Headaches & Migraines

What is the difference between a headache and a migraine? Most of the time we tend to use a migraine to describe a particularly painful headache, and while they do share a number of characteristics they can present themselves in quite different ways. Both can vary between mild/moderate/severe pain and affect either one side or the whole of the head. Sometimes they may pass quickly and other times they can last for days.

The key difference is that tension headaches tend to present just a tight sharp pain, while migraines project more constant throbbing qualities and include other symptoms that are more ‘flu-like’. It is common for migraines to be accompanied by light sensitivity, nausea, and a lack of energy. Exertion – even very light exercise such as climbing stairs – can make migraines suddenly become far worse, while headaches tend to stay quite constant and stable.

Before we look further into this topic it is worth mentioning that anyone who has suddenly developed extreme head pain ought to consider seeing a medical doctor or physiotherapist very quickly, especially if it is accompanied by lightheadedness, confusion, and dizziness.

What Causes Headaches & Migraines?

It may be surprising to learn but there is still not an explanation for what precisely causes tension style headaches. While it has long been thought that some kind of muscular tension played a part (especially around the neck) there must be some kind of chemical reaction that we cannot yet identify. As we shall see later, massage therapy can help with reducing the severity and frequency of headaches but there is still no scientific, permanent solution besides painkillers, which we do not advise. 

Fortunately, we are much more informed when it comes to migraines. These seem to be caused by changes in the blood flow through the skull leading to swollen veins that apply pressure to the nerves. It is worsened by multiple chemical reactions that accentuate the throbbing pain which characterizes migraines. 

While headaches may just appear for no clear reason there are a number of common factors believed to stimulate migraine attacks. These vary from food (alcohol, dairy products, citrus fruits), weather/atmospheric pressure changes, poor sleep, gluten intolerance, hormonal changes and even certain smells. Complementary physical therapies will look to identify the triggers which seem to start a migraine attack.

Another interesting difference between the two is that stress seems to play a key role in developing headaches while not much if any of a part in provoking migraines. Psychological assessments frequently demonstrate that people suffering acute stress very frequently exhibit a much higher proneness to severe headaches. Migraines, on the other hand, seem much more likely to be caused by specific environmental factors.

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Treating Headaches & Migraines

The first stage of treating severe head pain is to rule out the possibility that it may be caused by any other ailment. Your medical doctor will ask you to explain the frequency of your attacks, where the pain is located, and the form which it takes. From this, they may then discuss more personal matters such as stress levels, mental health history, and any family history of similar problems. Although do be aware both of these conditions are not currently believed to be hereditary.

In the first instance, it is likely that your doctor will request a blood screen that should be enough to eliminate any other potential causes. In almost all cases they will ask you to keep a headache/migraine diary that records the duration of the attacks and will hopefully suggest if there are any environmental causes. Remember to include what you are eating, how you are sleeping, and moments of particular stress.

Most people who consult with a doctor will have already used painkillers to try and cope with their pains, again, we do not recommend this and suggest you reach out to a physiotherapist before you try to medicate. 

If you do not have any success using commonly available painkillers then you may script from your doctor for more powerful drugs. Medication varies for both.

Migraine Medication: These are usually Triptan based and encourage the blood vessels in the skull to contract. Often these are very effective as they directly counteract the physiological cause of migraines, but it can take a while to establish a suitable dose. Many users report a variety of relatively benign side effects. These include but are not limited to tingling, hot flushes, dry mouth, slight lethargy/heaviness, drowsiness and sometimes nausea. 

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Triptans may not be perfect but it does tend to work for all but the most severe of cases. Anyone suffering long-lasting daily migraines could be steered towards trying BoTox but note that this is ineffective for other kinds of headaches. Your physiotherapist will have many options that you can choose from and have more natural measures to find pain relief.

Headache Medication: Assuming that general painkillers are not effective (there are many to try and establish a suitable/safe dose requires medical guidance) there is again a good chance that your doctor may still suggest trying other treatments. Even though they are not proven to be effective for tension headaches, the difference between headaches and migraines can be so slight that there is always the possibility of early misdiagnosis. 

If pain persists there are alternative options to look towards such as complementary physical therapies that assist with stress reduction and pain management. These can be extremely effective and many doctors who specialize in managing headache pain will suggest these during the earliest stages of treatment.

How Complementary Medicine Can Help, But Only After A Medical Appointment

Mindfulness, meditation and enjoying a healthy diet are all well known for helping people suffering from recurrent headaches and migraines. Physical Therapy with a trained medical doctor or physiotherapist will help alleviate the pain.  

Essential oils may provide another kind of release and are frequently used to supplement the treatment of tension headaches. Basil, flax, lavender, feverfew, and buckwheat oils are thought to be useful for these symptoms and can either be used in aromatherapy or lightly applied to the scalp and wrists. 

You may wish to consult with your doctor before trying any other therapies but there are rarely any reasons why they should complicate medical treatments.


There is no permanent cure for either headaches or migraines but millions of people do manage to successfully manage and cope with the pain they cause. As everyone is physiologically different, treatment plans need to be tailored in a way that specifically addresses what may be causing their problems. Establishing exactly what this is can be difficult and take a long period of experimentation, especially in the case of regular headaches. 

While migraines are often considered to be the more ‘severe’ form of head pain, the reality is, they are often actually much easier to treat and medicate. Physical therapies can also work wonders, especially when it comes to reducing stress levels and learning to handle pain and frustration.

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