Migraine
Assessment may identify neck, jaw, balance or movement factors that overlap with migraine.
Migraine is a neurological condition that causes recurring attacks of head pain and nervous-system sensitivity. Symptoms may include nausea, light sensitivity, sound sensitivity, visual changes, dizziness and pain that worsens with activity.
A GP usually leads migraine diagnosis and medical care. Physiotherapy may provide added support when neck pain, jaw tension, dizziness, balance problems, screen sensitivity or reduced exercise tolerance affect your symptoms or recovery.
If dizziness or vertigo forms a major part of your pattern, read about vestibular migraine. When head pain closely follows neck movement or sustained posture, compare cervicogenic neck headache.
Quick Answer
Migraine can cause repeated attacks lasting several hours or, at times, several days. Symptoms often include moderate to severe headache, nausea and sensitivity to light, sound or movement. Some people also experience aura, neck pain, dizziness, fatigue or difficulty thinking clearly.
Physiotherapy does not replace medical migraine treatment. However, it may help manage relevant neck, jaw, vestibular and exercise factors as part of a broader care plan.
What Is Migraine?
Migraine affects how the nervous system processes pain and sensory information. It is more than a severe headache. During an attack, normal light, sound, smell, movement or touch may feel uncomfortable or overwhelming.
Migraine attacks often last between 4 and 72 hours. The pattern varies between people. Some experience occasional attacks, while others have frequent migraine days that affect work, study, sleep, driving, exercise and family life.
A clear diagnosis matters because migraine may overlap with other headache conditions. For a broader starting point, visit the PhysioWorks headache information hub.
What Are Common Migraine Symptoms?
Migraine symptoms can change between attacks. Head pain may feel throbbing, pulsing, pressing or intense. It often affects one side, although it may change sides or involve both sides.
- moderate to severe head pain
- nausea or vomiting
- sensitivity to light
- sensitivity to sound or strong smells
- pain that worsens with normal movement or activity
- visual disturbance or aura in some people
- dizziness, vertigo or motion sensitivity
- neck pain or stiffness
- fatigue, poor concentration or brain fog
- increased sensitivity after the main headache settles
What Are the Phases of Migraine?
Not everyone experiences every phase. Symptoms can also overlap rather than following a strict order.
Premonitory Phase
Hours or days before the headache, some people notice tiredness, food cravings, mood changes, yawning, neck stiffness or trouble concentrating.
Aura
Some people develop short-term visual, sensory or speech symptoms before or during the headache phase.
Headache Phase
Head pain may occur with nausea and increased sensitivity to light, sound, smell, touch or movement.
Recovery Phase
After the main pain settles, tiredness, fogginess, weakness or sensitivity may continue for several hours or longer.
What Is Migraine With Aura?
Migraine with aura includes temporary neurological symptoms before or during an attack. Visual aura may cause flashing lights, zigzag patterns, blind spots or blurred areas.
Other aura symptoms may include tingling, numbness, difficulty finding words or altered sensation. Aura often develops gradually and usually settles within an hour.
Arrange medical review for new or changed aura
Seek medical advice if aura is new, lasts longer than usual, changes pattern or feels different from previous attacks. New weakness, marked confusion, collapse or persistent speech difficulty requires urgent assessment.
How Does Migraine Differ From Other Headaches?
Migraine may overlap with neck, jaw and vestibular symptoms. Your history and symptom behaviour help identify the main problem and any contributing factors.
Migraine
Often includes nausea, light sensitivity, sound sensitivity or increased pain with activity. Pain may pulse or throb, but this is not essential for diagnosis.
Cervicogenic Headache
Often relates closely to neck movement, restricted cervical movement or sustained posture. Symptoms may reproduce during a neck assessment.
Vestibular Migraine
May cause vertigo, imbalance, visual sensitivity or motion sensitivity, with or without a strong headache during each episode.
TMJ-Related Headache
May link with clenching, grinding, jaw muscle tenderness, chewing pain, restricted opening or jaw clicking.
Pressure or a tight-band pattern may fit a tension-type headache. Jaw symptoms may warrant review of TMJ-related headache.
What Can Trigger a Migraine Attack?
Migraine triggers vary widely. Often, several changes combine before an attack rather than one trigger acting alone.
- poor sleep or changes in sleep timing
- stress or the let-down period after stress
- missed meals or reduced fluid intake
- hormonal changes
- bright or flickering light
- loud noise or strong smells
- heat, weather changes or travel
- unaccustomed or intense exercise
- prolonged screen use
- neck or jaw overload in some people
A trigger is not always a cause. For example, neck stiffness may sometimes form part of the early migraine phase rather than directly causing the attack.
Can a Migraine Diary Help?
A diary may help you and your GP identify patterns over several weeks. Avoid making major lifestyle restrictions after one or two attacks. Look for repeat patterns instead.
- record the date and duration of each attack
- note headache severity and location
- record nausea, aura, dizziness and sensory sensitivity
- track sleep, meals, hydration, stress and activity
- record medication use and response
- note neck, jaw or balance symptoms
- record how long recovery takes
For Australian public health guidance, read Healthdirect’s migraine information.
How Is Migraine Diagnosed?
A GP usually diagnoses migraine from your symptoms, attack pattern and medical history. There is no single blood test or scan that confirms migraine.
Your doctor may investigate other causes when symptoms are new, unusual or changing. They may also discuss acute medication, preventive medication or referral to a neurologist when attacks are frequent, disabling or difficult to manage.
Useful information for your appointment includes:
- the number of headache and migraine days each month
- the usual duration and severity of attacks
- whether you experience aura
- nausea, sensory sensitivity or dizziness
- medication use and response
- changes in your normal pattern
- any relevant neck, jaw or balance symptoms
A symptom diary may help identify repeated migraine patterns and contributing factors.
When Should You Seek Urgent Medical Care?
Call Triple Zero (000) for urgent symptoms
Call Triple Zero for a sudden severe or worst-ever headache, especially when it occurs with weakness, numbness, facial droop, collapse, seizure, confusion, marked speech difficulty or major vision changes.
Seek prompt medical assessment for:
- a sudden or rapidly peaking severe headache
- a major change from your usual migraine pattern
- new weakness, numbness or loss of coordination
- new difficulty speaking or understanding speech
- fainting, collapse or seizure
- fever with marked neck stiffness
- headache after a significant head injury
- persistent vomiting or inability to keep fluids down
- new headache during pregnancy or soon after childbirth
- new headache in a person with cancer or reduced immunity
Use the severe headache symptoms and red flags guide for further information. When unsure, choose medical assessment before physiotherapy.
How Is Migraine Managed?
Migraine management often combines medical care, practical routines and an individual plan for acute attacks. Your GP may discuss medication taken during an attack and preventive medication when migraines occur often or cause significant disability.
Helpful management strategies may include:
- regular sleep and waking times
- regular meals and adequate fluid intake
- planned recovery during an attack
- gradual and consistent physical activity
- stress-management strategies
- reducing medication overuse risk
- medical review when the pattern changes
Can Physiotherapy Help Migraine?
Physiotherapy does not cure migraine or replace medical migraine care. However, it may support some people when musculoskeletal, vestibular or exercise-related problems add to their overall symptom burden.
A physiotherapist may assess:
- neck movement and upper cervical sensitivity
- upper-back movement and sustained postures
- jaw movement, clenching and muscle load
- dizziness, balance and motion sensitivity
- screen and visual-motion tolerance
- exercise response and recovery
- daily workload and pacing
Treatment should match the assessment rather than assume that every migraine comes from the neck.
How May Physiotherapy Support Migraine Care?
Neck and Upper-Back Care
Gentle treatment and movement exercises may help when neck stiffness, pain or reduced movement forms a separate contributing problem.
Jaw Assessment
Advice and exercise may help when clenching, grinding, chewing pain or TMJ sensitivity overlaps with headache symptoms.
Vestibular Rehabilitation
Selected balance, gaze and motion exercises may help when dizziness or visual-motion sensitivity occurs with migraine.
Graded Exercise
A staged plan may help rebuild activity tolerance without large and sudden increases in workload.
Screen and Workload Advice
Movement breaks and practical workstation changes may reduce prolonged neck and visual load.
Self-Management Planning
A repeatable plan can help manage pacing, early warning signs, activity changes and return to normal routines.
Can Neck or Jaw Problems Contribute to Migraine Symptoms?
Neck or jaw problems may contribute to symptoms in some people. However, neck pain can also occur as part of the migraine attack itself.
An assessment may help determine whether your neck or jaw represents:
- a separate musculoskeletal problem
- an overlapping headache source
- a factor that increases sensitivity or limits recovery
- an early symptom of the migraine attack
For symptoms involving both areas, see the guide to headache, neck and jaw pain.
What Can You Do Between Migraine Attacks?
Aim for steady routines rather than sudden or extreme lifestyle changes. Consistency is often more useful than trying to avoid every possible trigger.
- eat regular meals
- drink water through the day
- keep sleep and waking times reasonably consistent
- take short movement breaks during screen work
- build exercise gradually
- use your prescribed acute migraine plan early when appropriate
- review frequent or changing attacks with your GP
Gradual exercise progression may help build confidence and activity tolerance between attacks.
Is It Safe to Exercise With Migraine?
Many people can exercise between migraine attacks. Regular aerobic activity may help some people reduce migraine frequency or impact over time. Start at a level you can recover from and progress gradually.
Start low and build steadily
Begin with short, easy sessions. Increase one factor at a time, such as duration, speed or resistance. A gentle warm-up, adequate hydration and planned recovery may improve tolerance.
Stop exercising and seek assessment if you develop a sudden severe headache, new neurological symptoms, collapse or a headache that differs markedly from your usual pattern.
Related Migraine and Headache Guides
- Headache information and physiotherapy
- Vestibular migraine
- Cervicogenic neck headache
- Tension-type headache
- TMJ-related headache
- Severe headache symptoms and red flags
What to Do Next
Start with a clear medical diagnosis and a practical migraine plan. Arrange GP review if attacks are frequent, disabling, changing or no longer responding to your usual management.
Physiotherapy may provide added support when neck pain, jaw tension, dizziness, balance problems, screen sensitivity or reduced exercise tolerance affect your daily function.
Seek urgent medical care before physiotherapy when symptoms are sudden, severe, unusual or associated with neurological warning signs.
Migraine FAQs
Can physiotherapy help migraine?
Physiotherapy may help some people manage neck, jaw, dizziness, balance or exercise factors that occur alongside migraine. It does not replace diagnosis, medication or preventive care from your GP or neurologist.
What is migraine with aura?
Migraine with aura includes temporary visual, sensory or speech symptoms before or during an attack. Aura often develops gradually and usually settles within an hour. Arrange medical review when aura is new, changing or unusual.
How long can a migraine last?
The main migraine attack often lasts between 4 and 72 hours. Some people continue to feel tired, foggy, weak or sensitive after the main headache settles.
Can neck or jaw problems contribute to migraine symptoms?
Neck or jaw problems may add to symptom load in some people. However, neck stiffness can also form part of the migraine attack. Assessment helps identify whether a separate musculoskeletal problem needs treatment.
When should I seek urgent care for a headache?
Call Triple Zero for a sudden severe headache with weakness, numbness, collapse, seizure, confusion, speech difficulty or major vision changes. Seek prompt assessment for fever with neck stiffness, significant head injury or a major change in your normal pattern.
Choose your clinic and appointment pathway
Select a PhysioWorks clinic to continue to live booking, an appointment request or reception assistance.
References
- Reina-Varona Á, Madroñero-Miguel B, Fierro-Marrero J, Paris-Alemany A, La Touche R. Efficacy of various exercise interventions for migraine treatment: a systematic review and network meta-analysis. Headache. 2024;64(7):873-900. doi:10.1111/head.14696
- Luedtke K, Carvalho G, Szikszay T. Musculoskeletal dysfunctions and physiotherapy treatment strategies in patients with migraine. Musculoskeletal Science and Practice. 2023;66:102805. doi:10.1016/j.msksp.2023.102805
- de Almeida Tolentino G, Florencio LL, Pradela J, et al. Effects of combining manual therapies, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a 3-armed randomized clinical trial. Musculoskeletal Science and Practice. 2025;78:103360. doi:10.1016/j.msksp.2025.103360
- Liang Z, et al. Individualised physiotherapy assessment and management of migraine: the role of cervical sensitisation and musculoskeletal disorder. Musculoskeletal Science and Practice. 2025.
