Migraine or tension headache: what should you do?
Headaches have different causes. Learn which symptoms need urgent care, what to record, and when a physiotherapy discussion may be relevant.
If headaches keep returning, start by describing the pattern rather than choosing a treatment by name. Migraine and tension-type headache are different conditions, and neck or jaw discomfort can occur alongside them without proving the cause. A medical professional can assess the headache type and discuss treatment. Physiotherapy may sometimes help address a related neck or jaw problem, but it does not replace migraine diagnosis or medication advice.
When should you seek urgent medical help?
A sudden, extremely severe headache, or a headache with new weakness, difficulty speaking, confusion, loss of vision, a seizure, or fever with a stiff neck, needs urgent medical assessment. In Belgium, call 112 in an emergency. See the NHS headache advice for warning signs. Do not wait for a physiotherapy appointment in these situations.
Arrange a routine medical consultation if headaches are frequent, worsening, changing character, disrupting daily life or not responding to your usual plan. Headaches during pregnancy or after birth, or an aura lasting longer than usual, also deserve prompt medical advice. Avoid assuming every headache after screen work is “just posture”.
What is useful to record?
For several episodes, note when the pain began, how long it lasted, where you felt it, its effect on activity, and any nausea, light sensitivity or visual symptoms. Record sleep, meals, menstrual timing if relevant, stress, neck or jaw symptoms, and what medication you took. A simple note on your phone is enough; the aim is to give a clinician a clearer history, not to self-diagnose.
The NICE headache guideline recommends classifying the headache type and considering medication overuse. If you take pain relief often, tell the clinician how many days a month you use it. Do not change prescribed medicine solely on the basis of this article.
Where might physiotherapy fit?
If an assessment suggests that neck movement, muscle discomfort or jaw function is a separate concern, a physiotherapist may discuss those symptoms and your goals. A physiotherapist working in maxillofacial care, such as Sophie Carlier, can be relevant for a jaw-related problem. That link does not mean a migraine can be cured by jaw treatment. Medical evaluation remains important when the headache itself is the main concern or the diagnosis is uncertain.
Questions worth asking include: What type of headache seems most likely? What should make me seek help sooner? Is my medication use relevant? Are the neck or jaw symptoms part of this problem, or a separate issue? How will we know whether a treatment is helping?
For jaw-specific questions, see our guide to jaw and temporomandibular problems or explore maxillofacial physiotherapy.
Sources
- NHS, “Headaches”: when to seek help and what to record.
- NHS, “Migraine”: medical treatment and warning signs.
- NICE, “Headaches in over 12s”: classification and medication-overuse considerations.
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