Solving a Headache!

Are you a headache sufferer?

 Headaches are common in the general population with a lifetime prevalence of 90%, and 50% of the population presenting with headache at any one given time. It is a common complaint seen in Primary care and is responsible for 30% of outpatient neurology clinics. 

Healthcare practitioners sometimes find it difficult to diagnose headaches and patients are often prescribed pain killers. However, there is strong evidence to support the use of therapeutic management through physiotherapy, acupuncture and chiropractic manipulative therapy. 

Headaches explained….

The most common classification system for headache disorders is from the International Headache Society (ICHD). The two main categories are primary and secondary headache.

Primary headaches include migraines, tension type headaches and cluster headaches. Where as secondary headaches include headache due to trauma, neck pain, vascular disorders and cervicogenic headaches.

So, which headache do you have?

Tension type headache: 

This is the most common primary headache. It is described as a tight feeling, as if your head were in a vice. It is a mild to moderate steady ache, often in the forehead, or both sides of the neck and back of the head. It is commonly associated with soreness in the shoulder and neck, with muscle tightness and trigger points in the muscles that attach to the base of the head.


Migraines are generally a throbbing pain affecting one side of the head and are associated with nausea, vomiting, sensitivity to light and sound, and aura. This pulsating pain is moderate to severe and can last from 4-72 hours. 

Cluster headache:

The rarest and most painful form of headache. It is a severe headache localised to one eye and the temporal region as the temporal artery bulges and pulsates. It is not uncommon to have associated tearing, nasal congestion and sweating. Attacks generally last 45-90 minutes and usually occur the same time of day, often when from an afternoon nap or sleep at night.

Cervicogenic headaches:

This secondary type of headache originates from pain and dysfunction in the neck. Symptoms affect only one side of the head and neck, and can last from an hour to weeks.

Pain is moderate to severe and exacerbated by movements of the neck and posture. It is associated with increased tightness of surrounding neck and shoulder musculature, increased activity of superficial neck flexors and weakness of deep neck flexors.

​​SMLTherapeutic management:

  • Current evidence supports the following treatments-
  • Cervical spine mobilisation and manipulation
  • Strengthening exercises including deep neck flexors and postural scapular muscles
  • Thoracic manipulation and thoracic mobility exercise 
  • Acupuncture, soft tissue release and trigger point therapy for overactive neck and shoulder muscles 
  • Relaxation training and lifestyle advice

For more information on headache treatments or any of the other services we offer, please see our website, or contact us on 01454 838366.