Types of Headaches & Migraines

Headaches and migraines are extremely common, affecting almost two thirds of the population at one time or another and resulting in millions of doctors appointments every year. There are many different types, with the main ones being tension headaches and migraines.


Tension headaches are thought to account for around 90% off all headaches and symptoms may include:
• Dull and persistent pain that varies in intensity and is usually felt across the forehead and
• Tenderness of the scalp, neck and shoulder muscles
• Ache in the upper back and neck which may restrict movement
• Difficulty concentrating
• Disturbed sleep patterns

Migraines are particularly debilitating for sufferers and tend to be described as a throbbing headache which affects one side of the head. In addition to the symptoms above, migraine sufferers may also experience:
• nausea
• vomiting
• sensitivity to bright lights
• blurred vision or visual disturbances such as flashes or coloured lights surrounding a blind


A tension headache is thought to be due to tight muscles and stiff joints in the upper neck and tends to occur in patterns associated with physical or emotional stress. It can be triggered by muscle tension in the upper neck, poor alignment of the neck joints, poor posture, fatigue or a previous spinal or neck injury.

The exact cause of migraines is difficult to determine. They can be triggered by a number of factors, including stress, sleep loss, hormonal changes and intake of alcohol, caffeine and certain foods. It is thought that tight muscles and stiff joints in the upper neck also contribute to migraines. Occasionally there is a slight misalignment of the upper vertebrae, often caused by prolonged faulty posture.

How Can Physiotherapy Help?

Many sufferers of headaches and migraines rely on medication to try to control their symptoms, unaware that in fact in many instances, physiotherapy can offer significant and quick relief.

Your Physiotherapist will begin by discussing your history and carrying out a physical examination, in order to determine whether treatment will be beneficial. If your symptoms are related to musculoskeletal problems, particularly involving the neck or jaw, these can normally be relieved through the use of soft tissue massage techniques and advice on correcting posture, strengthening and stretching.

In the case of migraine sufferers, cervical spine and muscle tightness can trigger symptoms and this too can be effectively treated through physiotherapy. It is important to note that physiotherapy will not be effective for all types of migraine. For example, for ones which occur infrequently (once a month or less) with clear triggers such as certain foods, caffeine or alcohol, the benefits of physiotherapy will be limited.

Tips for Managing Headaches & Migraines at Home

• Do stretching and strengthening exercises to relieve tension in the neck – your Physiotherapist can recommend an exercise programme.
• Relaxation techniques can be beneficial in reducing stress and relieving neck and shoulder spasms.
• Ensure correct posture when sitting and standing to reduce stiffness and undue pressure on the neck.
• Check that you have the correct pillow for optimal neck position and comfort during sleeping.
• Use an ice pack to relieve migraine pain.

Case Study

The patient, a 45 year old woman, had suffered from regular headaches and migraines for most of her adult life. They were having a significant impact on her life, making it hard for her to focus on everyday tasks and preventing her from fully enjoying time with her children. The migraines were often so severe that she would be bedridden for 2 to 3 days at a time. She had visited her GP a number of times and had been advised to avoid potential triggers such as cheese, chocolate and alcohol. She was regularly taking painkillers in an attempt to control her symptoms.

The patient attended an initial assessment with one of our experienced Physiotherapists, during which her history, lifestyle and symptoms were discussed, and a physical examination was carried out. She was suffering from almost continual stiffness in her neck, which was believed to be related to her stressful, desk-based job.

A programme of physiotherapy treatment was reccommended, and the patient was also given advice on correcting her posture and implementing stretching and strengthening exercises at home. In addition, manual therapy into the trigger points at the top of the neck gave rapid reduction in intensity of her migraines.

After her first session of physiotherapy, the patient reported an improvement in her stiff neck and a reduction in the frequency of her headaches. This continued to improve with each session, and after 4 sessions she no longer experienced neck stiffness and reported only the occasional mild headache and a huge reduction in the amount of medication she required. The patient was able to continue to self manage through the use of exercises at home.

If you suffer from headaches or migraines, contact Elizabeth Webster Physiotherapy on 01423 884162 to discuss how physiotherapy could help you.