What Type of Headache Do I Have?

There are several different types of headaches commonly treated in physical therapy. Identifying the correct one will lead to the most optimal treatment interventions.

Cervicogenic headaches is a common type of headache that arises from the upper cervical spine. This type of headache is only on one side of the head and does not shift sides. Symptoms can occur with a “ram’s horn” pattern, in the back of the head and/or around the eye depending on the cervical spinal level involved. This type of headache is usually reoccurring with episodes that last between one hour up to weeks. Patients often describe their headaches as moderate-to-severe in intensity and as non-throbbing/non-lancinating pain that usually starts in the neck. Symptoms are often made worse by neck movements, sustained postures and provocation over the upper cervical spine. If the upper cervical spine (C1-C2) is the culprit, neck rotation to one side will be more limited and symptom-reproducing compared to the non-effected side.  

Tension-type headache is the most common type of headache and has a lifetime prevalence of 30 to 78% (depending on the study). Symptoms are diffuse and occur on both sides of the head/neck. Patients often report their headaches are “dull” and mild-to-moderate in intensity. Each episode can last for days to weeks and the number of episodes per month significantly varies. 

Migraines are on one side of the head and shift from side-to-side. They are typically described as throbbing/pulsating and are moderate-to-severe in intensity. Episodes typically last 4-72 hours. Migraine headaches may be accompanied by nausea, vomiting, aura and/or sensitivity to light and sound. 

References:

1. Headache Classification Committee of the International Headache Society (IHS) the International Classification of Headache Disorders, 3rd Edition. (2018). Cephalalgia, 38(1), 1–211. https://doi.org/10.1177/0333102417738202

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