Headaches: Types, Causes and How Manual Therapy Can Help

Headaches are very common, but frequent or recurring pain is not something you should ignore. Different types of headache have different causes, and the right treatment depends on an accurate assessment. At Costa Health in Riviera del Sol and Marbella, our clinicians use evidence based manual therapy, chiropractic, osteopathy and rehabilitation to help reduce headache pain, improve neck function and lower the risk of future episodes when the spine and muscles are contributing factors.

Why understanding your headache type matters

Many people rely on pain relief medication to cope with headaches. While this can be useful for short term relief, it does not address the reason the headache keeps coming back. Headaches can have several possible causes, ranging from tension in the neck and shoulders to neurological conditions or, less commonly, more serious illness.

Identifying the type of headache and any contributing musculoskeletal factors is the first step towards effective, longer term management. At Costa Health, our clinicians assess your neck, upper back, posture, movement patterns and relevant lifestyle factors to understand what is driving your symptoms and when manual therapy is likely to help.

Quick Tip: Keep a simple headache diary for a couple of weeks, noting the time, duration, triggers, location of pain and any associated symptoms. This information can be very helpful during your assessment.

Common types of headache

Several different headache types can affect the head, face and neck. Below are some of the most common patterns our clinicians see in practice.

Tension headaches

Tension headaches are the most common form of headache. They usually cause a dull, pressing or aching pain, often described as a feeling of tightness or a band around the forehead, or heaviness at the back of the head and neck.

Typical contributing factors include:

Muscle tension in the neck, shoulders and upper back
Poor posture, such as slumping over a laptop or phone
Stress and anxiety
Long hours working at a desk or driving
Jaw tension or clenching

Manual therapy can be helpful for many people with tension headaches because it targets the muscle tightness and joint restrictions that often aggravate symptoms. Treatment may involve gentle joint mobilisation, soft tissue techniques and advice on posture, work set up and stress related muscle tension.

Cervicogenic headaches

A cervicogenic headache is a headache that originates from structures in the neck, such as the joints, discs or muscles. Pain commonly starts in the upper neck and then spreads to one side of the head, often behind the eye, into the temple or towards the forehead.

Common symptoms include:

Neck stiffness or a feeling of restriction
Reduced neck movement, for example difficulty turning the head
Pain triggered or worsened by certain neck positions
Headache that appears after prolonged sitting, driving or computer work

Cervicogenic headaches are often linked to restricted joints, muscle tension, past neck injuries or long term postural strain. A detailed assessment is important to confirm whether the neck is the primary source of pain and to rule out other causes.

Migraines

Migraines are more than just severe headaches. They are a neurological condition that can significantly affect day to day life. Migraine attacks vary from person to person but may include:

Moderate to severe throbbing or pulsating pain, often on one side of the head
Nausea, with or without vomiting
Sensitivity to light, sound or smells
Visual disturbances or aura, such as flashing lights or blurred vision
Fatigue and difficulty concentrating

Manual therapy does not cure migraines, and medical management is often needed. However, when neck dysfunction or muscular tension is one of the triggers, improving neck mobility, reducing muscle tightness and addressing postural strain may help some patients reduce the frequency or intensity of attacks as part of a wider migraine management plan.

Cluster headaches

Cluster headaches are less common but can be extremely painful. They typically occur in clusters or cycles, with repeated attacks over several weeks or months followed by periods with no symptoms.

Typical features include:

Severe, sharp or burning pain around or behind one eye
Red or watery eye on the affected side
Nasal congestion or runny nose on the same side
Restlessness or agitation during attacks, as it can be difficult to stay still

Cluster headaches require medical assessment and are usually managed by a GP or neurologist. Manual therapy is not a primary treatment for this type of headache, but may be considered for coexisting neck or back issues.

When to seek professional help for headaches

While occasional mild headaches are common, you should seek assessment if:

Your headaches are becoming more frequent or more severe
Pain relief medication is no longer effective or you are needing it regularly
You often wake up with a headache
Your headaches are associated with neck pain, stiffness or a recent neck injury
Headaches interfere with your work, sleep, exercise or social life

At Costa Health, our clinicians will first check whether your symptoms are suitable for manual therapy or whether you need referral to your GP or another specialist.

Seek urgent medical help if: you develop a sudden, severe headache that feels different from your usual pattern, or a headache accompanied by one or more of the following: weakness or numbness in the face, arm or leg, difficulty speaking or understanding speech, confusion, loss of consciousness, vision loss, a stiff neck with fever, or headache after a significant head injury. These symptoms can indicate a medical emergency and require immediate attention.

How manual therapy can help headache sufferers

Manual therapy can play an important role in the management of certain headache types, particularly tension and cervicogenic headaches where the neck and upper back are involved. At Costa Health, your clinician will always begin with a thorough consultation to understand your medical history, headache pattern and any relevant imaging or reports you may have.

During your physical assessment, your clinician will typically:

Examine neck and upper back movement and joint mobility
Assess muscle tension and trigger points in the neck, shoulders and jaw
Check posture, especially how you sit and stand during work or daily activities
Screen for neurological signs or red flags that require medical referral

If manual therapy is appropriate, your personalised treatment plan may include:

Joint mobilisation or manipulation to help restore comfortable movement
Chiropractic adjustments where clinically indicated and with your informed consent
Soft tissue techniques, such as massage or myofascial release, to ease muscle tension
Individual rehabilitation exercises to support strength and mobility
Postural assessment and ergonomic advice for your work and home set up
Education on managing triggers, pacing activity and using self care strategies between sessions

Quick Tip: Adjust your screen so the top is at or just below eye level, keep your feet flat on the floor and take a short standing or walking break every 30 to 45 minutes to reduce neck strain that can contribute to headaches.

The aim is not just to ease the current episode, but to address the contributing factors and support you in reducing the likelihood of recurrent headaches where possible.

Why choose Costa Health for headache assessment?

Costa Health is a multidisciplinary clinic with locations in Riviera del Sol and Marbella, serving English speaking residents and expats along the Costa del Sol. Our team brings together Doctors, chiropractic, osteopathy, physiotherapy, sports massage and rehabilitation so that you can receive coordinated care in one place.

For patients with headaches, this means:

A thorough initial assessment to identify whether your headache is likely to be musculoskeletal in origin
Evidence based manual therapy tailored to your specific presentation
Clear communication with you about expected benefits and any limitations of treatment
Collaboration with your GP or specialist if further medical investigation is needed
Practical advice on posture, exercise and lifestyle to support long term management

If you are living with recurring headaches, you do not have to rely on short term relief alone. A structured assessment can help clarify the type of headache you have, the role that your neck and posture may be playing, and which treatment options are most appropriate for you.

Next steps

If headaches are affecting your daily life, consider booking a comprehensive assessment at Costa Health. Our clinicians will listen to your concerns, carry out a detailed examination and advise you on whether manual therapy is suitable or whether further medical opinion is recommended. From there, we can work with you to create a plan aimed at reducing pain, improving function and helping you feel more in control of your symptoms.

Frequently Asked Questions

Can manual therapy cure my headaches?

Manual therapy cannot guarantee a cure for headaches, as there are many possible causes. However, for tension type and cervicogenic headaches that are related to neck and upper back problems, manual therapy can often help reduce pain, improve movement and decrease how often headaches occur. Your clinician will assess whether your symptoms are likely to respond before starting treatment.

How many sessions will I need?

The number of sessions varies from person to person. Some patients notice improvement within a few treatments, while others with longer standing or more complex problems may need a longer course of care. After your assessment, your clinician will discuss a realistic treatment plan with you, including how often they recommend you attend and how to monitor progress.

Is manual therapy safe for headaches?

Manual therapy is generally considered safe when carried out by a suitably trained and registered clinician who has taken a full history and performed an appropriate examination. At Costa Health we screen for warning signs that suggest you should see a doctor instead, and we only recommend techniques that are appropriate for your age, health and specific condition. Your clinician will explain any proposed treatment and obtain your consent before proceeding.

Should I see my GP before coming to Costa Health?

You do not always need to see your GP before visiting Costa Health, although it is sensible to do so if your headaches are new, very severe or different from your usual pattern. If during your assessment we feel that medical tests or a specialist opinion are needed, we will advise you to contact your GP and can provide a summary of our findings if helpful. We do have a pain management doctor that you be referred to for further assessment if we feel appropriate.

Can lifestyle changes really make a difference to my headaches?

Yes, for many people, lifestyle plays a significant role in headache patterns. Factors such as posture, sleep, hydration, stress, screen time and work set up can all contribute. Alongside hands on treatment, your clinician will help you identify which factors are relevant in your case and suggest practical changes you can make to support your recovery and reduce the likelihood of recurrent headaches.