What image comes to mind when you hear the word ‘migraine’? You probably think of an atrocious and persistent headache and envisage someone clutching their head in pain.
Well, there’s truth in that: headache is a common migraine symptom. But migraines don’t always involve headaches and do involve a number of symptoms affecting other parts of your body. So, what’s going on?
What are migraines?
Migraines are definitely not ‘just a bad headache’. They are a complex neurological (nerve-related) disorder. Migraines can be hard to live with, interrupting your plans, affecting your job performance or schooling and curtailing your social life.
We don’t yet fully understand migraines. They involve a number of biological and environmental factors with a different mix for every person.
What triggers migraines?
Many different aspects of daily life may trigger migraines including:
- Intense emotions like stress, arguments and excitement
- Too much or too little sleep
- Missed or delayed meals or certain foods or food additives
- Sensory triggers like flickering lights, perfume or jarring sounds
- Environmental changes, especially changes in barometric pressure
- Screen time
- Poor posture
- For women, hormonal changes around menstruation, perimenopause or menopause
- Vigorous or high-impact exercise.
What are common migraine symptoms?
Migraine is a varied condition that affects each person differently but commonly includes:
- A headache that lasts for 4-72 hours with at least 2 of the following aspects:
- Affects one side of the head
- Has moderate to severe intensity
- Gets worse when you move.
- At least one additional symptoms such as:
- Sensitivity to light (photophobia)
- Sensitivity to noise (phonophobia).
Though headaches are a common symptom, some people do experience migraine without headache. People may also experience a range of other symptoms such as:
- Aura – visual disturbances such as zig-zag lines, flashing lights, blind spots or difficulty focusing
- A stiff neck and shoulders
- Brain fog
- Tingling, numbness or weakness
- Difficulty speaking
- Sensitivity to smell.
These symptoms can be distressing and disruptive. When you have a splitting headache, feel blinded by light, have spots before your eyes and are dealing with brain fog and nausea (for example), you can’t continue with what you were doing. You have to stop, whether you want to or not.
How a migraine gets on your nerves
Your nervous system uses electric and chemical signals to help all the parts of your body communicate with each other.
It’s a bit like your email system. Most of the time, you send the right message to the right recipient and all is well. But sometimes you accidentally hit ‘reply all’ when you meant to send a private message and suddenly the whole office is abuzz with news they weren’t supposed to get.
Most of the time, your nervous system works well. But sometimes it goes into accidental overdrive and causes a migraine by:
- Activating trigeminovascular pathways which control sensation in your face and jaw – resulting in headaches
- Creating an over-excited brain that triggers pain signals and generates other symptoms like nausea, light and sound sensitivity and aura.
Many different neurotransmitters (nerve signals) may be activated in an attack, making it hard to pinpoint the most appropriate treatment.
There are three main aspects to treating migraines: understanding your migraines, relieving their symptoms and reducing their frequency or severity.
Understanding your migraines
As noted above, migraine affects each person differently. It’s often a good idea to keep a migraine diary then look for patterns to help you understand your migraine triggers and what (if anything) works best to prevent or limit them.
Relieving migraine symptoms
Over time, you’ll hopefully learn to recognise your own early warning signs of a migraine and learn how to relieve your symptoms (often through trial and error).
Many people find relief in cool, dark, quiet rooms.
Your doctor may also suggest that you try certain medications when you feel a migraine coming on such as:
- Over-the-counter painkillers for both their pain-relieving properties and their impact on your nervous system
- Triptans, a class of drugs that help to calm overactive pain nerves
- Anti-nausea medications.
Reducing the frequency or severity of migraines
While there is no cure for migraine, you may be able to limit its frequency or severity through both self-care and medication.
A predictable, stable life may seem a little boring but it’s better than a migraine! Self-care to reduce migraines involves much of the same advice given to anyone trying to live healthily such as:
- Getting enough sleep and being consistent with bedtimes and wake times
- Finding a healthy rhythm of work, rest and play
- Eating a healthy diet and having regular, predictable mealtimes
- Exercising regularly
- Simplifying your life to reduce stress.
Your doctor may also prescribe vitamins or medications to take each day to prevent migraines. There are many different options here depending on your symptoms and medical history, including riboflavin (vitamin B2), Botox and beta blockers.
A range of other therapies may also help, including our own particular area of expertise: physiotherapy.
How can The Brisbane Spine Clinic help?
Physiotherapy is a non-pharmalogical treatment that may help to reduce the occurrence of migraines.
Though it recommended further research, a 2011 systematic review found that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be just as good at preventing migraine as prescription drugs (without their side effects).
Poor posture and muscle tension in the back, shoulders and neck can both contribute to migraines. Physiotherapy helps to reduce tension, promote good posture and encourage healthy movement.
In addition, vestibular physiotherapy can help to improve your balance system, reducing symptoms like dizziness which commonly accompanies migraines and is a dominant feature of vestibular migraine.
We have many years of experience in addressing headaches and migraines at The Brisbane Spine Clinic using the Watson Headache Approach, which requires no medication, is radiation-free, non-invasive and does not require injections.
If you’re living with migraines, please don’t suffer alone. We provide empathetic, evidence-based, high-quality care for many patients with migraine. Book an appointment today.
All information is general in nature