
Ziki Liang
Lecturer in Physiotherapy at University of Queensland; Specialist Musculoskeletal Physiotherapist with expertise in migraine, cervicogenic headache, and neck pain research.
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Jun 26, 2026
When Headache Starts in the Neck: Gwen Jull & Zhiqi Liang on Migraine, Cervicogenic Headache, and Clinical Reasoning
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35:52

Michael BoneyHOST
How does a clinician then differentiate? Like if somebody has had a headache for months on end, and they've got a combination of these findings, let's say even some central sensitization, I'm sure that gets challenging for the average clinician to differentiate whether this is truly migraine-based or cervicogenic-based or a combination thereof.

Ziki LiangGUEST
I think you still have to come back to the patient interview and very carefully listen to the patient.

Ziki LiangGUEST
So often people might come in and say they've had more than 10 years of this headache.

Ziki LiangGUEST
And what we want to know is, has this headache changed? What has it been about it? And we haven't talked about red flags yet, but that's something we're keeping in our back of our minds, if this is red flag headache.

Ziki LiangGUEST
But typically, people with migraine, they might have started off earlier, and the migraine symptoms could have been very typical when it first began, you know, and it would match the international classification of headache disorders criteria perfectly.

Ziki LiangGUEST
And a typical story might be someone who say, you know, previously the triggers were very clear.
6 MINS LATER

Amy McDevittHOST
What are some of the features that help you identify who might actually benefit from more of a cervical focused approach for someone that has migraine and that component of neck pain?