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Migraine and tension-type headache are among the most frequent diseases of the world. As pharmacological treatment often is associated with distinct side effects, there is an increasing need for non-pharmacological treatment options. However, there has been a striking lack of evidence with regards to the efficacy of the huge variety of non-pharmacological interventions. In this review, we present the available evidence for the most common non-pharmacological treatment options with focus on the national clinical guideline for non-pharmacological treatment of headache disorders published in 2021.

Idiopathic intracranial hypertension (IIH) is a challenging disease characterized by an increase in intracranial pressure which occurs without any known cause. The disease is mainly seen in obese females of child-bearing age. While originally described as rare, the incidence is increasing in parallel with pandemic obesity, and clinicians in all fields are increasingly likely to meet patients with IIH. The condition causes major morbidity due to chronic headache and visual loss if untreated. In the past ten years new diagnostic criteria and guidelines for management have been published.

Spontaneous intracranial hypotension (SIH) is a secondary headache disorder due to leakage of cerebrospinal fluid without a history of dural trauma. If not diagnosed in time, patients may develop invalidating headaches or even life-threatening complications. SIH diagnosis can be challenging as the presentation of the disease may vary significantly. In this case report of a classic course of disease in a 62-year-old woman, we illustrate challenges according to the diagnosis emphasising the importance to consider SIH as a differential diagnosis in cases of orthostatic but also atypical chronic headache.