Headache

Tension-type headache is the most common form of headache and is typically described as a bilateral, dull, pressing or tightening pain, often compared to a band around the head. The pain is usually mild to moderate in intensity, non-pulsating, and not aggravated by routine physical activity. Nausea and vomiting are absent, although sensitivity to light or sound may occur. This type of headache is strongly associated with increased tension in the cervical, shoulder, and masticatory muscles, as well as with the presence of myofascial trigger points. Prolonged static postures, psychological stress, and reduced tissue load tolerance are common contributing factors.

Cluster headache is characterized by extremely severe, unilateral, stabbing or burning pain, most commonly located around the eye, temple, or forehead. Attacks are accompanied by ipsilateral autonomic symptoms such as tearing, nasal congestion, rhinorrhea, conjunctival injection, and ptosis. Headaches occur in clusters over weeks or months, followed by remission periods. Although the primary mechanism is neurovascular, musculoskeletal dysfunction of the cervical region may influence symptom intensity.

Migraine without aura typically presents as a unilateral, pulsating headache of moderate to severe intensity that is aggravated by physical activity. Associated symptoms commonly include nausea, photophobia, and phonophobia. Many individuals with migraine report concomitant neck pain and stiffness, suggesting an important interaction between migraine mechanisms and cervical musculoskeletal function.

Migraine with aura shares the features of migraine without aura but is preceded by transient neurological symptoms. These may include visual disturbances such as flashes of light or scotomas, sensory changes, speech difficulties, or unilateral numbness. Aura symptoms usually develop gradually and resolve within an hour. Increased cervical and shoulder muscle tension is frequently reported before the onset of aura and headache.

Cervicogenic headache originates from structures of the cervical spine and surrounding soft tissues. Pain is usually unilateral and begins in the neck, radiating to the occipital, temporal, or orbital regions. Symptoms are commonly aggravated by neck movement or sustained postures. Reduced mobility of upper cervical segments and impaired deep cervical flexor function are typical clinical findings.

Vestibular migraine is characterized by recurrent episodes of vertigo, dizziness, and postural instability, with or without accompanying headache. Patients may also experience nausea, motion sensitivity, and visual intolerance. Coexisting neck pain and altered cervical proprioception are frequently observed and may contribute to symptom persistence.

Ocular (retinal) migraine involves transient visual disturbances in one eye, such as scintillations, blind spots, or partial vision loss. These symptoms are usually temporary and may occur with or without headache. Increased tension in cervical and periocular musculature may exacerbate visual complaints.

Headaches associated with temporomandibular joint (TMJ) dysfunction are commonly localized to the temple, preauricular region, and cheek and may radiate to the head and neck. Patients often report jaw pain, clicking or popping sounds, restricted mouth opening, and pain during chewing.

Bruxism and hyperactivity of the masticatory muscles are frequent contributing factors.

Headaches related to trigeminal nerve irritation typically present as brief, sudden, electric shock–like pain attacks affecting one side of the face. Episodes may be triggered by speaking, chewing, touching the face, or brushing the teeth. Although the origin is neurogenic, increased tension in the jaw and cervical muscles may intensify symptoms.