What is the criteria for a migraine? Can physical therapy help?
According to the International Headache Society, a migraine is a complex neurologic disease which affects over 1 billion people world wide.
There are many subtypes of migraine, but for general purposes, this outlines migraines with and without aura. Additionally, symptoms are important for proper diagnosis of your type of headache or migraine.
Diagnostic criteria for a migraine without aura includes:
🔹 Attacks lasting 4-72 hours
🔹 Unilateral in location
🔹 Pulsating quality
🔹 Mod to severe intensity
🔹 Aggravated b y routine physical activity
🔹 Associated with nausea, photo/phonophobia
🔹 Frontotemporal
Migraine with aura has very similar diagnostic criteria, but includes transient focal neurological symptoms that usually precede or sometimes accompany the headache. Such as visual, sensory or other central nervous system changes- these changes are reversible.
A person typically can experience something call prodromal or postdromal symptoms which happen before or after the migraine: symptoms may include difficulty concentrating, hyper/hypoactivity, neck stiffness, nausea.
How can physical therapy help my migraine?
It can be especially helpful to keep a journal for migraine tracking in order to pin down the common triggers responsible for onset. This is an important part of management.
There is growing evidence in the field that physical therapy in conjunction with pharmacological treatment, can improve migraine symptoms and decrease frequency. Therapy would focus on the craniocervical region and addressing vestibular/postural control components in order to decreased nervous system input (desensitization).
*Manual Therapy: Hands on techniques which can increase the mobility of the head and neck, decreased tension in the muscles and reduce spasming, and optimize muscle activity by downtraining overworked muscles.
*Therapeutic exercise: Exercises which focus on decreasing forces through the neck and spine as well as improve our posture are the primary focus. Weakness in the upper body means there will be a lack of support in the arms, shoulders, and neck when handling various loads of weight.
*Dry needling: This can target latent trigger points (muscle knots) in the muscles around the back of the head, temples, face, and neck to decrease tightness and referred headache type pain.
If you or someone you know deals with headaches or migraines and have only been given pharmacological treatments, there are missing pieces in your care! You may benefit from a physical therapy evaluation which can diagnose other musculoskeletal issues contributing to headache symptoms.
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