What your headaches could actually be coming from.

If you get regular headaches, you've probably wondered what's causing them. Is it your neck? Too much screen time? Not enough water? Stress? Often the honest answer is "a bit of everything", but there are some patterns worth knowing about.

This guide walks through the most common sources of headaches, what they tend to feel like, and where hands-on treatment can and can't help. It isn't a way to diagnose yourself. Your GP is the right person for that, particularly if your headaches are new or changing.

Headaches aren't all the same

Doctors divide headaches into two broad groups. Primary headaches, such as tension-type headache and migraine, are conditions in their own right. Secondary headaches are caused by something else, such as a problem in the neck, an infection, medication or, rarely, a serious condition in the brain.

Many people have more than one type. You might get occasional migraines and also regular tension-type headaches, for example. Keeping a simple headache diary for a few weeks, noting when they start, where they're felt and what was happening beforehand, can help your GP and your therapist see the pattern.

Tension-type headaches

Tension-type headaches are the most common kind. They're usually described as a dull, pressing or tight band around the head, across the forehead or at the back of the head. They're often mild to moderate and don't usually come with vomiting or a strong sensitivity to light.

The exact cause isn't fully understood. Stress, poor sleep, long periods in one position and tight, tender muscles in the neck, shoulders and scalp are all commonly linked with them. Many people notice they're worse at the end of a long workday or during stressful weeks.

Headaches from the neck

A cervicogenic headache is one that starts in the neck, usually the joints and muscles of the upper neck, just below the skull. The pain is felt in the head but its source is lower down.

Jaw clenching and TMJ

The muscles that close your jaw run up over your temples. When they're overworked, from clenching or grinding during the day or overnight, they can refer pain into the side of the head. Jaw-related headaches are often felt at the temples and may come with an aching jaw, tired chewing muscles or clicking.

Waking with a headache and a sore jaw is a common clue that you might be clenching or grinding at night. Your dentist can check your teeth for signs of wear and talk about whether a night splint might help. On the directory, you can filter by Jaw & TMJ pain to find therapists who treat this area.

Migraine

Migraine is a neurological condition, not a muscle problem. Attacks are often moderate to severe, frequently on one side, throbbing, and made worse by movement. They can come with nausea, vomiting and sensitivity to light and sound. Some people have an aura beforehand, such as flashing lights, zigzag lines or tingling.

Manual therapy doesn't treat migraine. Some people with migraine also have neck and shoulder tension, and easing that may help them feel more comfortable between attacks, but it isn't a substitute for medical care. Your GP can confirm the diagnosis and talk you through treatment and prevention options.

Knowing which kind of headache you have matters, because the things that help one type can do little for another.

Everyday contributors

Some of the most common contributors aren't muscles at all:

• Pain relief overuse. Taking pain relief for headaches very often can, over time, lead to more frequent headaches. This is called medication-overuse headache. If you're taking headache tablets on many days of the month, talk to your GP or pharmacist. Don't stop prescribed medicines without advice.

• Sleep. Too little, too much or irregular sleep can all bring on headaches.

• Fluids and meals. Not drinking enough water or skipping meals is a common trigger.

• Caffeine. Both a lot of caffeine and suddenly cutting back can cause headaches.

• Eyesight. Uncorrected vision or long stretches of close screen work can contribute to eye strain and headaches. An optometrist can check your eyes.

• Stress. It affects muscle tension, sleep and how sensitive you are to pain.

Where manual therapy fits

For tension-type headaches and headaches from the neck or jaw, a myotherapist or remedial massage therapist may be able to help as part of a wider plan. Research suggests manual therapy and exercise may reduce how often or how strongly some people get these headaches, though results vary and the studies are of mixed quality.

A good therapist will start by asking detailed questions about your headaches and screening for warning signs. Treatment might include soft tissue work on the neck, shoulders, scalp and jaw, gentle joint mobilisation, trigger point work and simple exercises for the neck and upper back. They should refer you to your GP if anything in your history doesn't fit a muscle-related pattern.

You can filter the directory by Headaches & migraine or Neck & shoulder pain, or browse Myotherapy to find a therapist near you.

When to see a GP or call 000

This guide is general information, not medical advice. Headaches have many possible causes, so see your GP to get a diagnosis, especially if your headaches are new, changing or getting worse.