Headache & Migraine Classification

Headaches are an extremely common condition with most people (almost 95%) suffering from some type of head pain at various stages of their life. Recurrent episodes of this pain is known as a headache disorder. It is estimated that around 50% of the general population suffer from some sort of headache disorder (Ahmed, 2012) and 10% of the population suffer from migraine (Hansen and Charles, 2019). Headaches and migraines are complex conditions involving our nervous system, in particular our brainstem. There are a number of different headache disorders that people can suffer from. These include primary headaches like migraine, tension type headache, chronic daily headache and secondary headaches like medication overuse headache.


Types of conditions we treat at VSRC (Please click to expand):

  1. Migraine
    Migraine is a debilitating primary headache disorder, which according to the International Classification of Headache Disorders is characterized by head pain along with a variety of other symptoms. There are two types of migraine – migraine with aura and migraine without aura (Olesen et al., 2018). Migraine will typically affect adult women more than men (3:1), however in childhood this ratio is more evenly spread.
  2. Migraine without aura
    is the more common type of migraine headache. It accounts for about 70% of migraine conditions. Typically, patients will experience pain, which is one sided, throbbing or pulsating, moderate to severe intensity and is associated with 1 or more of the following symptoms: nausea, vomiting, light sensitivity, smell sensitivity, sound sensitivity. These episodes typically last between 4 and 72 hours, however some patients may still experience episodes lasting less than 4 hours and longer than 72 hours depending on severity (Olesen et al., 2018).
  3. Migraine with aura
    is the less common type of migraine affecting about 30% of migraine sufferers. An aura is a reversible disturbance to one or more of the following systems: visual, sensory (our sense of touch), speech/language, motor (our muscle control). Auras typically last a few minutes to an hour, are one sided and accompanied or followed by headache within an hour to be classified as migraine with aura. When headache does not follow an aura, it is termed a silent or visual migraine (Olesen et al., 2018).
  4. Tension type headache (TTH)
    is a very common primary headache affecting around 80% of the population. Patients will often describe a ‘vice like’ pressure or tension around their head. TTH often affects both sides of the head, the forehead and/or the back of the head. They can last from a few minutes to a few weeks and can range from mild to moderate intensity. According to the The International Classification of Headache Disorders (ICHD-3), If the pain is infrequent it often has little impact on a patients life, however if the pain becomes more frequent TTH can be debilitating requiring medical care and intervention with medication (Olesen et al., 2018).

  5. Chronic tension-type headache (CTTH)

    is a headache that evolves from recurrent tension headaches. Chronic TTH typically affects both sides of the head, forehead or back of the head and can be described as a vice like pressure around the head or deep pressure within the head. Pain intensity is usually mild to moderate but in some cases can be severe. CTTH is sometimes associated with nausea, light sensitivity and/or sound sensitivity. It is often relentless, lasting more than 15 days per month for more than 3 months (Olesen et al., 2018). CTTH negatively affects most aspects of a person’s life and will often lead to frequent self medicating with varying medications like NSAIDs and strong analgesics. 

  6. Cervicogenic headache

    is a type of primary headache that is caused by dysfunction in the cervical spine. Cervicogenic headaches can originate from the joints, discs or muscles in our neck, and can often be a combination of these 3 structures (Olesen et al., 2018). Patients will often feel a sense of ‘tightness’ or ‘restriction’ in their neck, have restricted range of movement in their neck or upper back and their headaches will be significantly worsened by manoeuvres, which put pressure on specific neck structures.

    In contrast to tension-type headaches, which present on both sides of the head, cervicogenic headaches often present on one side of the head which generally correlates with the side of neck pain the patient experiences. 

  7. Cluster headache
    is a type of trigeminal autonomic cephalalgia, which is described as severe pain, strictly one sided, behind or around the eye, in the temporal region or a combination of all these sites. Sufferers also experience one or a combination of the following symptoms: nasal congestion, eye watering, eyelid swelling, forehead sweating, pupil constriction and/or eyelid drooping. Patients may also experience a sense of restlessness or distress. Cluster headaches will last between 15-180 minutes and come in clusters which can occur 1-8 times per day for a period of days, weeks and even months. After these ‘clusters’ patients will often experience remission periods lasting months or years. Men are affected 3x more than women for reasons unknown (Olesen et al., 2018). 
  8. Vestibular migraine
     is the term used to describe migraine associated dizziness or vertigo where patients have a past or current history of migraine with or without aura. The vestibular symptoms (dizziness, spontaneous vertigo, positional vertigo, visually induced vertigo, head motion induced dizziness/vertigo) associated with vestibular migraine are often moderate to severe and last between 5 minutes and 72 hours. Patients will often experience a one-sided, pulsating headache with a moderate-severe intensity however this is not always the case, with only half of the episodes that occur associated with head pain. Other symptoms a patient may experience include nausea and/or vomiting and motion sickness (Olesen et al., 2018).
  9. Cervicogenic dizziness
    is dizziness present with associated neck pain. Patients will experience imbalance, unsteadiness, disorientation, neck pain and reduced neck range of movement. It is suggested that cervicogenic dizziness arises from dysfunction of the upper cervical (top of the neck) nerves, particularly C1-3, and their association with our brainstem (Riley et al., 2017).

If you would like to discuss your treatment options or to make an appointment please call the clinic on (03) 9787 7702 or email info@vsrc.com.au. Alternatively you can complete our online questionnaire and we can call you to discuss your responses.


  1. Ahmed, F., 2012. Headache disorders: differentiating and managing the common subtypes. British Journal of Pain, [online] 6(3), pp.124-132. Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590146/> [Accessed 8 February 2021].
  2. Hansen, J. and Charles, A., 2019. Differences in treatment response between migraine with aura and migraine without aura: lessons from clinical practice and RCTs. The Journal of Headache and Pain, [online] 20(1). Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734209/#:~:text=Compared%20with%20migraine%20without%20aura,as%20revealed%20by%20imaging%20studies.> [Accessed 6 February 2021].
  3. Olesen, J., Bendtsen, L., Dodick, D., Ducros, A., Evers, S., First, M., Goadsby, P., Hershey, A., Katsarava, Z., Levin, M., Pascual, J., Russell, M., Schwedt, T., Steiner, T., Tassorelli, C. and Terwindt, G., 2018. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38(1), pp.1-211.
  4. Reiley, A., Vickory, F., Funderburg, S., Cesario, R. and Clendaniel, R., 2017. How to diagnose cervicogenic dizziness. Archives of Physiotherapy, [online] 7(1). Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759906/>.