Mississauga Chiropractor Presents: Migraine Headaches

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Categories: Lecture Series

Here’s another blog from a Mississauga Chiropractor…

Migraine Headaches are recurring head pain due to changes in the brain & surrounding vasculature.  Migraine headaches are one of the most common problems seen in emergency departments and doctor’s offices.

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Types of Migraine Headaches:

1)      Migraine with Aura (classic migraine) – 20% of migraines

  • Aura or prodrome – symptoms of the nervous system (usually visual or olfactory) that precede a migrane & are usually followed by headaches within an hour
  • About 60% of patients will report an aura developing hours to days before the onset of the headache

2)      Migraines without Aura (common migraine) – 80% of migraines

 

Demographics:

  • Estimated 23 million people in America suffer from migraines
  • Gender:  Females > Males (3:1)
  • Age: symptoms usually first present a puberty

 

–         Genetic predisposition to run in families, especially with females

–         Associated with ‘type-A’ personality types – high strung, perfectionists

 

History:  There is usually a history of some sort of “triggering factor”

  • Stress or when a stressful event is over
  • A tension headache that progresses into a migraine
  • Rapid hormonal changes – menstruation cycle or PMS, puberty, menopause
  • Rapid blood sugar changes:  fasting or hypoglycaemic, missed meals, heavy sugar intake
  • Vasoactive Foods:
    • Tyramine Rich Foods:  red wine, cheese, nuts, chocolate
    • Histamine (citrus foods), coffe, tea alcohol
    • Processed foods, preservatives, MSG
    • Food or seasonal allergies; environmental, chemical or toxins

 

Presentation:

  • Pain is usually moderate to severe, throbbing or pulsatile, unilateral & localized in the frontal/temporal &/or ocular area, builds up over a period of 1-2 hours, progressing posteriorly & becoming diffuse
  • Duration is usually several hours to an entire day
  • Nausea (80%) & vomiting (50%), photophobia &/or phonophobia are common
  • Headaches usually subsides gradually within a day or after a period of sleep
  • Aura can be visual, sensory, motor or any combination of these
    • Most common visual aura of migranes is scintillating scotoma (64% of cases)
      • Begin as a hazy spot from centre of a visual hemifield followed by shimmering light of different patterns expanding with scotoma
      • Picture shows example of visual changes during migraine which a patient may describe as multiple spotty scotomata
      • Paresthesias (40% of cases)
        • Numbness starts in the hand then migrates to the arm and may jump to involve the face & tongue (may take up to 20 minutes to spread)

 

Management:

  • Stress management and identifying and controlling the triggers (diet history, check relation to menstrual cycle)
  • Cervical and thoracic adjustments (72% effective)
  • Relaxation massage and trigger point therapy
  • Sleep – bed rest if acute (in a dark room); ensure that there is not too much or too little sleep
  • Acupuncture can prove very effective for migraine headaches (local cervical and cranial points)

 

Prognosis:

  • Migraines usually subside within 72 hours & decrease in severity & frequency with age.

 

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