Shirahśūla literally means pain (shūla) in the head (śirah). Ayurveda classifies headaches under Shiroroga, often due to Vata, Pitta, or Kapha imbalance, or a combination. Modern science correlates it with tension-type headaches, migraines, sinus headaches, and cluster headaches.

“शिरोरोगा बहवो दोषैः कृताः शिरसि जायते ।”
(सुश्रुत संहिता, ऊत्तरतन्त्र २५/३)

Ayurveda identifies multiple causes for Shirahśūla including diet, lifestyle, seasonal factors, emotional stress, and systemic disorders. Depending on the dosha predominance, the pain may present as throbbing, piercing, heavy, dull, or burning. Classical texts like Charaka, Sushruta, Ashtanga Hridaya, Madhava Nidana, and Bhavaprakasha describe Shiroroga in detail.

• Ati-śīta, guru, abhishyandi āhāra (cold, heavy, sticky foods)
• Ati-teekshṇa, katu, amla, lavana (excess pungent, sour, salty foods) → Pitta aggravation
• Viruddhāhāra (incompatible food like milk + fish)
• Atimadhura & excessive alcohol, fermented foods

• Ati-vyayāma (excessive exertion)
• Rātri-jāgaraṇa (night vigil)
• Diwasvapna (day-sleep)
• Exposure to sun, dust, wind, pollution
• Mānasa hetu — stress, grief, anger, anxiety

Nidāna sevana → Doṣha aggravation (Vata = pricking, shifting pain; Pitta = burning, throbbing; Kapha = heaviness, dull ache). Vitiated dosha localizes in shirah (head region) causing srotorodha and vāta prakopa leading to pain.

“वातपित्तकफैः क्लिष्टं शिरः शूलं करोति हि ।”
(भवप्रकाश निघण्टु, शिरोरोगाधिकार)

Diagnosis is based on dosha predominance and symptom profile. Ayurveda examines Nadi, Jihva, Drik and Shabda. Modern investigations: Blood pressure, sinus X-ray, MRI/CT brain for secondary causes.

• Heaviness in head
• Dizziness
• Nasal congestion
• Eye strain

• Throbbing headache
• Heaviness in head
• Burning sensation with photophobia (Pittaja type)
• Nasal congestion and heaviness (Kaphaja type)
• Pricking, shifting pain (Vataja type)
• Nausea and vomiting
• Insomnia and dryness in Vata type

• Throbbing or dull headache
• Pain worsens with stress, noise, or exertion
• Associated nausea, vomiting in Pitta type
• Blocked nose, heaviness in Kapha type
• Dryness, insomnia in Vata type

• Vataja Shirahśūla — pricking, shifting pain
• Pittaja Shirahśūla — burning, throbbing pain with photophobia
• Kaphaja Shirahśūla — dull, heavy, congestive headache
• Sannipataja Shirahśūla — combined dosha symptoms
• Krimija, Amlaja, Raktaja variants described in classics

• Migraines
• Chronic sinusitis
• Vision disturbances
• Hypertension-related complications

Vataja & Pittaja acute cases → Sadhya (curable). Chronic Kapha-dominant or Sannipataja → Yapya (manageable). Secondary causes like tumors → Asadhya.

General Principles: Nidāna parivarjana, Vāta–Kapha–Pitta balancing, Shodhana in dosha-specific cases, Śamana for long-term control.

Panchakarma:

• Nasya: Anu taila, Shadbindu taila, Brahmi taila for all types of Shiroroga.

  “नस्यं तु शिरोरोगेषु श्रेष्ठं”
  (चरक संहिता, सिद्धिस्थान ९)

• Virechana: For Pittaja headaches with burning/photophobia.
• Basti: For chronic Vataja Shirahśūla.

Herbal Medicines:

• Pathyadi kwatha
• Saraswata churna
• Brahmi vati
• Triphala churna
• Godanti bhasma for Pittaja
• Dashamoola kwatha for Vataja

External Therapies: Śirodhara with Brahmi taila, Takradhara in Pitta headache, Śiro-abhyanga with Mahanarayana taila.

Pathya: Laghu, ushna ahara, ginger tea, cumin-coriander-fennel decoction, warm milk with turmeric.

Apathya: Cold drinks, curd at night, excess fermented food, excessive screen time, overexertion.

Yoga & Pranayama: Śavāsana, Supta Baddha Konasana, Nadi Shodhana, Bhramari Pranayama. Meditation and chanting Om help relieve stress headaches.

• Light, warm, easily digestible food
• Use of ginger, tulsi, coriander
• Regular head massage with medicated oils

• Cold, heavy food
• Excess sour, salty, pungent food
• Day sleep and night vigil

Headache is multifactorial — includes tension-type, migraine, sinus-related, or secondary causes. Modern treatment: NSAIDs, triptans (migraine), antihistamines, and treating underlying causes. Ayurveda provides sustainable management through Panchakarma, herbal formulations, and lifestyle changes.

• BP monitoring
• Blood sugar
• MRI/CT brain
• Sinus X-ray