Migraines and Headaches

Ms. E had a diagnosis of a migraine by a neurologist some years ago and had noticed that as she was becoming more stressed at work, so they had changed from monthly to at least weekly. There was also a headache every day towards the end of the day, or if she was on her laptop for too long. The migraine medication was no longer effective at prevention it and she had exhausted options with the doctor and neurologist. She was hoping I may be able to reduce the non-migraine type headaches that were associated with stress.

Diagnosis and treatment

Upon examination, Ms. E stood as if she had a headache. Her shoulders were protracted (curved forwards) and her spine had just a small amount of curvature with extremely hypertonic muscles around her upper thorax and neck. There was very little range of movement available in her neck or upper thorax.

Treatment was focused around her thorax (ribs and thoracic spine), neck and head. The muscles around her head and neck were extremely painful upon palpation, so treatment was very gentle and functional techniques were used - where the joints are taken to a position of ease. Trigger point therapy was used along with inhibition.

As osteopaths, we have a large ‘tool box’ of techniques we can use. What may suit one patient may be completely inappropriate for another! I used intra-oral techniques (with consent) to reduce the tone in the muscles around the jaw and also worked into her thoracic diaphragm as it is innervated by C3-5 in the neck.

Ms. E was given gentle neck and pectoral stretches and was advised on supplements that she could try to reduce the migraines (once she had checked with her doctor). Abdominal breathing exercises were given during the following treatment to reduce tone in the thoracic diaphragm and a mindfulness app was recommended to reduce stress levels along with sleep hygiene advice.

Positive long-term impact

The treatments were spaced out over 3 weeks between each and by the forth treatment, the migraines had completely stopped. Ms. E had taken the supplements advised and I saw her again some time later for an unrelated problem; she had remained migraine-free but I feel this was largely to do with being proactive in her own care.


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