There are two types of headaches: primary and secondary. Primary headaches have no underlying disease – they are usually caused by excessive nervous system activity, or pain spreading from other parts of the body. Lifestyle factors also play a role. We treat primary headaches. Secondary headaches do have an underlying cause, such as an infection or tumour. Secondary headaches are treated by the NHS.

Facial pain is common and can result from the same causes as headaches. Other causes include jaw and dental problems. The pain can originate from a specific area of the face, or it may come from another part of the head. Poor lifestyle choices can result in facial pain.

Neck pain is not uncommon. It most commonly arises from musculoskeletal issues. This can result in a more serious problem especially when there is weakness or numbness in the arms or legs or if there is a sharp shooting pain in the arms, legs or down the spine. Sometimes it can affect your bowel or bladder. It can also arise from rheumatological issues or pressure on the nerves, from a tumour, from trauma, or from infection.

Sometimes pain arising from your neck can cause a headache. We treat pain in the neck arising from arthritis or mechanical issues.  Specialist referrals are made to rheumatologists or spinal surgeons where necessary.

Pain arising from the thoracic spine results in thoracic back pain. The thoracic spine is located at the back of the chest (the thorax), between the shoulder blades. It extends from the bottom of the neck to the start of the lumbar spine (spine in the lower back), roughly at the level of the waist.

Pain in the thoracic spine is common but does not persist for long. The pain is often sharp or stabbing in quality. It is less common than neck or low back pain but is more likely to have a serious cause.

Thoracic back pain can arise from other causes other than spinal pain. Pain arising from the lung, the uppermost part of the gut (the oesophagus), the stomach, the gallbladder and the pancreas can all result in thoracic back pain. Pain can also arise from the ribs or the nerves that run below the ribs and form the shoulder blades. Mental health problems and poor posture can also cause thoracic back pain.

Evidence from studies suggest that between 15-35 per 100 people report having had thoracic back pain at some time.

Back pain is very common and affects 8 out of 10 people at some point during their lives. It can be felt anywhere in the back, but low back pain is the most common area affected. The pain can radiate to other areas such as the legs. There are many different causes of lower back pain, but often the cause is unclear.

Almost 80% of all backaches have no significant pathology and are categorised under non-specific back pain. 5% of back pain are due to disc herniations, 5% have spinal stenosis, 4% a compression fracture and less than 2% of all back pains are caused by infections or spread of cancer. Non-specific back pain can result from back strain which can cause peripheral injury to muscle or ligaments or it can be due to osteoarthritis. Many patients cannot identify the events that may have caused the strain.

You can usually treat back pain by simple remedies like painkillers and gentle exercises. Sometimes a short duration of rest can help. Most back pains resolve in 12 weeks, but it becomes chronic when it persists beyond 12 weeks. The pain can arise from central sensitization in which the initial injury causes longer-lasting state of heightened sensitivity to pain.