Almost everyone has had one. That band squeezing your temples at the end of a long day, the throbbing jolt that forces you to switch off the lights, the dull pain that starts at the nape and creeps up to your forehead. We say “I have a headache” as if it were a single thing – and that’s the first mistake – because there are several types of headache, with different causes and, above all, different solutions.
Knowing which one you have is the first step to stop taking pills blindly. Let’s clear it up.
The three most common types (and how to tell them apart)
Most headaches fall into three broad groups. This table helps you get your bearings – not to self-diagnose, but to understand what we’re talking about:
| Tension (the most common) | Migraine | Cervicogenic (from the neck) | |
|---|---|---|---|
| How it feels | Pressure, like a helmet | Throbbing, “in beats” | Dull, constant |
| Where | Both sides | Usually one side only | Always the same side |
| Intensity | Mild to moderate | Moderate to severe | Mild to moderate |
| With exercise | Doesn’t get worse | Gets worse | No, but it does when you move your neck |
| Accompanying symptoms | Few or none | Nausea, light and noise bother you, sometimes “aura” | Starts in the neck, with limited neck mobility |
The tension type reigns by frequency and is linked to muscle tension and stress. The migraine is more disabling and has a neurological component. And the cervicogenic headache is, quite literally, a headache that comes from the neck.
Did you know …? Regular aerobic exercise – walking, swimming, gentle running – has been shown to be as effective as some preventive drugs at reducing migraines. Moving isn’t just “generally healthy”: it’s an evidence-based treatment.
Why does it appear? Causes and triggers
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The most common headaches don’t have a single cause, but a mix of factors worth knowing because many are in your hands:
- Stress, the number-one trigger of tension headache.
- Tension in the neck and jaw (poor posture, night-time bruxism).
- Sleep, too little … or too much.
- Posture and screens: the head pushed forward for hours in front of the phone or computer.
- Dehydration and caffeine (both excess and abrupt withdrawal).
With migraine, there are also its own triggers: hormonal changes, certain foods and drinks (red wine, mature cheeses …), skipping meals, intense lights or noises and sudden weather changes.
The neck–jaw–posture connection
Here’s the area where we can help most from physiotherapy. Bruxism – clenching or grinding the teeth, especially at night – overloads the chewing muscles and is a classic cause of morning headache. And the forward head posture in front of screens chronically tenses the neck, irritating the structures that connect neck and head: that’s the direct origin of cervicogenic headache and an aggravator of the tension type.
Translated: many headaches “in the head” actually start in the neck and jaw.
Warning signs: when it’s NOT “a normal headache”
The vast majority of headaches are benign. But there are warnings that mean you should seek medical attention without delay to rule out something serious:
⚠️ Seek urgent attention if the headache:
- Is sudden and explosive, “the worst of your life”, in under a minute.
- Comes with fever and a stiff neck (you can’t lower your chin to your chest).
- Appears after a blow to the head, or gets worse over the days.
- Comes with a neurological deficit: weakness, numbness, difficulty speaking, double vision, confusion.
- Wakes you at night or is worse when you get up, with nausea or vomiting.
- Is new after the age of 50, or changes pattern if you already had headaches.
What really works: beyond the pill
Managing common headaches is multimodal, and drugs are neither the first thing nor the only thing.
- Stress management. Relaxation, breathing, mindfulness and cognitive behavioural therapy reduce the frequency and intensity of tension headaches and migraines.
- Regular exercise. Moderate, consistent aerobic activity: one of the pillars, with solid evidence.
- Sleep hygiene. Regular schedules make a difference.
- Manual therapy and physiotherapy for tension and cervicogenic headache: neck mobilisations, trigger-point work and, above all, exercise. The combination gives the best results.
- Migraine: acute treatment of the attacks and, if frequent, preventive treatment. Here an assessment by a neurologist is advisable.
⚠️ Beware of painkiller overuse. Taking painkillers many days a month (more than 10–15, depending on the drug) can, paradoxically, chronify the pain: it’s “medication-overuse headache”. If you need pills almost daily, it’s a sign that a plan is needed, not more pills.
When to see someone?
Beyond the warning signs, it’s worth booking an appointment if: you have a headache more than once a week; it interferes with your work, sleep or social life; painkillers don’t work or you need them very often; or the pattern of your headaches changes. A practical tip: keep a small headache diary (when, how much, what you took, what you were doing). It’s gold for getting the diagnosis right.
In short
Let’s go back to that band squeezing your temples at the end of the day. Now you know it isn’t just “a headache”: it has a type, some causes and – very often – an origin in the neck, the jaw or the stress that you really can work on. The pill can get you out of a tight spot, but it rarely solves the root.
If your headaches keep coming back, there’s a lot to do before resigning yourself to living with them – starting with understanding which one it is.
Frequent headaches? At Clínica QO (Alicante) we assess the origin of your headache – neck, jaw, posture, stress – and design a plan to reduce how often it strikes, in your language.
Frequently asked questions
How do I know what type of headache I have?
By its features: the tension type squeezes like a helmet on both sides; the migraine is throbbing, on one side, with nausea and light sensitivity; the cervicogenic one starts in the neck and always on the same side. A professional can confirm it.
Can a headache come from the neck?
Yes. Cervicogenic headache originates in the cervical spine, and tension in the neck and jaw (including bruxism) is a very common cause of tension and morning headache.
What works best for tension headache?
Stress management, regular exercise, sleep hygiene and physiotherapy/manual therapy of the neck, ideally combined. Painkillers help on occasion, but shouldn’t be the foundation.
When should I worry about a headache?
If it’s sudden and extremely intense, comes with fever and a stiff neck, appears after a blow, is accompanied by neurological symptoms, wakes you at night, or is new after the age of 50. Seek medical attention.
Is it bad to take a lot of painkillers for headaches?
Yes. Overusing painkillers (more than 10–15 days a month) can chronify the pain, a situation called medication-overuse headache. If you need them almost daily, see a doctor for a suitable plan.
Sources and reference guides
- IHS — International Classification of Headache Disorders (ICHD-3): https://ichd-3.org/
- NICE — Headaches in over 12s: diagnosis and management (CG150): https://www.nice.org.uk/guidance/cg150
- Cochrane / revisiones sobre terapia manual en cefalea tensional y cervicogénica: https://www.cochranelibrary.com/
- MedlinePlus (NIH) — Dolor de cabeza: https://medlineplus.gov/spanish/headache.html
