Headache That Comes and Goes? The Truth Behind Recurring Headaches

If your headache isn’t constant, but keeps appearing, disappearing, and returning again, you’re not imagining it.

This “on-and-off” pattern is one of the most commonly misunderstood symptoms in clinical practice.

Many patients walk into my clinic saying, “It comes for a few hours, then disappears, then suddenly returns again.”

As a physiotherapist, I can tell you this pattern is often your body’s warning system, not just a random occurrence.

Let’s break this down deeply, with research-backed insights, so you understand why this happens and what your body is trying to tell you.

What Does a “Headache That Comes and Goes” Actually Mean?

An intermittent headache is one that:

• Appears for minutes to hours (sometimes days)
• Reduces or disappears completely
• Returns again under certain triggers

Unlike continuous headaches, these are often linked to trigger-based or mechanical causes, especially involving:

• Neck joints
• Muscles
• Nervous system sensitivity
• Lifestyle habits

In many cases, these headaches are secondary headaches, meaning they are caused by an underlying issue rather than being the primary condition. (Medical News Today)

Headaches That Come and Go Causes

1. Cervicogenic Headache (Neck-Related Headache)

This is one of the most overlooked causes, especially in people working long hours on screens.

A cervicogenic headache originates from the neck but is felt in the head. It may come and go depending on posture or movement. (Cleveland Clinic)

Why it fluctuates:

• Neck position changes throughout the day
• Muscle fatigue builds and releases
• Trigger points activate intermittently

Key signs:

• Pain starts at the base of the skull and travels upward
• One-sided headache
• Worse with neck movement or prolonged sitting

These headaches occur due to dysfunction in cervical joints, muscles, or nerves. (Healthline)

Lesser-known fact: Even mild forward head posture (as little as 2-3 cm) can significantly increase strain on cervical muscles, triggering episodic headaches.

2. Tension-Type Headaches

The most common type worldwide.

These tension headaches come and go based on:

• Stress levels
• Sleep quality
• Muscle tightness

They are often described as:

• A tight band around the head
• Mild to moderate intensity
• Gradually increasing and fading

Triggers include stress, fatigue, and dehydration, which can fluctuate throughout the day. (Health)

3. Migraine

Migraines are naturally cyclical.

They occur in phases:

• Trigger phase
• Attack
• Recovery

This is why they appear to “come and go.”

Common triggers:

• Hormonal changes
• Skipped meals
• Screen exposure
• Lack of sleep

Unlike tension headaches, migraines often include:

• Nausea
• Light sensitivity
• Pulsating pain

4. Posture-Related Headaches

Modern lifestyle = silent trigger.

Poor posture leads to:

• Muscle imbalance
• Reduced blood flow
• Increased inflammatory chemicals

This can activate myofascial trigger points, which cause headaches that fluctuate depending on activity. (Verywell Health)

Example:

• You sit → pain starts
• You move/stretch → pain reduces

That’s why it feels inconsistent.

5. Occipital Neuralgia (Nerve Irritation)

This condition involves irritation of nerves at the back of the head.

Characteristics:

• Sharp, shooting pain
• Comes in sudden bursts
• May disappear completely between episodes

Often triggered by:

• Neck tightness
• Injury
• Poor ergonomics

6. Cervicogenic Dizziness

Sometimes headaches come and go along with dizziness.

This is due to altered communication between:

• Neck joints
• Balance system (inner ear)

Symptoms can last minutes to hours and fluctuate depending on neck position. (Verywell Health)

7. Lifestyle Triggers That Fluctuate Daily

These are subtle but powerful:

• Dehydration
• Irregular meals
• Excess caffeine
• Screen overuse
• Sleep disturbances

Because these factors vary daily, the headache pattern becomes inconsistent.

Why Do These Headaches Feel So Unpredictable?

From a physiotherapy perspective, intermittent headaches are usually:

1. Load-Dependent

Your body tolerates stress up to a point. Once exceeded → pain appears.

2. Trigger-Based

Certain movements or habits activate symptoms.

3. Reversible (Early Stage)

Pain disappears when the trigger is removed.

The Neck–Head Connection

Here’s something many people don’t realize:

The upper cervical spine (C1-C3) shares nerve pathways with the head.

This is why:

• Neck problems = head pain
• Muscle tightness = headache
• Joint restriction = referred pain

This phenomenon is called referred pain, where the source and location of pain differ. (WebMD)

Lesser-Known Causes You Shouldn’t Ignore

1. Jaw (TMJ) Dysfunction

• Teeth clenching → intermittent headaches
• Often worse in the morning

2. Eye Strain

• Screen fatigue → evening headaches

3. Sleep Position

• Poor pillow support → morning headaches

4. Breathing Patterns

• Shallow chest breathing → muscle tension

When Should You Be Concerned?

Most intermittent headaches are benign, but watch for:

• Sudden severe headache (“worst ever”)
• Headache with fever or confusion
• Persistent vomiting
• Weakness or numbness
• Vision loss

These require immediate medical evaluation.

Physiotherapy Approach to Managing These Headaches

Assessment Includes:

• Posture analysis
• Neck mobility testing
• Muscle tightness evaluation
• Trigger point identification

Treatment Strategies

1. Manual Therapy

• Joint mobilization
• Soft tissue release

2. Exercise Therapy

• Deep neck flexor strengthening
• Postural correction

3. Ergonomic Correction

• Screen height
• Sitting posture

4. Neuromuscular Re-education

• Movement retraining

New & Emerging Treatments

Recent research trends highlight:

1. Sensorimotor Training

Improves neck proprioception and reduces recurrent headaches.

2. Pain Neuroscience Education

Helps patients understand triggers and reduce fear-based pain cycles.

3. Dry Needling & Myofascial Release

Effective for trigger-point related headaches.

4. Multimodal Therapy

Combining exercise + manual therapy shows better long-term outcomes than medication alone.

Home Exercises for Headaches That Come and Goes

If your headache keeps coming and going, your goal is not just pain relief, it’s breaking the trigger cycle.

These exercises focus on correcting the neck, posture, and muscle imbalances that commonly cause intermittent headaches.

Do these daily for best results.

1. Chin Tucks (Deep Neck Flexor Activation)

Why it works

Strengthens deep neck stabilizers and reduces strain on overactive muscles (a major cause of cervicogenic headaches).

How to do it

1. Sit or stand upright
2. Look straight ahead
3. Gently pull your chin backward (like making a double chin)
4. Do NOT tilt your head up or down
5. Hold for 5–7 seconds

Reps

• 10 repetitions
• 2–3 sets per day

Common mistakes

• Tilting the head instead of gliding it backward
• Using too much force

You should feel a gentle activation deep in the neck, not strain.

2. Upper Trapezius Stretch

Why it works

Releases tight muscles that commonly refer pain to the head.

How to do it

1. Sit upright
2. Hold the side of your chair with one hand
3. Tilt your head to the opposite side
4. Use your other hand to gently increase the stretch
5. Keep shoulders relaxed

Hold

• 20-30 seconds
• Repeat 3 times each side

You should feel a stretch along the side of your neck.

3. Levator Scapulae Stretch

Why it works

Targets a deep muscle often responsible for pain at the base of the skull.

How to do it

1. Sit upright
2. Turn your head 45° to one side
3. Look down toward your armpit
4. Use your hand to gently pull your head downward

Hold

• 20-30 seconds
• Repeat 3 times each side

This is one of the most effective but underrated headache-relief stretches.

4. Suboccipital Release

Why it works

Relieves tension in small muscles at the base of the skull that trigger headaches.

How to do it

1. Lie on your back
2. Place a tennis ball (or two taped together) under the base of your skull
3. Gently rest your head on it
4. Allow muscles to relax (no pressure pushing)

Duration

• 1-2 minutes

You may feel a “melting” sensation, this is muscle release.

5. Shoulder Blade Squeezes

Why it works

Improves posture and reduces forward head strain.

How to do it

1. Sit or stand upright
2. Pull your shoulder blades back and down
3. Imagine trying to hold a pencil between them
4. Hold without shrugging shoulders

Hold

• 5 seconds

Reps

• 10-15 reps
• 2 sets daily

6. Thoracic Extension

Why it works

A stiff upper back forces your neck to overwork, leading to headaches.

How to do it

1. Sit on a chair with back support
2. Place hands behind your head
3. Gently arch backward over the chair
4. Look slightly upward

Reps

• 10 repetitions
• 1-2 times daily

Movement should come from upper back, not lower back.

7. Neck Rotation Mobility Exercise

Why it works

Improves joint mobility and reduces stiffness-related headaches.

How to do it

1. Sit upright
2. Slowly turn your head to one side
3. Hold 2-3 seconds
4. Return to center
5. Repeat on other side

Reps

• 10 each side

Move slowly, no jerky movements.

8. Eye Relaxation Exercise

Why it works

Reduces eye strain, a hidden trigger for recurring headaches.

How to do it

Follow the 20-20-20 rule:

• Every 20 minutes
• Look 20 feet away
• For 20 seconds

Simple but extremely effective for modern lifestyle headaches.

9. Breathing Reset

Why it works

Reduces muscle tension and nervous system overload.

How to do it

1. Sit comfortably
2. Place one hand on chest, one on abdomen
3. Inhale deeply through nose (belly rises)
4. Exhale slowly through mouth

Reps

• 10 slow breaths
• 2-3 times daily

10. Wall Posture Correction Drill

Why it works

Re-trains proper alignment (key for preventing recurrence).

How to do it

1. Stand against a wall
2. Keep:
   • Head
   • Shoulders
   • Buttocks touching the wall
3. Slightly tuck chin
4. Hold position

Duration

• 30-60 seconds
• Repeat 2-3 times

Daily Routine Plan

Morning (5-7 min):

• Chin tucks
• Neck stretches

During Work:

• Eye exercise
• Shoulder blade squeezes

Evening (10 min):

• Suboccipital release
• Thoracic extension
• Breathing exercise

Clinical Insight

Most people only stretch when they feel pain.

But the real solution is: Consistency, not intensity

These headaches come and go because your triggers come and go.

Fix the trigger → you fix the pattern.

Red Flags

Stop and consult a professional if you feel:

• Sharp or shooting pain
• Dizziness worsening
• Numbness or tingling
• Vision changes

Myth vs Reality

Myth: “If it comes and goes, it’s nothing serious.”
Reality: It often indicates an early-stage dysfunction, best time to treat.

Final Word

A headache that comes and goes is your body’s warning signal, not a mystery.

Most of the time, it reflects:

• Neck dysfunction
• Postural stress
• Lifestyle imbalance

The good news?

These are highly treatable with physiotherapy, especially when addressed early.

Frequently Asked Questions

1. Why does my headache come and go throughout the day?
It is usually due to posture, stress, or neck strain that changes during daily activities.

2. Is an intermittent headache serious?
Most are not serious, but frequent or worsening headaches should be evaluated.

3. Can neck problems cause headaches?
Yes, cervicogenic headaches originate from the neck and are very common.

4. How do I know if my headache is from posture?
If it worsens with sitting and improves with movement, posture is likely the cause.

5. Can dehydration cause headaches that come and go?
Yes, fluctuating hydration levels can trigger intermittent headaches.

6. What is the best exercise for these headaches?
Chin tucks and neck stretches are highly effective.

7. When should I worry about my headache?
If it is sudden, severe, or associated with neurological symptoms.

8. Can physiotherapy permanently cure these headaches?
In many cases, yes—especially when caused by posture or neck dysfunction.

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Medical Disclaimer!

This article has been reviewed and written under the guidance of our Head Physiotherapist, Dr. Kruti Raj (PT, MUHS,CPT,CMPT). The information shared is intended for educational purposes only and should not be considered a substitute for personalized medical advice, diagnosis, or treatment.

Please consult us or any other qualified healthcare professional before beginning any exercise program, especially if you are experiencing pain, recovering from injury, or managing a medical condition.