My Head Hurts! Why Do I Have A Headache??

Did you know that not all headaches are the same? In fact there are many different types of headaches – and each one may be different in how they present. This is why your GP, pharmacist, Osteopath or health care practitioner will take a thorough history about your headache and medical history!

Common cause of headaches can be anything from tension and stress, postural strains, dehydration, food intolerances, lack of sleep, sinus infections, and very commonly tight muscles in the neck and shoulders. Less common causes can be more serious and can include brain tumors or bleeding in the brain. This needs to be investigated and treated immediately.

My Head Hurts

When seeing your osteopath for your headaches, we will take a thorough history of your headache to determine what type of headache it may be and what is causing it. Questions commonly asked about the headache may include:

  • Its location?
  • Its intensity – a number out of 10?
  • Its onset, ie, when did it start and any reasons it may have started?
  • Its quality – ie, is it dull, sharp, pounding, electric, throbbing etc
  • How long it has been present for?
  • Is it new or have you had the same headaches in the past?
  • Whether any medication has been required for the headache?
  • Is there any nausea or vomiting?
  • Visual changes like blurry vision
  • Dizziness or loss of balance
  • Fever or neck pain.
  • Worsening of headache with coughing or sneezing.
  • Neck stiffness with fever and headache

Finding the cause and type of headache will allow your osteopath to construct the best treatment and management plan for you. This may include referrals if required, lifestyle advice and management, and “hands on” treatment best suited for you.  The focus of hands on treatment will differ between patients and types headaches.

The most common types of headaches presented in clinic include:

Tension Headaches or Stress Related Headaches

Tension headaches normally arise when a stressful time ensues – whether it is work related or from other issues which are induce stress.

Tension headaches are often accompanied with tight muscles in the neck, jaw, shoulders and upper back.

They can also be related to clenching of the jaw and grinding of the teeth. Tension headaches are often described as a feeling of a very tight band or pressure across the forehead or back of head, which can be worse on weekends.


There are many different types of migraines and therefore there is a large criteria for their diagnoses. Migraines are a specific neurological disorder characterised by throbbing pain that usual affects one side of the head. They can often be accompanied by nausea, sensitivity to light, sound or smell.  The two main types of migraines are migraine with an aura or migraine without an aura. This “aura” presents with certain visual changes like blurry vision or even blind spots that alter vision – and it can be different from person to person. The headache part of the migraine is often described as being severe, debilitating and the sufferer needs to go into a dark, quiet room. Medication is often taken either as a preventative and/or for helping the migraine pain itself due to its intense and severe nature. Other relieving tools can be using a heat pack or ice pack, massage and trigger point release in the muscles of the upper back and neck (as long as it is safe to do so).

Cervicogenic headaches:

Cervicogenic headaches are headaches which come from your neck. The neck is anatomically called the “cervical spine” and hence the name cervicogenic headaches come about!

They can be due to neck muscle spasm, tightness or strain or an inflamed joint/s in your neck. They often present as a constant dull ache, situated at the back of the head and sometimes in the temples. It’s most commonly felt on one side of the head and is usually accompanied by neck pain or stiffness. Due to the dysfunction through the neck, it isn’t uncommon to experience some dizziness or nausea too – this needs to be differentiated from migraine where nausea may be present too – so the appropriate treatment and management is adhered to.

Cervicogenic headaches can also be caused by underlying poor posture – therefore, osteopathic treatment not only includes hands on therapy, it is also inclusive of ergonomic set up and awareness, and appropriate stretching, strengthening and rehabilitation exercises. This is a very important part of preventing these headaches from returning – as severely or as often!!

Sinus Headache:

Your sinuses are hollow cavities situated below and above your eyes, ie, behind the forehead bone and under your eyes leading towards your cheek bones. When these sinuses become infected, they can cause an increase in pressure causing headaches. They’re often accompanied by a recent cold or a fever.  Feeling of congestion, heaviness, fullness in the head and blocked ears can also accompany this style of headache.

The treatment and management of your headache will depend on the type of headache you’re suffering from. Once the cause and type of headache you have is diagnosed, your Osteopath will be able to specifically treat your headache. Or refer you for appropriate medical management with your GP or specialist if required.  For example, when treating a sinus headache, your treatment will be based around your lymphatic system, allowing optimal drainage of fluid and congestion from your sinuses and down through the front of your neck. This will differ to treatment for tension type headaches, which focuses more on releasing tight muscles and mobilising joints through your neck, shoulders and upper back.

Please ensure that if you are experiencing a new type of headache that you haven’t had before and can’t explain, or is associated with severe pain or fever, please consult your GP or emergency department at hospital for medical management immediately.

And feel free to get in touch if you have any further questions, concerns  or want some help with your headaches!!