Dealing with a headache that just won’t go away

The first step is to determine if there are any changes in the symptoms in response to head and neck or jaw movements. This gives us an indication if the neck, jaw or even the sinuses could be playing a role. If a headache is worse with movements or occurs in conjunction with neck pain, it is more likely to be a mechanical condition from the neck muscles/joints.

Headaches that do not respond to movement and those that are worse at night, could be an indication of inflammation – be that simple or sinister.

As a rule of thumb, if your headache is affected by movement, start off by seeing a physiotherapist. If it is not affected by movement, you may need to be referred for an assessment by another health care professional, depending on the details found on your assessment.

Other important considerations are:

• What times of the day the symptoms are better or worse?
• Can you identify a position or activity that affects the intensity?
• If hydration or certain foods may play a role
• If the pain coincides with nausea, visual changes, etc.

Here are 3 basic rules for headaches (and really for most pain):

• Do not hide or ’treat’ the symptoms by taking medication. You’re only fooling yourself.
• If the symptoms haven’t responded within 3 days (to whichever treatment you have chosen), that ‘treatment’ isn’t effective. Consider having an assessment done.
• An x-ray or MRI scan should be reserved for clinical assessment findings that indicate a need for imaging rather than using it as a first-line option.

Your health and physical wellbeing should be a priority deserving of quality care. Make sure to discuss any concerns you may have directly with your preferred physiotherapist, so that you can receive the appropriate guidance for your unique situation.