Accurate diagnosis is important to the correct treatment and management of headaches. Head pain can have many causes, not just migraine. There are in fact hundreds of types of headache. Correctly identifying the cause of pain leads to better treatment. Did you know that our Physiotherapists have advanced training in diagnosis and management of Headaches and Migraines?

Headaches are usually described as Primary or Secondary. Primary headaches include migraines, tension headaches and cluster headaches. Secondary headaches are caused by an underlying problem such as neck pain, whiplash or withdrawl.  Secondary headaches can be caused by more serious pathologies, although this is rare. Most headache sufferers have one of the primary headaches

Migraine is a disorder characterised by periodic attacks of head pain and associated symptoms. Migraine pain is a one-sided throbbing pain. It can be severe enough to cause to cause you to take time off school and work. Sufferers can also have nausea, photophobia (fear of light), and phonophobia (fear of noise). The headaches last from hours to days.

Some migraine sufferers also experience an Aura. This aura consists of a combination of visual and sensory disturbances which occur an hour before the headache starts. Visual symptoms include seeing spots and lights. Sensory symptoms can include tingling and pins and needles or numbness.

Tension headache is the most common form of primary headache. It affects up to 80% of the population. As the symptoms are not as severe as migraine, tension headache is only considered a problem if it becomes chronic. Tension headache pain tends to be bilateral, and pressing in nature. It is not severe enough to interrupt work. Many migraine sufferers will also have tension headaches and vice versa.


Neck headache is a Secondary Headache disorder and makes up to 18% of all headaches. It relates to a problem in the upper part of the neck. Pain in the neck is misinterpreted as pain in the face and head. It can be quite misleading as the pain is typically in the same area as a migraine. Sufferers will notice tenderness at the top of the neck and base of the skull. They may experience a loss of movement in the neck. The difference between neck headache and migraine is that treatment of the neck is generally able to relieve the headache immediately. Clinical experience indicates that manual therapy of the upper neck is more effective than pain killers for neck headache but be careful. TheInternational Headache Society recommends avoiding manipulation/cracking of the neck for this problem due to the risk of stroke.

If you are unsure about the cause of your headache symptoms you should keep a diary and discuss them with someone experienced in managing headaches.