Call 000 for a sudden severe headache, or a headache with confusion, neck stiffness, vomiting or vision changes. Seek medical advice for a new, changing, worsening or frequent headache, particularly after a head injury.
Why the headache type matters
Tension-type headache, migraine and cluster headache are different conditions. They should not be grouped together as a neck or posture problem. A clinician needs to consider the pattern, associated symptoms and possible causes before advising treatment.
The assessment should identify which pattern is most likely and whether further medical investigation is needed. Manual treatment should not be presented as an established treatment for every headache type.
Information that helps your clinician
A headache diary can record when pain starts, how long it lasts, where it is felt, associated symptoms and medicines taken. Note whether the pattern is new or different from your usual headaches.
Also describe the impact on work, study, sleep and exercise. Bring details of previous diagnoses or treatment, and tell your clinician how frequently you use headache medicines.
Neck symptoms and headaches
Headache and neck discomfort can occur together. Their coexistence does not establish that the neck is the cause. Ask the clinician how the examination supports the explanation and whether GP assessment or another referral is needed.
If a musculoskeletal component is identified, discuss the goals and evidence for the proposed treatment. Agree on a review point and what would prompt further investigation.
Treatment decisions
Headache management depends on the diagnosis. Discuss medicine use with your doctor or pharmacist; do not stop prescribed treatment because of general website advice. Medicines can have an appropriate role in headache management, depending on the diagnosis and the person’s circumstances.
A useful plan explains the purpose of each treatment, what you can do independently and what to do when symptoms change. A treatment that helps one headache pattern cannot be assumed to help another.
Prepare for an assessment
Write down when the problem started, what brings it on, what eases it and what has changed. Bring relevant reports and a medicines list. Describe the activities you want to regain, rather than only giving a pain score.
- What is the working diagnosis, and what remains uncertain?
- What findings would change the plan or need medical review?
- What can I do between appointments?
- How will we measure progress and decide whether to change treatment?
Care in Melbourne’s northern suburbs
For people in Epping, Mill Park, Lalor, Reservoir and surrounding suburbs, the Muscle Joint Bone team can help arrange an appropriate starting appointment. Confirm current services, practitioner availability and any referral or funding requirements.
Sources and further reading
- Northern Spinal: original headache resource
- Healthdirect: headaches
General education only. An assessment is needed to determine what applies to you.
