Can a neurologist help me with my migraines?

Hi poster!

Migraines can definitely be a debilitating condition, and have a massive negative effect on your quality of life, so getting them sorted out is a priority. There are a number of steps involved here, so I'll give you a quick rundown of things to consider, as I have a number of patients I treat for these conditions specifically, and am studying functional neurology, so have a special interest here:

1. Correct diagnosis: The diagnosis of headaches and their causes can be a complicated procedure, as many kinds of headaches have overlapping symptoms. Migraines tend to be severe and on one side of the head but this can extend to both sides of the head, while cervicogenic headaches (headaches caused by neck dysfunction) tend to be on both sides of the head, but can be on one...complex, as I mentioned.

2. Assessment of involved structures: Commonly, headaches are associated w disorders of the neck, not only involving correct motion of the joints, but also taking into consideration the muscles which have to bear the strain where poor posture is concerned, the muscles at the back of the base of the skull (suboccipital muscles) will commonly refer pain to the head, especially if a practitioner places pressure on the trigger points there. The eyes can also cause headaches from eyestrain, have you had your vision tested within the last year?

3. Lifestyle factors: Exercise can be associated with a strange type of headache unimaginatively named "exercise headaches", or with increased tension in the muscles I mentioned, which cause headaches. Also medications, dehydration, lack of sleep, stress, drug/alcohol use, and previous trauma may all play a role.

4. Headache features: The characteristics of a headache may give clues to how best treat them. You mentioned you have a headache diary, which is a great start, so documenting your headache frequency (how often), duration (how long), severity (how bad) and timing (at what point during the day they arise) can be beneficial, and a great measure of how treatment is affecting your condition (if any number of those measures decreases, that's a step in the right direction).

5. Treatment: Having seen an osteopath for correction of joint function in the neck is a fantastic step in the right direction, but if the joints are constantly being caused to become restricted again by incorrect muscle tone, poor posture, or other such factors, it may be helpful to see another practitioner who offers treatment to a number of these things. There are osteopaths and chiropractors (myself included) who perform dry needle acupuncture, or (mainly for those averse to acupuncture) TENS, trigger point therapy, and other physical therapies to reduce muscle tone; also, postural analysis and taping/exercises to correct the issues identified there can be very helpful. I would only recommend going to the length of seeing a neurologist if you have a worsening of your condition, the character of the headache changes or you have exhausted conservative care options.

I hope this rundown has given you some insight, and if you would like to be further consulted by a practitioner who provides multiple therapies, I am likely to know someone in your area, or am happy to see you myself if you live in the metro or Fremantle region of Western Australia.

If you require further information, feel free to respond.

All the best,

Dr. A

The information above is great the only thing I would ad to the is make sure that the chiropractor you see takes "global" view of your spinal function. What we mean by this is that the emphasis is not on the area of pain, it is on the full body function as aften there are areas of the spine that are totally asymptomatic however poor function and associated postural and biomechanical changes can cause the cervical spine to continue to "tighten up" aggrivating your headahces. Good Luck.

For more information about a more glaobal approach  http://www.ansellchiropractic.com.au/your-first-visit