illness, injury, pain, fatigue or a stressful event. For others, there may be no obvious trigger.
The most important message is this: FND is a real condition, and with the right education and support, symptoms can often be better understood and managed.
Common Symptoms of Functional Neurological Disorder
Functional neurological disorder can look different from person to person. Symptoms may come and go, shift over time, or feel similar to other neurological conditions.
Common symptoms may include:
- Weakness in an arm or leg
- Tremors, shaking or jerky movements
- Difficulty walking or feeling unsteady
- Numbness, tingling or altered sensation
- Dizziness or balance problems
- Brain fog or difficulty concentrating
- Fatigue
- Functional seizures or episodes of disconnection
Headaches are also common in many people living with FND. They may occur alongside migraine-like symptoms, tension-type headaches, neck pain or a general feeling that the nervous system is on high alert.
Why Headaches Can Happen With Functional Neurological Disorder
Headaches in functional neurological disorder are often complex. They are not always caused by one single structure or trigger.
In many people with FND, the nervous system becomes more sensitive. This means normal signals from the body can be amplified by the brain. Sensations that would usually be filtered out or ignored may start to feel stronger, more uncomfortable or harder to control.
This increased sensitivity may help explain why some people with FND experience headaches, dizziness, pressure, tightness or pain that changes from day to day.
It is also important to remember that people with functional neurological disorder can still have other headache conditions, such as migraine, tension-type headache or neck-related headache. FND does not rule these out. A careful assessment is important so that each person’s symptoms are understood properly.
How the Neck May Contribute to Headaches in FND
The upper neck has close connections with areas of the nervous system involved in pain and sensory processing. For some people, sensitivity in the upper neck may contribute to headaches or make existing headaches worse.
This may explain symptoms such as:
- Headaches that start near the base of the skull and move forward
- Pressure, heaviness or tightness around the head
- Headaches that increase with desk work, phone use or sustained posture
- Tenderness around the neck, shoulders or base of the skull
- Increased sensitivity to touch or movement
In functional neurological disorder, the nervous system may become more protective. Muscles can tighten more easily, pain signals may feel stronger, and the brain may pay more attention to sensations coming from the neck and head.
This does not mean that the neck is damaged. It may mean that the system has become sensitised and needs to be calmed, retrained and supported gradually.
What Can You Do If You Have FND and Headaches?
If you have functional neurological disorder and headaches, it can help to start by understanding that your symptoms are real and that support is available.
A few practical steps may include:
- Keeping a simple symptom diary to notice patterns
- Paying attention to posture, sleep, stress, hydration and fatigue
- Avoiding repeated checking or testing of symptoms where possible
- Using gentle movement rather than pushing through severe flare-ups
- Seeking assessment from clinicians who understand headache and nervous system sensitivity
It is also important to speak with your GP or medical team if your headaches are new, suddenly severe, changing rapidly, or associated with symptoms such as fever, fainting, new confusion, vision loss or significant neurological changes.
Functional Neurological Disorder Is Treatable With the Right Support
Functional neurological disorder can feel overwhelming, especially when headaches are part of the picture. But FND does not mean your symptoms are imaginary, and it does not mean that nothing can be done.
When headaches occur alongside functional neurological disorder, the neck and nervous system may both play an important role. With careful assessment, education and an individualised plan, many people can start to make sense of their symptoms and work towards better function.
If this sounds familiar, consider booking a session with one of our physiotherapists at the Brisbane Headache and Migraine Clinic. We can help assess what may be contributing to your headaches and guide you through a personalised management plan.
You can book online or call 1800 432 322 to get started.
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References
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