Headaches - types, and when its a real pain in the neck.

Headaches- types, and when its a real pain in the neck.

Headaches are a common complaint, commonly the result of referred pain from muscles and joints in the neck. Hands on treatment and exercise has been shown to be an effective strategy to improving symptoms when this is the case.

Occasional headaches are a near universal human experience. However for some ‘occasional’ becomes ‘frequent’, and their quality of life impacted - abstaining from normal activities, and relying upon medication.

There a many different types of headaches, with varying characteristics and causes. Most broadly, headaches can be divided into:

-‘Primary’ headaches - the most common type, including the diagnoses of: Migraine, Tension Type Headaches, Cervicogenic Headaches, and those causes by dehydration; and -

-‘Secondary’ - which are rare, but much more serious (IHS. 2018). Secondary headaches are those caused by another pathology, and are usually accompanied by other symptoms such as: fever, weight-loss, confusion, visual disturbances, or are sudden, progressive and severe. If this is the case it is important to seek medical attention (IHS. 2018).

Primary headaches make up the vast majority of headaches experienced, and are not related to any serious pathology. Both Cervicogenic Headaches, and Tension Type headaches are caused by referred pain from structures around the head, neck and jaw. Relief from headaches in these people is usually found by treating the symptomatic tissues in the neck, and through lifestyle changes that cause these tissues to become sensitive in the first place.

Tension Type, and cervicogenic headaches are frequently treated by Osteopaths, indeed a large 2015 study found that the type of treatment performed by Osteopaths such as; massage; mobalisation; and stretching: to be as effective, or more effective than medication in the short and long term in managing these symptoms (Mesa-Jiménez. 2015). Treatment may not always just be directed at tissues that are causing the referred pain, but also in anatomically related structures such as the mid-back and shoulders

Migraines are another common type of Primary headache, but despite their frequency are surprisingly poorly understood scientifically - with a multitude of tissues, and mechanisms having being implicated (Camara. et al 2016, Borsook. et al, 2015, Rist. et al, 2015). These headaches have a particular characteristics: they are usually felt only on one side of the head or face; are worse with exertion; are often associated with certain ‘triggers’; and are often accompanied by ‘aura’ - visual, auditory, or other sensory phenomena.

These headaches are most commonly treated with medication with variable success. Some people find that taking time to fully understand the triggers of these headaches - foods, sleep patterns, emotions - they can reduce the frequency of attacks. There is also some research to support treatment of the neck in the management of Migraines (Chabli. et al, 2011). The poorly understood causes, diverse presentation, and common misconceptions around Migraines (Hoffman. Recober, 2014) can make them a difficult condition to manage - but thorough exploration of all angles can often help people reduce the frequency of severity of these headaches.

If you suffer frequent headaches, it can be worth seeing professional for advice and reassurance - in many instances improvements can be made very quickly. For some, particularly people with Migraines it can be a longer process - given the multitude of factors associated with the complain.


Mesa-Jiménez JA, Lozano-López C, Angulo-Diaz-Parreno S, Rodríguez-Fernández AL, De-la-Hoz_Aizpurua JL, Fernandez-de-Las-Penas C. (2015). Multimodal manual therapy vs. pharmacological care for management of tension type headache: A meta-analysis of randomized trials. Cephalalgia. 35(14):1323-32, 2015

Chabli. A, Tuchin. PJ, Russel. MB. (2011). Manual Therapies for migraine: a systemic review. Journal of Headache and Pain. 12(2):127-133.

Hoffman. J, Recober, A. (2014). Migraine and triggers: post hoc ergo propter hoc? Current Pain and Headache Reports. 17(10)

Camara. CR, Rodriguez-Gutierrez. R, Monreal-Robels. R, Marfil-Rivera. A. (2016). Gastrointestinal disorders associated with migraine: A comprehensive review. World Journal of Gastroenterology. 22(36):8149-8160

Borsook.D, Erpelding. N, Lebel. A, Linnman. C, Veggeberg. R, Grant. PE, Beuttner. C, Becerra. L, Burnstein. R (2015). Sex and the Migraine Brain. Neurobiological Disorders. 68:200-14

Rist. PM, Buring. JE, Kruth. T. (2015) Dietary patterns according to headache and migraine status: A cross-sectional study. Cephalgia. Vol. 35, issue. 9

IHS. (2018). The International Classification of Headaches. 3rd Edition. Cephalgia. 38(1);1-211