Abstract: The existence of different syntactic configurations for phrases with similar meanings is not by chance. In this paper, we will use the natural semantic metalanguage to offer explications for the different syntactic constructions of common “headache phrases” in French, Italian, Spanish, Romanian, English. The explications will allow us to better understand how the speakers of each language conceptualize their day-to-day headaches, and how their choice of syntax changes the expression’s meaning.