Treating Migraines: Chiropractic Care
A migraine headache is a complex, chronic neurologic disorder. It is characterized mainly by recurrent moderate to severe head pain usually on one side, often preceded by symptoms like fatigue, nausea, sensitivity to light or sound, and visual disturbance. The exact mechanisms that cause migraines are somewhat unclear, but evidence suggests there are a complex series of neurologic and vascular events that may result in vasoconstriction/dilation of blood vessels and hyperexcitability of the neurons in certain brain regions.
Some 30 million Americans suffer at least one migraine headache each year. It disproportionately affects females more than males, 19-21% vs 6-10% respectively, and is the leading cause of severe headache disability. As a result, the estimated economic cost due to lost workdays is near 13 billion dollars per year in the United States alone. There are some identifiable risk factors for the development of migraine disorder, and research does demonstrate a strong genetic component. For example, if one parent suffers from migraines, a child carries a 50% increased risk. Other risk factors include being overweight, low cardiovascular fitness, high blood pressure, high cholesterol, insulin resistance, and medication overuse. Medication overuse is of particular interest, as research has shown that migraines tend to become more chronic following excessive use of acetaminophen, naproxen, aspirin, opiates, and triptans. Vitamin D deficiency is another risk factor associated with migraine attacks.
If risk factors are what predispose one to the condition, then “triggers” are what actually set off the headache. When the number of triggers exceed a certain threshold for a given predisposed person, a migraine attack is initiated. Some triggers include alcohol, stress, excessive caffeine, artificial sweeteners, citrus foods, hormone changes, lack of quality sleep, dehydration, environmental exposures, etc. On top of this list, there are physical triggers like upper neck tension, restricted joint movement, and soft tissue dysfunction. This is where Chiropractic care can make a difference. Keeping the physical triggers at bay will help to avoid the accumulation of stress and keep the critical threshold from being exceeded.
CHIROPRACTIC MANAGEMENT OF MIGRAINE HEADACHE:
Treatment of migraine headache is subdivided into two categories: abortive therapies and prophylactic treatments. Abortive therapies are most successful when administered within the first minutes of the attack. These mostly refer to medications and supplements that help ease headache pain. Prophylactic treatment is aimed at mitigating migraine triggers to avoid the threshold phenomenon. Three common chiropractic therapies can be used in isolation or combination to reduce the frequency and intensity of these headaches.
Cervical spinal adjustments. There is plentiful research demonstrating the positive influence of spinal manipulation in the treatment of migraine headaches. Freeing up the motion between the vertebral segments in the upper neck will normalize joint function, balance out nervous system input/output, and ensure proper circulation to and from the brain.
Soft tissue manual therapy. Several muscles in the upper back and neck region are implicated in headache syndromes. Hypertonicity and tension in the upper trapezius, levator scapula, sternocleidomastoid, and sub-occipitals add to the accumulation of trigger stress and can easily be resolved through manual therapy.
Rehabilitation and muscle activation. Postural distortion and muscle imbalances lead to stress overload in the body. Deep neck flexor and shoulder girdle weakness, along with upper neck and front chest tightness is a common postural imbalance referred to as upper crossed syndrome. The long-standing imbalances create a chronic overload on certain regions of the body, and if not addressed with stretching and strengthening activities it will manifest as pain one way or another. Not all migraine triggers are created equal, and in these modern times where people spend most of their time sitting behind a desk, staring down a computer screen, physical triggers play an outsized role in headache pain. Chiropractic treatment effectively reduces the buildup of physical stress. It is quick, accessible, and carries less risk of side effects when compared to most migraine medications.
To get started at improving your headaches today, here are 3 activities to try out that address one of the above-mentioned physical triggers.
1. Deep neck flexor strengthening exercise: 3-4x week, 3 sets of 10 repetitions.
How to perform:
-Lay on your back in a comfortable position with your knees bent, feet flat
-Initiate diaphragmatic breathing into your lower ribcage, feel expansion in all directions ie. front, back and sides
-Start by tucking your chin down towards your neck, and then lift your head up as to bring your chin towards your chest (it’s like an abdominal crunch but for your neck.
- Lower down with control to starting position and release chin tuck
2. Suboccipital self-myofascial release: Daily or as needed.
How to perform:
-Place 2 tennis balls side by side in a (clean) sock
-Lay down on your back and place the tennis ball sock right under the base of your skull
- Use intuition and feeling here, the muscles and soft tissues of your upper neck should sink into the pressure of the tennis balls
-Stay and breathe through your diaphragm until you feel a release, adding subtle movements like nodding your chin up and down or side to side may enhance the sensation
-Work the tennis balls down your neck to your upper back, keeping the pressure on either side of the spine
3. Cervical range of motion: Daily.
How to perform:
-The neck has 6 ranges of motion it can access: flexion, extension, rotation right/left, side bending right/left
-Standing or seated upright, perform 10 repetitions of each movement sequentially
Flexion- bring your chin towards your chest 10x
Extension- look up and back 10x
Rotation- look over your shoulder 10x right 10x left
Side bending- tilt your ear down towards the shoulder 10x right 10x left
Normalizing range of motion and lubricating the joints will go a long way in helping migraine headaches.
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