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  • Q&A with Australian Health Practitioners

    Can migraine, tinnitus and cervical pain co exist as the same condition?

    I have episodes of migraine. Recently developed left side cervical spasm along with shoulder pain. For last 2 weeks i am having continuous tinnitus also. What can be the cause and treatment?
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    Mr Roger O'Toole


    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

    Can Migraine, tinnitus and cervical pain co-exist as the same condition?

    Undeniably yes. 

    Research over the past decade has demonstrated quite clearly that the underlying abnormality in migraines is the brainstem, or more specifically the trigemino-cervical nucleus (TCN).

    This is a part of the brainstem that relays all the senory information, including pain, from the face, head and upper part of the cervical spine. We know from PET scan studies, from reflex studies and from the action of medications called Triptans across all headache groups that the TCN is overactive in all forms of headache.

    Importantly in your case, the TCN also receives input from the ear. The ear drum (trigeminal nerve) and middle ear (glossopharyngeal nerve) both send information back to the TCN.

    With an overactive TCN your brain can receive “pain” or other sensory information and interpret it as if it were coming from part of the head including the middle ear and ear drum, without there being a problem in that area. Much like getting a burning pain in your leg with a lumbar nerve root problem - your leg isn't hot or burnt, and the temperature is no different, but your brain senses the burning anyway.

    The upper 3 cervical nerves feed directly into the TCN and intermingle with the trigeminal, and branches of the glossopharyngeal and vagus nerves, and as such, problems in the upper cervical spine have the ability to “switch on” or refer pain to any of the areas supplied by these nerves.

    Now, just because they can doesn't mean they are in your case. There are other causes of migraine and tinnitus and much remains to be discovered.

    Quite simply though, if the usual pain of your migraine and/or tinnitus can be temporarily reproduced and eased using highly specific techniques, then it is highly likely they are related and there is a very good chance you can be successfully treated by addressing the upper cervical spine.

  • Special interest include; Wellnes,nutrition, physical exercise, headaches and sports injuries. My aim is to improve the wellness and health of all my clients. View Profile


    Most certainly. As mentioned above the trigeminal nerve receives direct sensory information from the cervical spine or neck. Postural changes places large stresses upon the cervical spine in particular the upper neck, which can stimulate the  TCN as mentioned above. Another important part is visual input from the eyes. Eye muscles signals feed directly to areas of your brain stem that control neck movements. To see things clearly we need to be able to stabilize our neck. 

    Over excitation or stimulation of the input centres will cause referred pain patterns as a result of over stimulation and the bodies inability to distinguish between where the information is coming from. Spinal manipulation is very effective at helping to reduce hypersensitive signals. As a chiropractor we specialise in joint manipulation to affect spinal and cortical pathways.

    if you are experiencing these symptoms I would recommend you seek a health care professional as those symptoms could also becoming from more serious origins, 

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