June is Migraine awareness month – an opportunity to bring awareness to migraine sufferers and break the stigma that migraines are just a headache. Those suffering from migraines know just how severe they can be in intensity, the other symptoms that accompany it and the multiple different triggers they can have.
4.9 million Australians live with migraine – 71% are women.
Of the 4.9 million, 7.6% or around 400,000 experience chronic migraine (more than 15 migraine days per month).
Migraines cannot be cured, but finding the right combination of treatment can help manage the symptoms and flare ups and make a real difference.
WHAT IS A MIGRAINE HEADACHE?
A migraine is a complex inherited neurological disorder that is characterised by episodic attacks of head pain and other associated symptoms. Most people don’t know they are about to have a migraine until they start developing signs and symptoms. Migraine attacks can vary, some may experience them weekly, some may go years without having an attack. Migraines are usually severe in nature consisting of a throbbing or pulsing sensation, usually on one side of the head but they can also occur bilaterally (although the side can change between attacks).
According to the National Institute of Neurological Disorders and Stroke, about one in three individuals with migraines report experiencing an aura before the headache (more on aura’s below).
WHAT ARE THE SIGNS AND SYMPTOMS?
People who have migraine episodes with auras might not experience an aura every time. Migraine episodes can occur in six distinct phases – though not everyone experiences all phases. Migraines occur most frequently in the morning, especially upon waking. Some people have migraines at unavoidable times, such as before menstruation or on weekends following a stressful week of work.
Phase one Premonitory– this phase consists of the warning symptoms that a migraine attack has started. This can occur a few hours to a few days before the rest of the migraine attack. Some warning symptoms may include: mood changes, food cravings, yawning, brain fog, disturbed sleep, frequent urination, nausea, aches and stiffness, speech difficulties.
Phase two Aura– Approximately one third of migraine suffers experience auras. Auras can affect a person’s visual, sensory, motor and sometimes movement pathways that occur before or during a migraine attack. Symptoms may include visual disturbances, numbness, weakness, confusion, difficulty speaking, dizziness, vomiting, abdominal pain.
Phase three Acute- AKA as headache phase (Not everyone with migraines experience headaches). Symptoms may include headache, nausea/vomiting, giddiness, insomnia, nasal congestion, mood swings, sensitivity to light, sound and smell, neck pain.
Phase four Resolution– Most migraine attacks fade, some may suddenly stop. This phase normally consists of a sudden end to the acute phase of symptoms, urgent need to sleep, fatigue, euphoria or suddenly feeling good.
Phase five Postdrome-AKA as the migraine hangover. This stage consists of fatigue, depressed mood, euphoric mood, brain fog, lack of concentration.
Phase six Interictal– This is the phase between migraine attacks where the patient has no migraine symptoms. Those who live with chronic migraines might not get an interictal phase, with only little respite from one attack to the next.
WHO IS MOST LIKELY TO SUFFER FROM MIGRAINES?
Migraines occur in both children and adults but affect adult women three times more than men. There have been several factors identified with higher risks of migraines but can differ from person to person. These include:
WHAT IS THE TREATMENT FOR MIGRAINES?
Migraines can be managed and many people who live with migraines are able to control their attacks.
Migraines can be managed by addressing some of the above risk factors such as managing sleep, eating well, avoiding certain triggers such as alcohol. If you find you experience quite frequent migraines, seeking an opinion from your doctor on different medications you could trial have been found to be quite effective. If you do find you are in the middle of a migraine attack, trialling things like, ice packs, hot showers, sleep and resting in a dark quiet space have been known to help reduce symptoms.
HOW CAN CSSM HELP? Migraines can have many triggers and at Camberwell Sports and Spinal Medicine we can help try identify any musculoskeletal triggers you may have. We can do this by assessing your thoracic and cervical spine, TMJ and surrounding musculature. We will also look for any asymmetries or dysfunctions side to side. Treatment may include techniques such as joint manipulation and mobilization, dry needling, myofascial release, counterstrain, soft tissue massage, and muscle energy techniques. We may also provide our patients with a home exercise program to assist in maintaining the changes we create in our appointment.
Furthermore, we can assist our patients in identifying what lifestyle factors may be predisposing them to their migraine and then together, come up with a management plan to reduce the likelihood of reoccurrence.
It is important to understand that while the word migraine is misused to mean ‘bad headache’, migraine is not a headache. Headache is just one of the possible symptoms of a migraine attack. Headache without accompanying symptoms, such as nausea or light sensitivity, is rarely diagnosed as migraine.
References: MAM2022 Resources. (2022). Retrieved 31 May 2022, from https://www.migraine.org.au/mam2022_resources (2021). Retrieved 27 August 2021, from https://treasury.gov.au/sites/default/files/2021-05/171663_migraine_australia.pdf
Peckel, L. (2019). Pathologic Differences Between Migraine With or Without Aura. Retrieved 27 August 2021, from https://www.neurologyadvisor.com/advisor-channels/headache-migraine-advisor/pathologic-differences-between-migraine-with-or-without-aura/
Headache: Hope Through Research | National Institute of Neurological Disorders and Stroke. (2021). Retrieved 27 August 2021, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research
About the author
CSSM Osteopath Jaimi Schroen enjoys treating a broad range of injuries, with a particular interest in headaches, temporomandibular joint (TMJ) disorders as well as vertigo and dizziness. Jaimi loves educating her patients about their bodies and showing them just how connected everything is and how closely structure and function are related.
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