How to manage your headache without medication

Chronic headaches can be very painful and it can make you struggle to concentrate. This has a negative effect on your work, relationships and general well being. Some people can only get through their day if they take hand full of pills and medication. In this article we will give you 4 steps on how to manage your headaches without medication.

Headaches are a common problem that can have a disabling affect on its sufferers and it can also play a big role in socio-economic problems. Many migraines-suffers take a day off from work to recover, and this has a negative impact on the economy. The world health organisation (WHO) reports that it is one of the 5 most disabling disorders in Women (WHO – Stovner et all 2007) and has a greater functional limitation than chronic diabetes, hypertension, osteoarthritis or lower back pain (Solomon 1997).

Follow these 4 steps to treat and manage headaches without medication.

Step 1: Understand how headaches work.

If you want to treat a headache effectively you need to understand how headaches work.

Headaches are classified into:

  • Primary/vascular headaches that include migraine, cluster and tension – type headaches.
  • Secondary/ non vascular headaches include cervicogenic headaches, exercise related headaches and post traumatic headaches (e.g. whiplash injury)

Primary/ Vascular Headaches

Primary or vascular headaches are influenced by the arteries going to the brain. Biochemical changes can cause vaso-dilation and constriction of the arteries in the brain. When there is too much vaso- dilation/swelling in the arteries, it can cause a headache. Symptoms of the vascular headaches presents normally in a very set pattern (Please see the table below). Vascular headaches respond well to medication, because the medication treats the vaso-dilation or restriction.

Secondary/ Non-vascular Headaches

The secondary group of headaches/cervicogenic headaches are caused by a disorder in the neck. Pain can be vague and patients normally have a history of associated neck pain or shoulder pain. Non-vascular Headaches can also get relieve from medication but it only suppress the symptoms for a little while and the root of the problem does dot get fixed, and that is the neck component.

Please see the table below for the specific symptoms of each headache group:

Primary / Vascular HeadachesSecondary / Non-Vascular Headaches
MigraineClusterTension type headacheCervicogenic headache
  • Attacks that last from 4 – 72 hours
  • With or without an aura symptom (sensitivity to light/sound, tingling in fingers)
  • Unilateral pain that may change sides
  • Moderate to severe throbbing pain
  • Nausea with or without vomiting
  • Photo/ Phonophobia (light and sound sensitive)
  • Lasts for only a certain period of time
  • Unilateral pain that may change sides
  • Begins abruptly and builds up quickly
  • Excruciating pain
  • Goosebumps or tearing of the eye.
  • Headaches lasting 30 min to 7 days
  • Pressing, tightening and non-pulsating pain
  • Bilateral, band-like pain
  • Mild to moderate
  • No nausea or vomiting
  • Mild Photo/ Phonophobia (light and sound sensitive)
  • Prevalent in teenagers and adults
  • Bilateral or unilateral dominant headaches – that don’t shift sides
  • Associated with unilateral neck, shoulder or arm pain
  • Headache aggravated by neck muscle tension or bad posture
  • Restricted neck motion or tenderness to the neck muscles
  • A history of a previous whiplash injury


Mostly headache patients presents with symptoms from both types of headaches (namely vascular and non-vascular). In practice it’s rare to see a patient that ONLY gets a migraine. Most patients have symptoms that are a mix picture between a migraine, tension and cervicogenic headaches. So even if you have a migraine, your neck muscles might still play a role in your pain

The diagram below is a good illustration as to where most people’s headaches originates.

Fig 1: An Illustration where most people’s headaches originates.

diagram that shows different types of headaches


So, if you can figure out the cause of the headache, you will treat it much better. If you struggle to understand where your headache come from you should consult your physiotherapist or doctor.


Step 2: Book an appointment at the physio.

Physiotherapists are equipped with skills and knowledge to help you figure out what type of headache you have and where it originates from. When you know the cause, you are half way there to get it better.

Physiotherapy treatment can help immensely for the acute and chronic headache patient. Physiotherapy will focus on sorting out the neck disorder. Research shows, that patients need less medication to manage their headaches if they do regular physiotherapy treatment.

There are certain factors that will contribute to getting a headache. Factors like stress, sitting in front of your computer and driving. We call them triggers. Think about a glass of water. Each “factor/trigger” fills your glass bit by bit and eventually it overflows, and triggers a massive headache/migraine. Physiotherapy helps to empty the glass, thereby helping you to manage your headache without medication.

What can you expect from a physiotherapy session?

At Just Physio we do a thorough evaluation of the neck and jaw. The physiotherapist will start by asking about the history and onset of your headaches, previous trauma and factors that might contribute to the headache. After getting the history, the physiotherapist will do certain tests on the neck and jaw to look for any stiffness and dysfunction in the joints, muscles and nerves. Treatment will focus on mobilization of the cervical joints and jaw, myofascial release of the stiff muscles and neural mobilisation of the cervical nerves.

Physiotherapy can and will make a huge difference in the chronic headaches sufferer’s life! It’s important to understand that physiotherapy is not a quick fix. We recommended that you start by attending a few treatment sessions close to each other. This will help to get the pain under control.

Your physio will then guide you on when to come again for treatment. The idea is to “wean” you off physio, but also to make sure the “glass” does not over flow again.

As your neck pain and posture improves you will only be needing to come in once a month or once every two months for treatment. Every patient is different, therefore a unique treatment program will be worked out according to the specific needs of each patients.

Step 3: Change your posture at work

A study done in 2007 showed that most people can’t maintain a proper posture when they are working, leaving us with stiff neck muscles and joints. A stiff neck can trigger a headache. Change your posture position regularly during your work day and get up every hour to stretch or walk around. 

Please look at the picture below to see how you should set up your workstation.

Fig 2: How to set up your work station.

Correct posture at workstation

Step 4: Do regular exercise

Research shows that regular moderate intensity exercise 3 times a weak can help to decrease stress and increase a general well being (Taylor et all 2002-2005, Bronfort et all 2004). Exercises helps our bodies to release “happy hormones” called endorphins. Endorphins helps to decrease stress and muscle stiffness.

Choose a cadio exercise that you enjoy doing. This will get the blood flow going to help get rid of stress. Address the weak and stiff muscles with a strengthening and stretch program.


Get your FREE exercise program, and start to manage your headaches!

Share this blog and receive your FREE Headache exercise program today. This will be the first tool to help you manage your headache without medication.


By attending physiotherapy, looking at your posture and doing exercises you will be able to manage your headaches without medication! Book now and take the first step in managing your headache without medication.

What are the benefits of attending physiotherapy at JUST PHYSIO?

  • We do a thorough evaluation of your problem. A headache can only be treated effectively if the cause of the problem is known.
  • Treatment will focus on:
    • decreasing pain
    • increasing range of motion of the neck
    • decreasing muscle spasm
  • An individualised exercise program will be given.
  • Posture evaluation and ‘correct posture’ advice will be given

Written By: Adrien Dannhauser (BPhyst, SPT1)

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *