Migraine Headache Treatment

What is a migraine headache?

Migraine is one of the most prevalent health conditions in the world, it accounts for the 6^th highest amount of days lost to disability, globally ^{[1, 2]}.

People who experience migraine describe pain on one side of the head primarily. This pain may switch sides either during an attack or between separate attacks. The sensation is often a moderate to severe, pulsating or throbbing pain ^[2]. Migraine sufferers also experience a range of other symptoms, including; nausea and vomiting, as well as sensitivity to light, sounds and smell. Lasting between a few hours and up to 3 days, migraines can cause significant disability and have a big impact on people’s quality of life.

Types of migraines

Migraines can differ in terms of the types of symptoms that are experienced, therefore it is important to be accurately assessed, in order to be given the correct diagnosis and then successful treatment. These are a few of the most common types of migraines.

1. Migraine with Aura

An aura is the build-up of neurological symptoms that is commonly experienced as part of a migraine. Aura will often precede a full attack and lasts for between 20-30 minutes.

Symptoms may include:

Visual disturbances such as; dark/white spots, lines, waves or even a temporary loss of vision
Temporary sensory changes such as; numbness, burning or a prickling sensation
Changes to your speech
Nausea and or vomiting
Becoming sensitive to light, sound and smell
Changes to sensation down one side of the body or face
Confusion

2. Migraine without Aura

Migraine without aura is when a pulsating or throbbing headache is experienced, without the build-up of neurological symptoms prior to it. This is reported to occur in 70-90% of migraine cases. As described earlier, pain is pulsating, or throbbing in nature and will affect one side of the head or face.

These can include;

Vomiting and nausea
Mood changes and confusion
Sensitivity to light, sound and smell
Fatigue
Diarrhoea

3. Migraine without Headache (Silent Migraine)

It is possible for people to just experience the associated symptoms of a migraine, without the head or face pain. These can still be quite disabling to a sufferer, due to the nature of the associated symptoms.

Symptoms of a Silent Migraine can include:

Altered vision or visual disturbances
Speech disturbances
Nausea and/or vomiting
Sensitivity to light, smell and sound
Altered or absent sensation down one side of the body or face
Fatigue, confusion or mood changes
Diarrhoea

4. Chronic Migraine

People who suffer from headaches or migraine on 15 or more days in a month, over a three-month period are considered to suffer from Chronic Migraine. Of these attacks each month, at least 8 would have to be considered migraines, and the rest can be other types of headache. These types of headaches can be debilitating for sufferers, due to the frequency at which attacks occur ^[3].

5. Episodic Migraine

Episodic Migraine is when a sufferer will experience headache or migraine on less than 15 days in a month. These types of headaches can include migraine, both with or without aura. Episodic and chronic migraines together have been reported to affect 14% of the world’s population, and 18% of women ^[3].

6. Migraine with Brainstem Aura (Basilar-Type Migraine)

This type of migraine is most common in children and adolescents. It specifically is most common in teenage girls and can be associated with the start of menstruation. Symptoms include everything that a Migraine with Aura would have, without the muscle weakness. Due to where this type of headache originates from, these migraines can cause vestibular or balance symptoms ^[4].

Symptoms include:

Vertigo or dizziness
Loss of co-ordination
Ringing in the ears
Fainting
Loss of vision, or double vision
Throbbing, pulsating pain on one side of the head

7. Hemiplegic Migraine

Sometimes a migraine sufferer may experience a temporary paralysis to one side of the body, during a migraine attack. These migraines are called a Hemiplegic Migraine. This weakness or paralysis can be accompanied by pins and needles or numbness. Given the closeness in symptoms to that of a stroke, these migraines can be quite alarming and cause considerable distress. Head pain may be similar to typical migraine with aura, or be absent.

Symptoms may include:

Vertigo
Difficulties with swallowing or speaking
Weakness on one side of the body
Temporary visual loss
Confusion

What is the cause of migraines?

Modern research suggests that the idea of Migraines being caused by an increase in blood flow to the vessel in the head, is incorrect ^{[1, 5]}. It was originally thought that this abnormal or excess blood flow was causing damage and therefore migraine pain was experienced. It has been shown that any changes to blood vessel flow in migraineurs is minimal and insignificant, and is very unlikely to cause the symptoms of migraine ^[5].

Central sensitisation of the brainstem, arising from dysfunction in the upper cervical spine has been shown to be a contributing factor to migraines, in more recent research ^[1]. Nerves travelling to a sensitised Trigeminal Cervical Nucleus in the brainstem, can be used to reproduce migraine headache and symptoms in sufferers. This indicates that migraine is more a neurological condition arising from the cervical spine, rather than a vascular one, and therapy to the neck can be successful in its treatment.

I’ve done it all, is there anything else that can help me?

Many Migraine sufferers have experienced their symptoms for decades, and have had many different therapies and medications, with varying success. Often medications can be only masking the symptoms, and not treating the cause. It isn’t uncommon for sufferers to have tried; physiotherapy, chiropractic-care, osteopathy and acupuncture, as well as advanced treatments like; Hormone Replacement Therapy, Botox injections or radiofrequency and cauterisation of nerves in the head or neck.

Despite the level of previous treatment, most sufferers continue to live with Migraines. A big reason why this is the case, is because most practitioners don’t attempt to identify the root cause of your headaches. At ‘The Headache & Migraine Clinic’, we use the experience that we have gathered from seeing countless similar patients with migraine, as well as utilizing the most current and up-to-date research to assess, treat and correctly diagnose your headaches. By assessing the joints in your upper cervical spine and then using techniques to determine the level of sensitivity in your brainstem, we can determine if this is the cause of your migraine. If we can determine that this is indeed the cause of your migraines, then treatment can start immediately. When appropriate, out technique is effective in 85-90% of sufferers, and is safe, medication-free and non -invasive. If it looks like we are unable to help with your migraines, then we will refer you to the appropriate heath provider.