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Headaches and Dizziness

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This article is currently under review and may not be up to date. Please come back soon to see the finished work! (26/08/2026)

Original Editor - Jess Bell Top Contributors - Jess Bell, Kim Jackson, Lucinda hampton, Vidya Acharya, Nupur Smit Shah and Maryellen Tighe, PT, DPT

Introduction

Headaches and dizziness have numerous causes, and there are many different types. This page explores some of the key types of headaches and causes of dizziness that may be encountered in clinical practice. It also highlights red flags and other signs/symptoms which warrant referral.

Headache Classification

Headaches are grouped into three main areas:[1]

  • Primary headaches
  • Secondary headaches
  • Neuropathies, facial pain and other headaches

Primary Headache

Primary headaches are the most common headache type.[2] These headaches include migraines, tension type headaches, trigeminal autonomic cephalgias, and other primary headache disorders.[3][1] They are not caused by other anatomical or physiological abnormalities, and they are not related to inflammation or infections.[2]

Migraine

Migraine is a recurrent headache disorder affecting around 15% of the global population, with peak prevalence between ages 22 and 55 years.[4] It typically begins in childhood (approximately 10% of children are affected) to early adulthood, though onset can occur later in perimenopausal/menopausal women.[3][5] [6] Women are affected three times more than men,[4] and migraine tends to run in families.[4][7] Migraines have a significant personal and economic impact and are one of the top causes of disability worldwide.[1][8]

Migraines are characterised as recurrent episodes of moderate to severe headache. They are typically unilateral and pulsating in quality. They are aggravated by, or cause avoidance of, physical activity and last 4-72 hours.[9] They are commonly accompanied by nausea, vomiting, photophobia and phonophobia. In some cases, a headache occurs with no warning signs and resolves with sleep.[4] However, patients may experience a prodromal phase before onset, with symptoms such as fatigue, euphoria, depression, irritability, food cravings, constipation, neck stiffness, increased yawning, and/or abnormal sensitivity to light, sound, and smell.[4] Migraines can occur with or without aura.[1] An aura refers to a sensory or neurological symptom (visual, sensory, speech) that occurs before the migraine starts. Each symptom typically lasts no longer than an hour.[1]

In children, migraines typically present as bilateral frontal-temporal headaches rather than the unilateral pattern seen in adults. Headaches in the occipital region have been considered a red flag in children,[3] though recent research has questioned this.[10][11]

Tension Type Headaches

Tension type headaches (TTH) are the most prevalent of primary headaches in the general population.[12] There are four types of TTH: infrequent, frequent, chronic, and probable. The lifetime prevalence of TTH ranges from 30-78%.[1][13] TTH are more common in women.[3]

TTH are recurrent episodes of headaches that may last 30 minutes to 7 days.[9] They are typically bilateral and are characterised by a pressing or tightening pain that is non-pulsating in nature and mild to moderate intensity. They are not aggravated by routine physical activity. Nausea and vomiting are absent, and photophobia OR phonophobia may be present (never both).[9]

TTH are often associated with pericranial muscle tenderness, but the pathogenesis likely involves both central and peripheral mechanisms.[14][15]

Trigeminal Autonomic Cephalalgias

Trigeminal autonomic cephalalgias (TAC) are primary headaches characterised by severe unilateral pain in the trigeminal distribution, accompanied by ipsilateral cranial autonomic symptoms, such as lacrimation (eye watering), ptosis (droopy eyelids), and nasal congestion. These headaches are typically of short duration.[1][3]

There are five types of TACs: cluster headaches, paroxysmal hemicranias, short-lasting unilateral neuralgiform headache attacks (either with conjunctival injection and tearing (SUNCT) or cranial autonomic symptoms (SUNA)), hemicrania continua, and probable TAC. Cluster headache is the most common; the other four types are relatively rare.[1]

Cluster Headaches

Cluster headaches are characterised by severe unilateral pain, typically orbital or periorbital (behind or around the eye), lasting 15 minutes to 3 hours. They are associated with ipsilateral autonomic symptoms, including lacrimation and nasal congestion. These attacks often cause marked restlessness and agitation and, due to their severity, can have a major impact on quality of life.[16][17]

Episodes occur in clusters lasting from weeks to months, or sometimes over a year.[3] The cause is unknown, but it is thought to involve coordinated, abnormal activity in the hypothalamus, the trigeminovascular system, and the autonomic nervous system. The hypothalamus appears to play a major role in initiating episodes, while the attacks themselves likely require involvement of the peripheral nervous system.[17]

New Daily Persistent Headache

New daily persistent headache (NDPH) is a rare primary headache.[18] It typically occurs in patients who have no previous history of headache.[1] To be classified as NDPH, the headache must be daily and unremitting from onset and persist for more than 3 months. A key diagnostic feature is that patients can clearly recall the specific date their headache began.[1]

The pathogenesis of this condition is not well understood, though proposed mechanisms include persistent neuroinflammation, abnormal glial activation, and dysfunction of pain modulation pathways. Some cases may be triggered by infection, emotional stress or other physiological and psychological precipitating events.[1][18]

Primary Exercise Headache

Primary exercise headache (PEH) is a primary headache disorder that occurs during or after sustained, strenuous physical exercise with no underlying intracranial disorder.[1][19] The prevalence of PEH varies across studies, but it is relatively rare compared to other headaches.[19] PEH can occur in hot weather or at altitude, and typically follows sustained, strenuous, endurance-focused exercise.[1]

The headache is generally bilateral, pulsating or throbbing in quality and lasts up to 48 hours.[19] Due to its throbbing nature and association with exercise, PEH symptoms can appear similar to more serious conditions. Thus, it is essential to exclude secondary causes on first presentation (e.g., subarachnoid haemorrhage, arterial dissection and reversible cerebral vasoconstriction syndrome).[1]

The underlying pathophysiology is not fully understood, though dysregulated cerebrovasculature may be involved.[19] Symptoms typically resolve when the specific exertion stops or is avoided.[3][1]

Secondary Headache

Secondary headaches are caused by another factor. Causes include trauma (head or neck), vascular disorders, non-vascular intracranial disorders, substance use or withdrawal, infection, disorder of homeostasis, structural disorders, and psychiatric disorders.[1] The following sections cover some types of secondary headache.

Sleep Apnoea Headache

Sleep apnoea headaches are present on awakening.[1] However, morning headaches can also be caused by other serious conditions, including intracranial neoplasm or severe hypertension, making differential diagnosis important.[3]

To diagnose sleep apnoea headache, the patient must have confirmed sleep apnoea (apnoea-hypopnoea index ≥5) and the headache must have a temporal relationship with the onset of sleep apnoea. The headache is typically bilateral, is described as pressing, resolves spontaneously within 4 hours of waking, and often occurs on more than 15 days per month.[1][20]

The underlying mechanism causing sleep apnoea headaches is not fully understood, but it may involve hypoxia and hypercapnia from repeated breathing interruptions.[20][21]

External Compression Headache

This type of secondary headache has not been studied extensively.[22] It is caused by the sustained compression of, or traction on, pericranial soft tissues[1] (e.g. due to wearing tight goggles, face masks, helmets, sweatbands, tight hats for a prolonged period of time[3]). Pain is worse in the area where the pressure is applied and typically resolves within an hour after the pressure/compression is removed.[22]

Headache Attributed to Head or Neck Trauma

New headaches that occur for the first time after a head and/or neck trauma are categorised as secondary headaches caused by trauma. They are one of the most common types of secondary headache.[1]

Headaches attributed to head or neck trauma tend to resemble TTH or migraine, so diagnosis depends on the temporal relationship between the trauma and the onset of headache. Headaches must have developed within 7 days of the trauma/injury; or within 7 days of regaining consciousness; and/or within 7 days of recovering the ability to sense and report pain.[1]

Medication Overuse Headache

In medication overuse headaches, patients have a pre-existing primary headache, but develop a new headache, or worsening of their existing headache, as a result of regular overuse of medication (on 10 or more or 15 or more days/month, depending on the medication) for more than three months. This type of headache typically resolves when the person is no longer overusing medication.[1]

Headache Related to Substance Use or Withdrawal

Headaches can also be related to substance exposure (e.g. alcohol, drugs, toxic substances) or withdrawal. There is a temporal relationship between the exposure/withdrawal of the substance and headache onset.[1]

Serious Pathologies in Headache

Cerebrovascular Accidents

Headache may accompany cerebrovascular accidents. Different types of CVA cause different headaches. In ischaemic strokes, headaches may be mild to moderate in intensity and ipsilateral or bilateral. Subarachnoid haemorrhage typically causes a sudden-onset, severe thunderclap headache—this is a medical emergency.[23]

Hypertension

Headaches attributed to arterial hypertension are often bilateral and pulsating in nature. They tend to occur during an acute rise in blood pressure (BP): systolic BP ≥180 mm Hg and diastolic BP ≥120 mm Hg. Headache onset is linked to the onset/worsening of hypertension.

Neoplasm

Headaches caused by intracranial neoplasm will have at least one of the following features:[1]

  • progressive in nature
  • worse in the morning and/or when lying down
  • worsened/aggravated by Valsalva-like manoeuvres
  • accompanied by nausea and/or vomiting

Headache is not usually the only symptom associated with an intracranial tumour (isolated headaches only occur in 2-16% of patients); there will usually be other symptoms such as neurological deficits and seizures.[1]

Giant Cell Arteritis

Giant cell arteritis (GCA, temporal arteritis) is the most common type of vasculitis in people aged over 50 years, with a higher incidence in the northern hemisphere, particularly Scandinavia.[24] Common presenting features include new onset headache, jaw claudication and cutaneous allodynia. Left untreated, GCA can lead to vision loss. These symptoms, therefore, require immediate referral.[24]

Takayasu Arteritis

Takayasu arteritis is a rare type of vasculitis that can also cause headache.[25] It can cause blockage or narrowing of the artery (stenosis) or an abnormality or dilation of an artery (e.g., aneurysm). It can also lead to arm and chest pain, high blood pressure, and eventually lead to heart failure or stroke.[3]

Red Flags Associated with Headaches

The SNNOOP10 list is an evidence-based red flag detection tool for secondary headaches. When accompanying secondary headache, the following symptoms are considered red flags:[26]

  • S - Systemic symptoms (fever, weight loss)
  • N - Neoplasm in a patient's history
  • N - Neurological deficit or dysfunction, including decreased consciousness
  • O - Onset of headache is sudden (thunderclap headache)
  • O - Older age (new onset after age 50)
  • P - Pattern change (or recent onset of new headache)
  • P - Positional headache
  • P - Precipitated by cough, sneeze, exertion/exercise
  • P - Papilloedema (swelling of the optic disc)
  • P - Progressive headache and atypical presentation
  • P - Pregnancy or 6-8 weeks postpartum (puerperium)
  • P - Painful eye with autonomic features
  • P - Post-traumatic onset
  • P - Pathology of the immune system (HIV, immunosuppression)
  • P - Painkiller (medication) overuse or new medication coinciding with the onset of headache

Specific Considerations When Assessing the Cervical Spine

When assessing patients with cervical spine dysfunction and headache, it is essential to screen for serious pathology, particularly signs of vertebrobasilar insufficiency (VBI), defined as inadequate blood flow through the posterior circulation of the brain.[27]

Vascular screening: Assess for the 5 Ds (dizziness, diplopia, dysarthria, dysphagia, drop attacks), vertigo, and syncope.[3]

Risk factors for cervical instability: Determine whether there is a history of rheumatoid arthritis or other inflammatory arthritis, which can cause attenuation of the transverse ligament and atlantoaxial instability.[3] In children, ask about recent upper respiratory tract infection, as pharyngeal infections can, in rare cases, lead to atlantoaxial instability (Grisel's syndrome).[28]

Neurological warning signs: Screen for bilateral or widespread neurological symptoms and cranial nerve signs such as dysphasia, dysarthria, visual deficits, or diplopia, which may indicate brainstem ischaemia or other serious pathology.[3]

Headache characteristics: Ask what triggers or worsens the headaches, when they occur, whether they are worse in the morning, whether they change with position (lying down, sitting up), and whether coughing, straining, or Valsalva manoeuvres affect the pain (which may indicate raised intracranial pressure).[3]

Dizziness

Dizziness is a common presentation with numerous causes, including infections, psychological factors, upper cervical spine dysfunction, and disorders of the vestibular system (peripheral or central origin).[3]

Differentiating Vestibular Presentations

Vertigo describes an illusion of motion (spinning, tilting, or swaying sensation), typically indicating vestibular system involvement. Other dizziness presentations may include lightheadedness (often vascular/presyncope), visual motion sensitivity, or imbalance without spinning sensation.[29]

Screening for Vascular Causes of Dizziness

When assessing patients with head and neck pain and dizziness, it is essential to screen for cervical arterial dysfunction, which includes vertebral artery dissection and vertebrobasilar insufficiency.[30] The classic warning signs requiring immediate medical referral include the 5 Ds: diplopia, dizziness, drop attacks, dysarthria, and dysphagia. Additional concerning symptoms include ataxia, and the 3 Ns: nausea, numbness, and nystagmus.[31] Vertebral artery positional testing (sustained cervical extension and rotation while monitoring for symptoms) is often used to help differentiate vascular from vestibular causes of dizziness, but it has significant limitations. If vascular pathology is suspected based on symptoms or positive testing, immediate medical referral is required.

[32]

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common peripheral vestibular disorder.[33] It presents as brief episodes of vertigo (<1 minute) that are triggered by position changes. Symptoms are caused by displaced otoconia in the semicircular canals. The Dix-Hallpike manoeuvre is used to screen for posterior canal BPPV, though a negative result cannot rule out BPPV. The supine roll test assesses horizontal canal involvement.[3]

[34]

[35]

Physical Therapy Management

It is the most commonly used non-pharmacologic treatment of TTH[36]. Cervical exercises, relaxation, massage, postural exercises, cranio-cervical techniques, thermotherapy, vertebral mobilization and stretching are effective in reducing TTH symptoms such as pain frequency and intensity. In the studies that have applied joint mobilization, cervical range of motion has improved. Other parameters such as quality of life, impact and pain disability and psychological aspects have improved with MT[37].

Various treatment options are available for treating headaches; however, since the clinical effectiveness is unclear, a Delphi study[2] was conducted to obtain consensus on physiotherapy treatment for tension-type headaches, migraine, and cervicogenic headaches. The study concluded that:

  • Active mobilisation exercises, upper cervical spine mobilisations, passive mobilisation with movement (MWM), work-related ergonomic training, and active MWM can be used to treat cervicogenic headaches and
  • Life-style advice, manual trigger point techniques, and work-related ergonomic training for migraine and tension-type headaches[2].


Physical therapy interventions have the largest effect on Migraines and Cervicogenic Headaches:

Cervicogenic - helpful Largest effect from PT treatment

Spinal manipulations in Soft Tissues – C/S and T/S is beneficial. [9][18]

Effectively conducted mobilisations have the same effect as manipulations. [9]

Cervicogenic - unhelpful No benefit of other Manual Therapy - massage, dry needling, mobilisations.

Limited evidence of exercises – however there is good effect of combinations of manual therapy and exercise. [18][38]

Migraines - Helpful Physical Therapy treatment is especially effective with migraines

Low–Moderate evidence that aerobic exercises have a benefit. [4][39][40]

Higher quality evidence favors exercises - type/duration/intensity unspecified. [3]

Manual therapy is beneficial with migraines. [41]

Tension Type Headaches -Helpful Manual Therapy has a moderate effect on soft tissues, Manipulation has no benefit. Soft tissue therapy and dry needling is beneficial on pain intensity and frequency. [42][43][44]


CBT has some evidence on impact on headaches, not intensity or frequency| perception of headache affected by CBT. [45]

Aerobic exercises have an impact on capacity, not pain - increased capacity, but didn’t change pain, frequency, intensity. [4][3]

Psychological and aerobic – teach the patient how to live with the headache. [4]

Tension Type Headaches - Unhelpful Strength training had no benefit compared to posture correction, neither technique was beneficial either. [46]

Summary

There are many different types of headaches and dizziness, which can be encountered in clinical practice. Some signs require urgent referral, and should always be considered when assessing a patient who has head or neck pain and dizziness.

Resources

The International Headache Classification (ICHD-2)

WHO Factsheet on Headache Disorders

AHS Guidelines and Position Statements



References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018; 38(1): 1-211. 
  2. ↑ 2.0 2.1 2.2 2.3 Manzoni GC, Stovner LJ. Epidemiology of headache. Handb Clin Neurol. 2010;97:3-22.  Cite error: Invalid <ref> tag; name ":1" defined multiple times with different content
  3. ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 Dent D. Headaches and Dizziness Course. Plus. 2020. Cite error: Invalid <ref> tag; name ":2" defined multiple times with different content
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Burstein R, Noseda R, Borsook D. Migraine: multiple processes, complex pathophysiology. J Neurosci. 2015;35(17):6619-6629. Cite error: Invalid <ref> tag; name ":3" defined multiple times with different content
  5. ↑ Ornello R, De Matteis E, Di Felice C, Caponnetto V, Pistoia F, Sacco S. Acute and preventive management of migraine during menstruation and menopause. J Clin Med. 2021 May 24;10(11):2263.
  6. ↑ Rao R, Hershey AD. An update on acute and preventive treatments for migraine in children and adolescents. Expert Review of Neurotherapeutics. 2020. Published online.
  7. ↑ Bron C, Sutherland HG, Griffiths LR. Exploring the hereditary nature of migraine. Neuropsychiatr Dis Treat. 2021 Apr 22;17:1183-94.
  8. ↑ Dong L, Dong W, Jin Y, Jiang Y, Li Z, Yu D. The global burden of migraine: a 30-Year trend review and future projections by age, sex, country, and region. Pain Ther. 2025 Feb;14(1):297-315.
  9. ↑ 9.0 9.1 9.2 9.3 9.4 GBD 2023 Headache Collaborators. Global, regional, and national burden of headache disorders, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet Neurol. 2025 Dec;24(12):1005-1015. Cite error: Invalid <ref> tag; name ":4" defined multiple times with different content
  10. ↑ Genizi J, Khourieh-Matar A, Assaf N, Chistyakov I, Srugo I. Occipital Headaches in Children: Are They a Red Flag?. J Child Neurol. 2017;32(11):942-946.
  11. ↑ Conti R, Marta G, Wijers L, Barbi E, Poropat F. Red flags presented in children complaining of headache in paediatric emergency department. Children (Basel). 2023 Feb 13;10(2):366.
  12. ↑ Jensen RH. Tension-Type Headache - The Normal and Most Prevalent Headache. Headache. 2018;58(2):339-345.
  13. ↑ Bentivegna E, Luciani M, Paragliola V, Baldari F, Lamberti PA, Conforti G, et al. Recent advancements in tension-type headache: a narrative review. Expert Rev Neurother. 2021 Jul;21(7):793-803.
  14. ↑ Lee HJ, Cho SJ, Seo JG, Schytz HW. Update on Tension-type Headache. Headache Pain Res. 2025;26(1):38-47.
  15. ↑ Zhou J, Cheng S, Yang H, Lan L, Chen Y, Xu G, et al. The brain structure and function alterations in tension-type headache: A protocol for systematic review and meta analysis. Medicine (Baltimore). 2020 Jun 12;99(24):e20411.
  16. ↑ Russell MB. Epidemiology and genetics of cluster headache. Lancet Neurol. 2004;3(5):279-283.
  17. ↑ 17.0 17.1 Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17(1):75-83.
  18. ↑ 18.0 18.1 18.2 18.3 Chen T, Pei X, Bai X, Zhang X, Zhao Y, Lin C, et al. Abnormal brain iron deposition in patients with new daily persistent headache: a prospective quantitative susceptibility mapping study. J Headache Pain. 2025 Nov 5;26(1):239. Cite error: Invalid <ref> tag; name ":5" defined multiple times with different content
  19. ↑ 19.0 19.1 19.2 19.3 Upadhyaya P, Nandyala A, Ailani J. Primary Exercise Headache. Curr Neurol Neurosci Rep. 2020;20(5):9.
  20. ↑ 20.0 20.1 Sunbul EA, Karacı R, Karabulut EGT, Güleç H, Domaç FM. Polysomnographic and clinical characteristics of sleep apnea headache patients. Sleep Breath. 2024 Dec;28(6):2591-2596.
  21. ↑ Hong Y, Kang MK, Kim MS, Mo H, Cox RC, Im HJ. Morning headaches: an in-depth review of causes, associated disorders, and management strategies. Headache Pain Res. 2025;26(1):66-79.
  22. ↑ 22.0 22.1 Hensel O, Kraya T. Primary headache attributed to external compression or traction to the head: a narrative review. Brain Behav. 2025 Jan;15(1):e70202.
  23. ↑ Lu J, Liu W, Zhao H. Headache in cerebrovascular diseases. Stroke Vasc Neurol. 2020 Jun;5(2):205-210.
  24. ↑ 24.0 24.1 Bilton EJ, Mollan SP. Giant cell arteritis: reviewing the advancing diagnostics and management. Eye (Lond). 2023 Aug;37(12):2365-2373.
  25. ↑ Li-xin Z, Jun N, Shan G, Bin P, Li-ying C. Neurological manifestations of Takayasu arteritis. Chin Med Sci J. 2011;26(4):227-230. 
  26. ↑ Do TP, Remmers A, Schytz HW, Schankin C, Nelson SE, Obermann M, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology. 2019 Jan 15;92(3):134-144.
  27. ↑ Pirau L, Lui F. Vertebrobasilar Insufficiency. [Updated 2020 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482259/
  28. ↑ Osiro S, Tiwari KJ, Matusz P, Gielecki J, Tubbs RS, Loukas M. Grisel’s syndrome: a comprehensive review with focus on pathogenesis, natural history, and current treatment options. Childs Nerv Syst. 2012 Jun;28(6):821-5.
  29. ↑ Dy JS, Freeman AM. Vertigo in Clinical Practice: Evidence-Based Diagnosis and Treatment. [Updated 2025 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482356/
  30. ↑ Rushton A, Carlesso LC, Flynn T, Hing WA, Rubinstein SM, Vogel S, Kerry R. International framework for examination of the cervical region for potential of vascular pathologies of the neck prior to musculoskeletal intervention: International IFOMPT cervical framework. J Orthop Sports Phys Ther. 2023 Jan;53(1):7-22. Erratum in: J Orthop Sports Phys Ther. 2023 Jun;53(6):372-374.
  31. ↑ Myers BJ, Davey D, Cook CE. Factors associated with cervical arterial dysfunction: a survey of physical therapist educators in the United States. J Man Manip Ther. 2021 Feb;29(1):33-39.
  32. ↑ TSPT Blog. Vertebral Artery Test. Available from: https://www.youtube.com/watch?time_continue=16&v=sxXZzUomTuQ&feature=emb_logo [last accessed 07/09/2020]
  33. ↑ Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003;169(7):681-693.
  34. ↑ BMJ Learning. Vertigo - Dix-Hallpike Manoeuvre from BMJ Learning. Available from https://www.youtube.com/watch?v=8RYB2QlO1N4 [last accessed 07/09/2020]
  35. ↑ EducatedPT. Supine Roll Test for Horizontal Canal BPPV. Available from https://www.youtube.com/watch?v=ns8XZ4rKiJc [last accessed 07/09/2020]
  36. ↑ Chowdhury D. Tension type headache. Annals of Indian Academy of Neurology. 2012 Aug 1;15(Suppl 1):S83-8.
  37. ↑ Espí-López GV, Arnal-Gómez A, Arbós-Berenguer T, González ÁA, Vicente-Herrero T. Effectiveness of physical therapy in patients with tension-type headache: literature review. Journal of the Japanese Physical Therapy Association. 2014;17(1):31-8.
  38. ↑ Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, Emberson J, Marschner I, Richardson C. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine, 2002:27(17):1835-1843.
  39. ↑ Touche R.L, Fernández Pérez J.J, Acosta A.P, Campodónico L.G, García S.M, Juárez D.A, García B.S, Angulo-Díaz-Parreño S, Cuenca-Martínez F, Luis Suso-Martí, Paris-Alemany A. Is aerobic exercise helpful in patients with migraine? A systematic review and meta-analysis. Scandinavian Journal of Medical Science & Sports. 2020:30:965–982.
  40. ↑ Lemmens J, De Pauw J, Van Soom T, Michiels S, Versijpt J, Van Breda E, Castien R, De Hertogh W. The effect of aerobic exercise on the number of migraine days, duration and pain intensity in migraine: a systematic literature review and meta-analysis. The journal of headache and pain. 2019: 20(1):1-9.
  41. ↑ Chaibi A, Tuchin P.J, Russell M.B. Manual therapies for migraine: a systematic review. The journal of headache and pain. 2011:12(2):127-133.
  42. ↑ Kamonseki D.H, Lopes E.P, van der Meer H.A, Calixtre L.B. Effectiveness of manual therapy in patients with tension-type headache. A systematic review and meta-analysis. Disability and Rehabilitation. 2022:44(10):1780-1789.
  43. ↑ Ferragut-Garcias A, Plaza-Manzano G, Rodriguez-Blanco C, Velasco-Roldan O, Pecos-Martin D, Oliva-Pascual-Vaca J, Llabres-Bennasar B, Oliva-Pascual-Vaca A. Effectiveness of a Treatment Involving Soft Tissue Techniques and/or Neural Mobilization Techniques in the Management of Tension-Type Headache: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation. 2017:98:211-219.
  44. ↑ Pourahmadi M, Dommerholt J, Fernández-de-Las-Peñas C, Koes B.W, Mohseni-Bandpei M.A, Mansournia M.A, Delavari S, Keshtkar A, Bahramian M. Dry needling for the treatment of tension-type, cervicogenic, or migraine headaches: a systematic review and meta-analysis. Physical Therapy. 2021:1-31.
  45. ↑ Martin P.R, Aiello R, Gilson K, Meadows G, Milgrom J, Reece J. Cognitive behavior therapy for comorbid migraine and/or tension type headache and major depressive disorder: An exploratory randomized controlled trial. Behaviour Research and Therapy. 2015:73:8-18.
  46. ↑ Madsen BK, Søgaard K, Andersen LL, Tornøe B, Jensen RH. Efficacy of strength training on tension-type headache: A randomised controlled study. Cephalalgia. 2018 May;38(6):1071-80..
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