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  • Q&A with Australian Health Practitioners

    What else can I do to help my migraines?

    I've been suffering from Migraines for about 7+ years. I usually wake up with them in the morning, and sometimes they will wake me up from a sound sleep, (3am-7am).

    Lately I've noticed that my upper neck has pain too when I'm having a migraine. Most of my migraines are on the top of my head(skunk stripe). Sometimes I can feel the migraines start from deep inside the center of my brain.

    The last couple years they are more frequent/intense. My symptoms are: head, neck pain sometimes, pain is mostly on top of my head, dizzy, light headed, sensitively to light, sound and movement, occasionally nausea, and/or vomiting.

    No preventive meds work;I use Zomig, which helps most of the time.
    Within the last 10 months, I've had to go to the ER for additional relief, due to the severity of the pain.

    I tend to have at least 9 to 15 migraines a month, and I try not to depend to much on Zomig. Usually lying down in a dark room and lots of sleep may help.
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  • 1

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    Roger O'Toole is the Director and senior clinician of The Melbourne Headache Centre. Since opening the Melbourne Headache Centre in 2012 Roger has amassed over … View Profile

    The fact that Zomig is doing something for you tells us that underpinning your condition, as in a vast majority of headache conditions, is a sensitised brainstem (the site of action of Triptans such as Zomig, Imigran, Sumatriptan, Maxalt etc).

    One of the major inputs into the area of the brainstem that is overactive in these conditions is the upper cervical spine. We know that the upper cervical spine can refer this type of headache, and in fact according to research published by the president of the international headache society, professor Peter Goadsby (1)
    "“Headache of cervical origin and migraine often shows similar clinical presentations”.

    So you can see it can be hard to differentiate. Headaches coming from the upper cervical spine can be severe, can cause nausea and vomitting, dizziness, light and sound sensitivity.  If your condition has been stable (i.e. hasn't changed rapidly or significantly in the past 6 months) then I would seek a skilled examination of your upper cervical spine from a practice that specialises in headache and migraine treatment, to at least rule your neck out as part of the problem.

    1. Goadsby PJ, Bartsch T  Anatomy and physiology of pain referral patterns in primary and cervicogenic headache disorders.  Headache Currents 2005;10:42-48.

  • 3

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    Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile

    Totally agree with Mr O'Toole. Interestingly, there is an increasing understanding of the link between the upper cervical spine and the brain stem which may explain why not only is it hard to differentiate from a symptomatic picture, but also that therapeutic intervention aimed at the upper cervical spine, such as spinal manipulative therapy, has a positive effect on these conditions. 

    So, that being said, I would futher back up his recommendation at getting your spine assessed by a professional in the area. 

    Classic migraine is triggered most often by changes in hormones or stress, Sometimes women find the OCP helps with this, and for both sexes, aiming to reduce stress is a very important step.. beyond that I have added some things that may assist reduce the stress in your upper neck and reduce that component of stress on the nervous system and neck .

    What can you do?

    - Take a break and stretch every 30 minutes to one hour if you spend a large amount of time in one fixed position, such as in front of a computer, typing or reading. Stretches should be done in a comfortable range of motion.

    - Gentle exercise may help relieve the pain associated with primary headaches. Avoid high impact exercise if you are prone to dull throbbing headaches.

    - Avoid teeth clenching or grinding. The upper teeth should never touch the lower teeth, except when swallowing. This results in stress at the temporomandibular joints (TMJ) - the two joints that connect your jaw to your skull - leading to TMJ irritation and a form of tension headaches. If your unconsciously clench, it may be a sign of cranial imbalance. Have your chiropractor check it out.

    - Drink at least six glasses of water a day to help avoid dehydration, which can lead to headaches.

    What can a Chiropractor do?

    After a thorough history and examination process, the Chiropractor will determine what your headache triggers are. They will then utilise some of the follow; each case is individual but this is a rough guide.

    - Perform chiropractic adjustments (there are many different types; your Chiropractor will tailor a specific type for you) to improve spinal function and alleviate the stress on your system. At our practice we offer a non torsional method of adjusting the spine.

    - Provide nutritional advice, recommending a change in diet and perhaps the addition of specific supplements. 

    - Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques.

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