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Writer's pictureDr. Trent Whittaker

Headache and Migraine Management: A Comprehensive Guide

Discover effective headache and migraine management strategies with chiropractic care, remedial massage, and targeted exercises. Learn how TT Chiropractic & Remedial Massage in Surry Hills can help you live pain-free.


A guide to manage headaches and migraines

Headaches, ranging from mild to debilitating, affect millions globally. They are not just a personal health concern but also a significant societal burden, impacting work productivity and overall quality of life. This article aims to provide a thorough understanding of headache types, diagnosis, and management, emphasising chiropractic care and incorporating insights from the latest clinical practice guidelines.


In This Article:



Understanding Headaches and Migraines


Headaches can be broadly classified into primary and secondary categories.


  • Primary headaches, such as migraines, tension-type headaches, and cluster headaches, have no underlying medical condition that causes them.


  • Secondary headaches result from other medical conditions, such as head injuries, vascular problems, or infections. Cervicogenic headaches, pain referred from a source in the neck, are common in Chiropractic practice.


Australians suffer from headaches or migraines


Migraines


Migraines are characterized by intense, pulsating pain, typically on one side of the head, and may be accompanied by nausea, vomiting, and sensitivity to light and sound. They can last from a few hours to several days and significantly impair daily functioning.


Migraine Characteristics

Studies have shown that migraines affect over 4.9 million Australians. 71% of migraine sufferers are women, which is thought to be due to hormonal factors.



Tension-Type Headaches


The most common headache type, tension-type headaches, present as a constant ache or pressure around the head, often described as feeling like a tight band. These headaches can be episodic or chronic and are usually bilateral.


Tension-Type Headaches Characteristics

Cervicogenic Headaches


A secondary headache, cervicogenic headaches, originate from disorders of the neck and are perceived in one or more areas of the head and face. These are often triggered by neck movement or sustained awkward head positioning.


Cervicogenic Headaches Characteristics

Diagnosis of Headaches


Diagnosis begins with a detailed patient history and physical examination. The International Classification of Headache Disorders (ICHD) provides criteria for diagnosing various headache types. Key diagnostic tools include headache diaries, where patients record the timing, frequency, duration, and characteristics of their headaches, and the Migraine Disability Assessment (MIDAS) questionnaire, which evaluates the impact of migraines on the patient's life.



Red Flags in Headache Diagnosis


Certain "red flags" may indicate a more serious condition requiring immediate medical attention:

  • Sudden, severe headache

  • Headache with fever, stiff neck, or rash

  • Headache following a head injury

  • A new headache in an older person



Management and Treatment Strategies


Chiropractic Care


Chiropractic care, particularly spinal manipulation, has shown efficacy in managing certain headache types, especially migraines and cervicogenic headaches. Treatment plans should be individualised, considering the patient's specific symptoms, headache type, and response to previous treatments.


Remedial Massage for Headaches


Remedial massage can be highly effective in alleviating headaches and migraines. Studies have shown that massage therapy can reduce the frequency and intensity of migraines by improving blood flow, reducing muscle tension, and promoting relaxation. By targeting specific trigger points and tight muscles in the neck, shoulders, and upper back, remedial massage helps to release tension that often contributes to headache pain.


Exercises and Stretches for Headache Relief


Regular exercises and specific stretching routines can play a crucial role in managing and preventing headaches and migraines. Research indicates that exercises focusing on improving posture, strengthening the neck and shoulder muscles, and enhancing overall physical fitness can reduce the occurrence of tension-type and cervicogenic headaches. Stretching exercises, especially those targeting the neck and upper back, help to maintain flexibility and reduce muscle stiffness, which can alleviate headache symptoms.


Pharmacotherapy for Headaches


While chiropractic care focuses on non-pharmacological treatments, understanding the role of medication in managing headaches is essential for comprehensive care. For migraines, both preventive medications (to reduce the frequency and severity of attacks) and acute treatments (to relieve pain and associated symptoms during an attack) are available.


Multidisciplinary Approaches


A multimodal approach, combining chiropractic care with other treatments like physical therapy, exercise, stress management, and dietary modifications, can be beneficial, especially for chronic headache sufferers.



Practice Recommendations


Migraine Headache


  • Spinal manipulation is recommended for patients with episodic or chronic migraine with or without aura.

  • Multimodal multidisciplinary interventions including massage may benefit patients with migraine.

  • Low-load craniocervical mobilization may improve tension-type headaches.


Tension-type Headache


  • Spinal manipulation cannot be recommended for episodic tension-type headaches. For chronic tension-type headaches, a recommendation cannot be made for or against spinal manipulation.

  • Low-load craniocervical mobilization is suggested for longer-term management.


Cervicogenic Headache


  • Spinal manipulation is recommended for treatment.

  • Joint mobilization and deep neck flexor exercises may improve symptoms.


Migraine Characteristics - treatment

Tension-Type Headaches Characteristics - treatment

Cervicogenic Headaches Characteristics - treatment

Managing the Risk of Adverse Events


  • Adverse events from spinal manipulation for headache treatment, if reported, were minor.

  • All patients require vigilance to exclude serious pathology through history, examination, and possibly further testing.

  • Dissection of a cervical artery (CAD) is one potential cause of secondary headache. Risk factors include smoking, the use of oral contraceptives, and possibly migraine with aura.


These guidelines support the use of Chiropractic Care for managing certain types of headaches, emphasizing an evidence-based, patient-centered approach. It's important to note that these guidelines are intended to support, not replace, the clinical judgment and personalised care plan for each patient.



Conclusion


Headaches, a prevalent health issue, require a thorough understanding of their types, diagnosis, and management strategies. Chiropractic care, supported by evidence-based clinical practice guidelines, plays a significant role in the non-pharmacological management of certain headache types. A multidisciplinary approach, incorporating both non-pharmacological and pharmacological treatments, offers the best outcome for headache sufferers, aiming not only to alleviate pain but also to improve quality of life.



Take the First Step Towards Relief


At TT Chiropractic & Remedial Massage, we are dedicated to helping you manage and alleviate headache pain through personalised, evidence-based chiropractic care.


Book a consultation or call us on 0403 579 729 today to learn more about our services and how we can help you live pain-free and active.

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