Understanding Headaches: Part 3 - Migraine

For those that suffer migraines, there is nothing more daunting, frustrating or interruptive to daily life. Once experienced, migraines tend to be a repetitive cycle in peoples lives; though episodes do decrease with age. They are typically felt on one side of the head or face with severe intensity. Any movement or activity will increase the pressure, as will bright lights or noise. Often, sufferers will hide in a dark room where it is quiet and simply wait it out. At best, an episode will last a few hours, but they can last for up to 3 days. As you can guess, this can cause great interruption to your day-to-day. As a result, those who suffer migraines tend to take more time off work and are likely to disengage socially during episodes.

One of the key features of migraine headaches is that the sufferer will tend to know it is coming on. This is often termed ‘aura,’ a sensation (whether pressure, nausea, visual changes, etc) which alerts the person that within the next 60 minutes their life will be a little less productive.

Like tension type headache, migraine is also a primary headache disorder. This means that the cause is not related to another event or structure. Many theories exist on how migraines develop. Some stem from a vascular constriction or spasm which causes pain, while other theories point to the cervical spine (the vertebrae in the neck) causing an influx of stimulus into nerve fibres which supply the head and face. There are also several known triggers for migraine, that is an event, exposure or factor which can spark a migraine to occur. These include foods such as wine, chocolate or MSG. Stress, hunger or fatigue can also play a role. Most commonly in women however, the natural hormonal fluctuations surrounding the menstrual cycle play a major role in migraine development.

The most important component of migraine management is diagnosis. By working with your healthcare practitioner (family physician, nurse practitioner or chiropractor) you will be able to narrow down your diagnosis and determine if migraine is the most likely disorder affecting you or if another headache type is most likely. There are also several other conditions which can create symptoms similar to migraines which need to be ruled out. Once you have reached a diagnosis, working with your practitioner to develop the best treatment plan is your next step.

The recent Chiropractic Practice Guideline to headache management has reviewed the most up to date scientific literature and concluded that spinal manipulation (chiropractic adjustments) alongside massage therapy, exercise and nutritional changes is the best first line approach to the treatment of migraine. Through a treatment plan such as this, migraine sufferers are likely to experience a decrease in the frequency of their migraines. Acupuncture has also been shown to be quite effective in the treatment of migraines. Many sufferers also relay that receiving treatment during the ‘aura’ phase of a headache, or as early into the headache as possible will reduce the duration a migraine lasts for, or even stop it altogether. This gets you back to work, enjoying family life and takes back your weekend!

Remember, there are many types of headache disorders. Identification which guides proper management will lead to the best outcomes.

Stay tuned for our next headache chapter as we discuss cervicogenic headache, a common and commonly missed headache type.