The Three Types of Headaches You Might Be Experiencing

Patients often arrive at our Burlington clinic saying they have "chronic headaches" without realizing how different the major types are. Tension headaches, migraines, and cervicogenic headaches each have distinct features and respond to different treatment approaches. Knowing which one you have changes the plan completely.

1. Tension headaches

The most common type. Roughly 80% of adults will have one at some point.

What they feel like

• Dull, pressing pain on both sides of the head
• Often described as a tight band around the head
• Mild to moderate intensity — annoying but usually not disabling
• Can last 30 minutes to several hours
• No nausea, no light or sound sensitivity (usually)

What causes them

Sustained muscle tension in the neck, shoulders, and scalp. Often triggered by stress, poor posture, eye strain, dehydration, or jaw clenching. Desk workers are particularly prone.

What helps

• Reduce sustained muscle tension — manual therapy, soft tissue work, acupuncture
• Address postural drivers — desk setup, mid-back mobility, posture habits
• Manage stress and sleep
• Stay hydrated and take breaks during prolonged screen time

2. Migraines

Distinct from tension headaches and not just "a really bad headache."

What they feel like

• Throbbing or pulsing pain, often on one side of the head
• Moderate to severe — frequently disabling
• Often accompanied by nausea, sensitivity to light and sound
• May have a warning aura (visual disturbances, tingling, etc.)
• Lasts hours to days

What causes them

Migraines are a neurological condition with genetic, hormonal, and environmental components. Triggers vary — common ones include certain foods, hormonal changes, sleep disruption, stress, weather changes, and dehydration.

What helps

• Migraine-specific medications (under medical supervision) for both prevention and acute treatment
• Identifying and managing personal triggers
• Manual therapy and acupuncture for cervical/upper back contributors — these can reduce frequency and intensity
• Sleep, stress, and hydration habits

Migraines often need a multidisciplinary approach: medical management plus physical care. We frequently see patients whose migraine frequency dropped meaningfully when we addressed neck and upper back contributors that had been flying under the radar.

3. Cervicogenic headaches

Headaches that originate from the neck. Underdiagnosed, but very treatable when correctly identified.

What they feel like

• Pain that starts at the base of the skull or upper neck and radiates forward
• Usually one-sided
• Often associated with neck stiffness or limited range of motion
• Triggered or worsened by neck movements or sustained neck positions
• Can mimic migraines closely

What causes them

Dysfunction in the upper cervical joints, muscles, or nerves. Often related to posture, whiplash history, or repetitive strain. The trigeminal nerve and upper cervical nerves share processing pathways, so neck issues genuinely feel like head pain.

What helps

Cervicogenic headaches usually respond well to physical care:

• Manual therapy and joint mobilization at the upper cervical spine
• Chiropractic adjustments for the cervical spine
• Targeted strengthening of deep neck flexors
• Postural and movement re-education
• Acupuncture is often a useful adjunct