For many of us, headaches are an occasional nuisance. But for some, they are regular and debilitating. Are painkillers the only answer? In this article, we discuss the kinds of headache amenable to osteopathic treatment, investigate what research says, and look at how an osteopath assesses and treats headaches.

Types of headache

Headaches come in two major categories: primary and secondary.

Secondary headaches are a symptom of another problem or condition (such as a cold, a side-effect of medication, temporal arteritis or simply a bang on the head).

Primary headaches are a condition in their own right – they don’t have a known underlying cause.

By far the two most common types of primary headache are migraine and tension-type headaches.

A migraine is a headache that has a neurological origin – it’s to do with the brain and its associated structures.

‘Tension-type’ is really a catch-all term for headaches that don’t fit any other category. They are accompanied by tenderness in the muscles of the head and neck, and they are often linked to stress and poor sleep.

Although we often think of migraines as more severe, in fact both types can vary in intensity and duration.

A common secondary headache is the cervicogenic headache. This comes from problems with the discs, ligaments, joints and muscles of the neck. The nerves that bring sensation signals from these tissues enter the spinal cord at the same level as many of the nerves that bring signals from the head, and sometimes the brain can’t interpret which area is hurting. This phenomenon is known as referred pain.

Osteopaths can treat all these headaches. Treatment either resolves them entirely, or it reduces their frequency and severity.

Migraines

Migraines are headaches that originate in the tissues, nerves and blood vessels of the brain. They tend to be one-sided, and they are often preceded by ‘aura’: visual, auditory or other neurological disturbances. People with migraine are often sensitive to light and smells and describe their pain as ‘throbbing’.

Tension-type headaches

Tension-type headaches are generally on both sides of the head. They feel like a band of tightness or pressure. People with tension-type headaches are often sensitive to noise but, unlike some migraine sufferers, not to smell. Although these headaches are generally less intense than migraines, they can be quite severe, and they can last for a long time.

Cervicogenic headaches

Cervicogenic headaches are typically on one side of the head – the same side as the triggering joint, disc or other tissue in the neck. They can be mild to severe, and intermittent or constant. Moving the neck feels stiff and painful. The sufferer may also have nausea and vomiting, eye pain, blurred vision and sensitivity to light.

There are many other kinds of headache, but they are far less common. However, if you have a headache that is unusual for you in severity, persistence, suddenness of onset, or is accompanied by other symptoms such as numbness, weakness, visual disturbance or difficulty with speech or movement, you should get checked by a doctor.

Can osteopathy help headaches?

The good news is that, if you suffer with one of these common headaches, osteopathy can help!

Tension-type headaches, migraines and cervicogenic headaches all feature tenderness, pain and dysfunction in the muscles and other structures of the head and neck.

In cervicogenic headaches, these issues cause the head pain. It’s less clear with the other headaches, but there’s certainly an association.

Osteopaths know how to evaluate the structures of the neck and apply techniques that can dramatically reduce dysfunction and pain.

What does the research say?

Research on osteopathy for headaches, though limited, is showing promising results.

One study of 44 patients with tension-type headaches showed that osteopathic treatment produces significant reductions in headache frequency over a three-month period.

Manual therapy and exercise reduce cervicogenic headache intensity, frequency and disability, according to this 2022 analysis.

Another review looking at the effectiveness of manual therapies for migraines suggests that interventions such as massage and spinal manipulation can be equally as beneficial as migraine medication. This offers an alternative to people who struggle with the side-effects that medication can produce.

How do osteopaths treat headaches?

There is a common thread in these three headache types. Joints, especially those in the upper neck, are often restricted or irritated, and muscles in the neck, shoulders and face frequently contain myofascial trigger points.

These small, irritable muscle knots are extremely tender to touch. They also refer pain elsewhere, commonly into the head. They are the sign of muscles that are chronically stressed and overworked.

Osteopaths can identify and treat trigger points. And they can ease joints in the neck, reducing irritation and improving mobility.

An osteopath will seek to identify not only the dysfunctional tissues, but also the reasons that the problems are occurring. It may be related to posture, or poor mobility in the upper or lower back, pelvis, or even in the legs and feet. There may be issue with nutrition and hydration. Perhaps your sleep position is affecting your neck.

A multi-pronged, holistic approach that takes your whole health into account is better able to give you long-lasting results.

Osteopathy addresses the underlying causes of your headache, rather than masking the symptoms.

What does a typical treatment for headaches involve?

Every treatment is designed around the patient. That means no two treatments will be exactly alike. However, you might expect a typical treatment for headaches to look a bit like this:

• Massage eases tension in the muscles of the shoulders, neck, jaw and head.
• Special soft tissue techniques like post-isometric relaxation lengthen muscles and improve mobility.
• Gentle mobilisation of the neck, using techniques such as traction or positional release, can reduce irritation in the small neck joints.
• Trigger point treatment reduces hyperirritable muscle knots, easing the pain they refer into the head.
• Joint manipulation can restore normal mobility to the neck and back.
• Work to other areas of the body can normalise biomechanics, reducing strain – particularly in the upper neck.
• Advice on what to expect, and on exercises and management techniques you can use at home to make sure relief is long-lasting.

An osteopath has many techniques to draw from and will select the ones most appropriate for your situation. They’ll also ensure you’re fully informed and happy about the techniques they suggest before starting.

How many treatments will I need?

This, of course, varies with the causes and circumstances of your headaches.

In some situations, a single session that addresses the musculoskeletal triggers of your headache can be enough. At other times, several sessions might be a better option to deal with more chronic issues.

Some people choose to have occasional ongoing treatments to ensure they keep their headache triggers at bay. Others prefer to book in if they have a recurrence.

Your osteopath will make a suggestion, depending on what they think will give you the best outcome.

The choice is entirely yours!

Interested in finding out more?

Here at Woodside Clinic, our osteopathy team understands headaches. They know what to look for and can identify where osteopathic treatment can help. Even if you’re a long-term sufferer, there are almost always issues that your osteopath can address to help alleviate the burden of headaches.

So don’t struggle with headaches. Try booking a session and see what a difference osteopathy can make!