Migraines: How Physio Can Help

Migraines: How Physio Can Help

Like rain on your wedding day, headaches always seem to show up when you can least afford to deal with them. There’s a wide range of headache experiences, starting from a mild tension-type headache right up to a raging migraine; the type that stop you in your tracks and lay you up in bed all day!  Yet any type of headache can have a seriously negative impact on your life. Research suggests that nearly all those with migraines (as well as 60% of those with a mild-tension headache) have a reduced capacity for work and social engagements.   

Migraines vs Headache

There are three types of primary headaches: tension-type, trigeminal autonomic cephalalgia (TAC) and migraine. A tension-type headache (TTH) is probably the most common, and almost everyone will experience this at least once throughout their lives. They are often caused by stress, lack of sleep, tension, and poor posture. Physiotherapy commonly treats cervicogenic headaches (a subtype of TTH), which arise from problems in your neck, and can recur chronically unless the neck is addressed. These commonly experienced TTH’s differ in severity but respond well to pain medication, rest and physiotherapy review.

TAC headaches come on suddenly (like an attack) and are described as the worst of all the headaches. They include subclasses such as the cluster headache and unilateral neuralgiform attacks. Generally, TAC’s are rare. They are short lived and only last seconds, although some can last several hours. These headaches require specialist medical attention and medications.

Migraines are a much more intense type of headache when compared to TTH’s, but are made much worse by the accompanying nausea and vomiting, as well as sensitivity to light and sound. They throb (pulse) and can last for between 4 and 72 hours. Migraines are often debilitating and stop people from going about their daily routine.

What are the symptoms of a migraine? 

Some people experience a warning prior to a migraine which is called an aura. This involves visual disturbances such as flashing lights or halo effects, with the most notable sign the fortification spectra (an image that overlays your vision). Other early warning symptoms may also include changes in smell or perception, gut symptoms, changes in behaviour and muscular symptoms for up to twenty-four hours prior to an attack. During the migraine, it’s common to expect a strong pulsing pain on one side of your head. You may also feel nausea and vomiting, sensitivity to light and sound, problems with speech and maybe even pins and needles in the arms and legs. Most people feel drained for about twenty-four hours after a migraine, and it’s no surprise why!

What causes a migraine?

Although migraines are fairly common, nobody knows for sure what causes them. There is often a genetic predisposition but it’s not always the case. It is believed that a migraine is caused by the interaction between the brain and the cranial blood vessels. Certain parts of the brain respond promptly and excessively to stimuli and result in pain in the head or upper neck, as well as changes to blood flow in the face.

What triggers a migraine?

Some possible triggers for migraines are hormonal and environmental changes. Migraines might also be linked to things like stress, diet, allergies and alcohol consumption. Keeping a diary of when migraines occur is the best way to determine if you have any patterns and maybe find out what your triggers are. Remember, an increased occurrence in migraines is a cause to seek medical attention for further investigation.

How physiotherapy can help

Migraine can be treated with painkillers, rest and ice or heat packs. Physiotherapy can also help to offer some relief. Manual therapy such as massage and stretching may help relieve some of the tension from the muscles, especially around the neck and shoulders. Dry needling in these areas may also offer some relief. Many of those who suffer with migraines develop a strategy that works for them, individualised through trial and error.

As migraines are usually a chronic condition, a physiotherapist can teach you self-massage and stretching techniques you can use at home the next time a migraine strikes. They can even help you to improve your posture as a preventative measure for any type of headache. 

The Watson headache approach is a manual therapy methodology and protocol for migraine treatment that is used by physiotherapists. It involves examining and managing the upper cervical spine to determine if there is a link to your headaches. This is particularly useful for chronic sufferers whose headaches have been thoroughly investigated but they have not found effective relief. The non-invasive approach involves a series of non-manipulative techniques to discover which vertebrae may be the trigger for your headaches. There’s no manipulation of the spine so it’s gentle on the body and may help to provide relief for long-term sufferers. Andrew, our resident head and neck physiotherapist, is trained in the Watson headache approach!

If you are a frequent headache or migraine sufferer, we may be able to help provide you with some much-needed relief. Please make an appointment today!


All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion.

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