What is a Migraine Headache?
The World Health Organisation describes Migraine headache as a common type of primary headache, usually affecting only one side of the head, and producing moderate to severe pulsating pain. This type of recurrent headache is often accompanied by nausea and can last from hours to 2-3 days. In addition, 10-30% of migraine sufferers will experience some form of aura – this may include symptoms such as visual disturbances (sparkles, flashes or blind spots), or pins and needles or numbness in the arms or legs.
Figures from the Migraine Trust suggest that migraine headaches affect up to 1 in 7 people, with over 190,000 migraine attacks EVERY DAY in the UK. It affects 3 times as many women as men, and is most prevalent in the 35-45 year old age group.
Migraine Diagnosis and Treatment
Headache is the commonest neurological symptom presented to GPs, accounting for 4% of all GP consultations in the UK every year (APPGPHD). Despite its prevalence, recent research reveals that migraine is “often under-recognised, misdiagnosed and inadequately treated in the primary healthcare setting” (Minen et al, 2015).
Conventional treatment is largely based on prescription medications such as the Triptans. A new class of drugs (CGRP inhibitors) uses antibodies to dampen the brain’s response to pain, and has been hailed as an “incredibly important” advance. However, less than 50% of migraine patients report satisfactory outcomes with their conventional medical treatment. Medications can have unpleasant side-effects, and furthermore can be regarded as hiding the symptoms, rather than finding the cause of the problem.
What causes migraine headaches?
Despite it being so common, the causes of migraine remain poorly understood. Activation of paired nerve structures called the Trigeminal ganglia, located on the underside of the brain, appears to be a factor. The Trigeminal nerves have a number of functions- they supply sensation to the face and the front of the scalp, and control the chewing muscles. They have widespread connections, in particular to the Trigeminal Nucleus Caudalis, a spinal cord structure located in the upper part of the neck. This interacts with other nerves serving the back of the scalp (occipital nerves) and to the muscles and joints of the upper neck.
Recent research has suggested that irritation of the Greater Occipital nerve by muscle entrapment at the top of the neck could be one factor contributing to migraine headache via these interactions. Injections and even surgery to release peripheral entrapments here has shown promising results for long term relief in a significant proportion of suffers (Guyeron et. al., 2002).
Osteopathic Treatment is Effective for Migraine prevention
Osteopathy offers a natural, drug-free and effective approach to migraine prevention. Following a thorough case history, you will receive a full physical examination – including a careful assessment of the movement of the joints and tone of the muscles at the very top of the neck, which can cause irritation of the occipital nerves.
Your osteopath will also assess other areas which can cause problems further up- for example, the greater occipital nerve has to pass through the semi-spinalis capitis muscle, which originates on the thoracic spine, between the shoulder-blades. By addressing and treating these underlying musculoskeletal problems, and giving you some everyday postural advice, osteopathic treatment can reduce the frequency of your migraine headache episodes- and many people will be completely free from headaches after a course of treatment.
Migraine Specialist Osteopath in Bath
I am a registered osteopath with a special interest in migraine prevention and treatment. I am a member of Osteopaths for Progress in Migraine Headaches (OPMH) and have completed postgraduate research into peripheral mechanisms for Trigeminal nerve activation at Keele Medical School.