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    Migraine Solutions: Physical Therapy


    Many people who suffer from migraines utilize pain medications, injections (I.e. Botox), or acupuncture as their solution to migraines. However, few people realize that they can get relief through physical therapy.


    If you have ever suffered from a migraine, you know how debilitating they can be. According to American Migraine Foundation, “The World Health Organization places migraine as one of the 10 most disabling medical illnesses on Earth.” From missing work, school, and other important events, migraines can quite literally sweep you off your feet. However, with the help of a qualified physical therapist, you can return to your normal activities – migraine-free!

    Symptoms of Migraines

    According to the MayoClinic, migraines can progress through four different stages known as: prodrome, aura, attack, and post-drome. However, an individual doesn’t always go through all of the stages.

    1. Prodrome – One to two days before the migraine hits, you may notice these warning signs: food cravings, cervical stiffness, mood changes, constipation, increased thirst/urination, frequent yawning

    2. Aura – Before or even during a migraine, aura symptoms may occur. Typically, aura symptoms begin gradually and build up, lasting between 20-60 minutes. Most symptoms are visual within the aura stage including: vision loss, seeing shapes/spots/flashes of light. Other symptoms include: difficult speaking, hearing noises/music, weakness in the face/one side of the body.

    3. Attack – If left untreated in this stage, migraines can last anywhere from 4 to 72 hours dependent on the person. Symptoms of the attack phase include: pain that throbs/pulses, sensitivity to light/sound/smell, nausea, vomiting.

    4. Post-drome – After the attack phase, you may feel tired, confused, or drained for up to 24 hours. Sudden movements may cause the symptoms/pain to arise again for a brief period.

    How physical therapy can help cervicogenic headaches

    Technically speaking, migraines are not of musculoskeletal origin so some may say that a physical therapist cannot “treat” them. However, tension headaches can be mistaken for migraines and those can be treated by a physical therapist. A cervicogenic headache is defined as a headache that is caused by issues in the cervical spine/neck as opposed to a migraine that is caused by issues rooted in the brain.

    If you choose to try physical therapy for your headaches, this is what your sessions may look like.

    Your therapist will assess many areas that may affect or contribute to a cervicogenic headache. Those may include you neck, TMJ/jaw, thoracic spine/upper back, your posture and your ergonomics or desk set up.

    1. Manual therapy – Those suffering from cervicogenic headaches may notice tightness in their shoulders, neck, or jaw. Your physical therapist will perform what is called “manual therapy” to help release the muscles and improve any tightness in the joints that may be restricting motion. Manual therapy techniques are defined by the APTA as skilled hand movements and skilled passive movements of joints and soft tissue. These techniques are intended to improve tissue and joint mobility as well as to induce relaxation of these tissues and decrease pain.

    2. Postural strength and retraining- Your therapist will assess your posture then educate you on any desk modifications you can make as well as strengthening and mobility exercises that will help you to maintain that posture throughout the day. Sitting or standing in certain positions may put pressure or stress on the neck and at the base of the skull, which may trigger headaches.

    3. Behavioral modifications – Education and modifications can be made to a person's habits that may be contributing to their headaches. For example, changing positions throughout the day, avoiding prolonged eye strain, and mouth guards to decrease teeth grinding are all potential changes that may improve or decrease headaches if they are rooted in the cause. If you fall asleep in an awkward position, such as too far back or off to one side, it may also cause headaches. Different pillows may be discussed in addition to ergonomic desk accessories that help people maintain postures that minimize stress and strain on the body.

    4. Vestibular stabilization exercises –  The vestibular system is part of our inner ear and contributes to our sense of balance and orientation. There are physical therapists who are trained specifically on vestibular stabilization and rehabilitation if that is needed.  These physical therapists can assess the vestibular system to determine if any issues lie there that may be contributing to a headache.


    If you're tired and frustrated over your migraines and are ready to try something new to overcome them, we are here to help! Let's get you scheduled for a session with one of our physical therapists so they can help you determine if physical therapy can help solve with your specific migraine symptoms.



    References

    American Migraine Foundation, "The Facts About Mirgraine," March 28,2019, https://americanmigrainefoundation.org/resource-library/facts-about-migraine/