At Blackberry Clinic our physios,osteopaths and chiropractor treat headaches and migraines. Our pain management doctors offer radiofrequency denervation treatment for migraines.
Here is some more information about migraines and how physical therapy may help.
A migraine is a recurrent headache that strikes after, or along with sensory disturbances known as aura. These disturbances can include flashes of light, blind spots and other vision changes, or tingling in your hand or face. A migraine can last between 2 to 48 hours (sometimes longer), and usually affects one side of the head, comes on gradually (over 15 to 30 minutes), feels pulsating, is of moderate or severe intensity, and can be aggravated by routine physical activity. Nausea, vomiting, pulsating or throbbing pain, along with a hypersensitivity to light and noise are also common symptoms. Migraines affect around one in 10 people. They are three times more common in females and tend to affect young people who are otherwise healthy. Most people who get migraines will have a family member with the same problem.
Migraine is thought to be a neurovascular pain syndrome ie. involving nerves and blood vessels where electrical activity in the nerves in the brain stimulate the surrounding blood vessels to release painful inflammatory chemicals, but very little is actually known about it. The pain is often so bad that it makes it very hard to drive or concentrate. An aura typically consists of a combination of disturbances:
Visual – including seeing spots and lights or being aware of blind spots
Sensory – include tingling and pins and needles or numbness
Movement problems – include reduced coordination, dizziness and speech disturbance.
These symptoms will be completely reversible and tend to happen up to 60 minutes before the onset of a migraine, almost like a warning sign.
HOW IS MIGRAINE DIAGNOSED?
Everyone presents differently and may have features of other headache types which can make diagnosis difficult. Most headaches can be diagnosed and classified according to your history and an examination by a healthcare practitioner. There is no one specific test, scan or examination that can confirm or differentiate migraine from another headache type. In some cases you may be referred to a neurologist who specialises in migraines, who can help with medication prescription.
WHAT ARE TRIGGERS FOR MIGRAINES?
There are many causes or ‘triggers’ for migraines and being able to identify them in yourself will go a long way to keeping your migraine episodes at bay. Often keeping a diary of what you have done, or eaten and drunk during the day will help you to identify any patterns or triggers preceding a migraine which you can subsequently avoid.
Triggers may include:
Vasodilators (some heart medication like calcium channel blockers, aspirin and nitroglycerine)
Skipping meals
Weather changes
Dehydration or insufficient clear fluid (water) intake
Sleep deprivation
Stress
Excessive afferent stimuli (eg. flashing lights, strong odours)
History of head trauma, underlying neck problem
Hormonal changes, monthly cycle, contraception, menopause
Certain foods – chocolate, caffeine,aspartame (artificial sweetener), sugar, processed meats, foods containing lots of colorants and preservatives like MSG
Genetics – there is a family history of migraines in about 60% of cases, suggesting a hereditary factor exists.
HOW CAN PHYSICAL THERAPY HELP MIGRAINES?
Migraines are individual, you may present with a few or all of the above symptoms, with or without an aura. A “copy and paste” principal for treatment shouldn’t be applied, because what works for one person, may not work for you. The best thing is to contact your healthcare practitioner such as a doctor or physical therapist, to find what works best for you. When considering treatment most people believe migraines are only managed through medication and avoidance of triggers. Yes, medication does play a vital role in migraine management, however there are many benefits from physical therapy interventions.
With migraines, muscles around your head and neck can become very tender and present with spasm. Combined with any stress or underlying neck pain, physical therapy may be key to reducing the pain and intensity of your migraine episode as well as decreasing the frequency and duration of each episode.
Manual therapy, including massage has been shown to be as effective as some medications in reducing the pain and intensity of a migraine. Regular massage (weekly massage treatment) has also been shown to be a good preventative measure for migraine management substantially reducing the frequency of migraines.
Cold therapy in the form of gel ice packs or frozen neck wraps can be applied at the onset of a migraine, targeting the carotid arteries at the front of the neck, and can significantly reduce the pain.
Exercise therapy has been shown to be integral in the management of migraines. In some people activity can be a trigger for their migraines, and avoiding physical activity during a migraine is normally necessary. But regular exercise has been proven to reduce the intensity and frequency of migraines, so if you can gradually build up your level of physical activity under the guidance of your physical therapist, this can help. In addition, specific neck exercises and stretches can be used to reduce tension and stress between episodes and even during an attack.
Acupuncture has been shown to be effective in reducing pain intensity with migraines. Over the long term regular treatment has shown a decrease in consumption of medication necessary to manage the migraine.
Relaxation techniques – this is a little more controversial, because it’s difficult to calculate its efficacy clinically, but each person is different and this may be beneficial to you. Your physical therapist can teach you relaxation and deep breathing techniques that may be used during or preceding a migraine to reduce its intensity and improve your coping mechanism during an attack.
The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. ©Co-Kinetic 2018
Blackberry Clinic
