If your headaches keep returning, your neck may be part of the reason.
Many people with regular headaches try the usual fixes first. They drink more water, change pillows, reduce screen time or stretch the tight muscles around their neck.
These things can help some people feel better for a short time. But if your headaches keep coming back, especially after sitting at a desk or feeling tension at the base of your skull, the issue may be less about tightness and more about control.
One commonly overlooked factor in neck headaches is the strength and endurance of the deep neck flexors. These small muscles sit at the front of your neck and help support your head during everyday movement.
Why I’m talking about this
My name is Kevin Go, a physiotherapist with a strong focus on neck, shoulder and headache-related conditions.
Many patients I see, including office workers and golfers, come in with headaches that seem to start in the neck. They often do not realise how much their neck strength, posture and muscle control may be contributing to the problem.
The deep neck flexors are often one important part of that puzzle.
What are the Deep Neck Flexors?
The deep neck flexors are small stabilising muscles at the front of your cervical spine, which is the neck section of your spine.
Their job is not to create big, powerful movements. Instead, they help guide and support your neck so your head can stay balanced during daily activities such as sitting, walking, turning, reading and working at a computer.
When these muscles are working well, your neck usually moves more smoothly and your larger neck muscles do not need to work as hard.
When they are weak or not activating properly, other muscles may start to compensate. Over time, this can increase strain through the upper neck and may contribute to neck headaches in some people.
Research has found that people with cervicogenic headaches often show reduced strength or endurance in the deep neck flexor muscles, although headaches are usually influenced by more than one factor.
How Weak Deep Neck Flexors Can Contribute to Neck Headaches
Your head is heavy, and your neck has to support it all day.
When the deep neck flexors are not doing their job well, your head may gradually drift forwards. This is often called forward head posture. It can place extra load on the joints and muscles at the top of the neck.
This does not mean posture is the only cause of neck headaches. It also does not mean everyone with forward head posture will develop pain. But for some people, poor neck control can add to the overall load on the neck and make headaches more likely.
The pattern often looks like this:
- the deep neck flexors become weak or less active
- larger neck muscles work harder to compensate
- the upper neck becomes tight, overloaded or irritated
- pain may refer from the neck into the head
- stretching gives short-term relief
- the headache returns because the underlying control issue has not changed
This is why some neck headaches feel better after massage or stretching, but only for a little while.
Why Stretching Alone May Not Be Enough
Tight muscles are often part of the story, but they are not always the main problem.
If the larger muscles around your neck are tightening because they are doing too much work, stretching them may reduce discomfort temporarily. But if your deep neck flexors are still not supporting your head well, the same muscles may tighten again.
In this situation, the base issue is often stability rather than flexibility. That means the goal is not simply to loosen the neck. It is to help the right muscles switch on, build endurance and share the workload more evenly.
When Should You Get Neck Headaches Assessed?
It is worth having your neck assessed if your headaches:
- often start at the base of your skull
- are linked with neck stiffness or neck pain
- get worse after desk work, driving or reading
- improve temporarily with stretching or massage
- keep returning despite changing pillows, posture or screen habits
A physiotherapy assessment can help identify whether your neck joints, muscle control, posture, strength, workload or daily habits may be contributing to your headaches.
It can also help determine whether deep neck flexor exercises are appropriate for you, or whether another approach is needed.
A Small Change Can Make a Meaningful Difference
Neck headaches can be frustrating, especially when they keep returning after short-term relief.
If weak or poorly controlled deep neck flexors are part of the problem, improving strength and endurance may help reduce the load on the rest of your neck. The key is choosing the right exercises, performing them correctly and building gradually.
Book a session with one of our physiotherapists to identify what may be contributing to your neck headaches and receive an individualised treatment plan to help you move, feel and function at your best.
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References
Choi, W. (2021) ‘Effect of 4 weeks of cervical deep muscle flexion exercise on headache and sleep disorder in patients with tension headache and forward head posture’, International Journal of Environmental Research and Public Health, 18(7), p. 3410. doi:10.3390/ijerph18073410.
Pal, T.K., Chaudhuri, S. and Basak, T. (2025) ‘Prevalence of deep neck flexor weakness and deep neck extensor tightness in college-going students suffering from cervicogenic headache’, Journal of Advances in Medicine and Medical Research, 37(6), pp. 41–49. doi:10.9734/jammr/2025/v37i65850.
Sikka, I. et al. (2020) ‘Effects of deep cervical flexor training on forward head posture, neck pain, and functional status in adolescents using computer regularly’, BioMed Research International, 2020(1). doi:10.1155/2020/8327565.
