Sat, Jun

Am I having a Migraine?


To know the treatment for a headache or migraine one needs to know the source first. There are many variations of a headache including neck, tension and migraine headache. I will leave out tension headaches and discuss in another article relating to TMJ. To figure out the type of headache we first must ask ourselves a few questions: where is it located? What is its behavior? What eases the symptoms? What makes it worse?

True migraines are of vascular nature. They are usually on one side of the head including the eye. They can get worse with light and noise. They are not eased with certain positions or pressures. Sometimes they can be triggered by adverse reactions to food, drink, or stress.

In comparison, headaches stemming from the neck are of a mechanical nature. Positioning and pressures can help. Anything that would relax the neck such as a hot shower might ease the headache. This type of headache is usually caused by irritation of a nerve in the neck called the Greater Occipital nerve. Pain or headache symptoms start in the back of the neck and over the head and and above the eye (they call this manifestation the "Rams Horn" presentation for obvious reasons). Treatment for this type of headache would differ than that of a true migraine in that you are not treating the vascular components, but of the compression of that nerve. In order to take pressure off that nerve you would need to relax the muscles (hence why a hot shower would help), realign the upper cervical vertebrae with stretching and hands on manual therapy including light massage and vertebral mobilization.

Try this: next time you get a migraine try one of three things to rule out a neck a headache 1) take a hot shower or put a heating pad on your neck 2) put pressure in the back of your neck right below your skull and hold that light pressure for 5 to 10 seconds 3) put both your hands underneath your skull and gently start to lift up. If none of these help, the neck might not be your problem.

Note: infrequently, headaches can represent more serious problems. Some risk factors for more serious underlying pathology includes if you've had a recent traumatic blow to the head, a history of cancer, AVM, history of drug abuse, history of high blood pressure as well as a long time smoker. Consult your physician if they are frequent, abnormal and severe in intensity.


Dr. Joshua Mazalin works as a Physical Therapist at ProexPerformance Group in Los Angeles.



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