Types of Headaches

Headaches are a very common condition for many individuals, with various causes, but did you know physiotherapy can help treat them? Primary headaches are due to a headache condition, such as migraines, and secondary headaches are a symptom of another condition, such as neck stiffness. It is important to note that if headaches are new to you and present with a sudden severe onset, visual disturbance, vomiting, fever, or altered level of consciousness, you should seek immediate medical care.

A migraine is a unilateral or bilateral headache with two or more of nausea, light sensitivity, and interference with activities, and may present with aura. Tension-type headaches do not often present with nausea or activity interference; they must have at least two of: bilateral presentation, non-pulsating pain, mild-moderate pain, and not worsened by activity. Migraines and tension-type headaches are often treated with medication, but physiotherapy can assist with behavioural management such as implementing a headache diary to determine triggers (i.e., food, stress, environment), adjusting lifestyle factors, promoting exercise, relaxation and stress management.

Cluster headaches, or trigeminal autonomic cephalalgias, present as frequent and severe headaches that last less than 3 hours, are unilateral, and have same-side autonomic symptoms such as eye redness, tearing, drooping eyelid, or constricted pupils. The trigeminal cranial nerve has a role in these headaches, and specialist referral is recommended to manage this condition.

Cervicogenic headaches are secondary and result from neck pain or dysfunction that refers to pain in the head and face regions. These headaches are caused by irritation of cervical spine structures, such as joints, muscles, spinal nerves and nerve roots, and dura mater. Repetitive motions and postures, degeneration, and traumatic injuries can increase stress and strain to cervical structures, which can cause pain and headaches. Cervicogenic headaches present similarly to other headaches and are often unilateral, have a variable duration that can be chronic or episodic, and may have different symptoms such as light and sound sensitivity. The key differentiating characteristic is that there must be neck involvement, where neck movement or postures, muscular trigger points, or impaired range of motion triggers neck pain that can radiate to the head and face. Physiotherapists use clinical reasoning and special tests to diagnose these headaches, and treatment includes manual therapy, stretching and strengthening, exercise, and postural re-training.

If you are suffering from headaches, book an assessment with a licensed physiotherapist!


Written by Thea Ruzycki