Migraine Headache

Written by Dr. Jason Ngan, DC

What is a Migraine Headache?

A migraine is a type of headache characterized by moderate to severe pain on one side of the head. The pain can be debilitating and last for hours. There are two main types of migraines, common and classic. The classic type are migraines that happens with an aura. Auras are sensory disturbances that happens before or concurrently with the headache. These disturbances include vision changes such as blind/blurry spots, flashes of light, and numbness and tingling in the face and hands. The common type are migraines that happen without an aura.

What Causes Migraine Headache?

Migraine are caused abnormal changes (vasodilation) in the blood vessels of the head. This causes inflammation to tissues and irritation to nerves (recurrent meningeal nerves) in the brain. When the brain is in this state, any small trigger can turn into a major headache. Some triggering factors include:

  • Bright lights

  • Consuming certain foods

    • Chocolate, cheeses, red wine, nuts, caffeine, etc

  • Tension/tightness in muscles in the head, neck, and shoulders constricting nerve and blood flow

  • Menstrual cycle

  • Hormonal imbalance

  • Weather changes

  • Abnormal sleep patterns

  • Pregnancy can also affect blood flow and cause migraines

What are the Signs and Symptoms?

  • Headache that is pulsating or pounding

  • Headache in one side of the head

    • Pain behind 1 eye

  • Usually lasts 4-72hrs

  • Aura (in classic migraines): visual disturbances

  • Nausea and vomiting

  • Dizziness

  • Sensitive to light and sound

  • Preceded by a prodrome: mood changes (anxiety, depression, or happiness), food cravings, stiff neck, increased yawning, increased thirst/urination

How is a Migraine Headache Diagnosed?

Migraine headaches are diagnosed with a thorough medical history and physical examination. The diagnosis criteria for migraine headaches are set by the International Headache Society.

  • Diagnostic imaging such as x-ray, CT, or MRI are not used to diagnose migraine headaches but they can be used to rule out other pathologies.

What are the Treatment Options?

Headache types are often misdiagnosed. At Ngan Chiropractic, we carefully investigate the cause of the headache and treat appropriately. Migraines affect people differently. Some migraine patients respond really well to holistic treatments such as chiropractic care, stress management, and dietary changes. Other patients respond well to prescription medication. Chiropractic care is recommended for pregnant patients suffering from migraines since medication is not recommended for these patients.

  • Chiropractic manipulation and mobilization

  • Spinal traction

  • Soft tissue therapies

  • Gua-sha

  • E-stim

  • Ergonomic/postural/sleep counseling

  • Rehabilitative exercises and stretching

  • Keep a dietary log to identify which foods causes the migraines.

Other treatments that patients may seek (not provided at Ngan Chiropractic) include acupuncture, and medication.  

References

  1. Andreou, A.P., Edvinsson, L. Mechanisms of migraine as a chronic evolutive condition. J Headache Pain 20, 117 (2019). https://doi.org/10.1186/s10194-019-1066-0

  2. Eigenbrodt, A.K., Ashina, H., Khan, S. et al. Diagnosis and management of migraine in ten steps. Nat Rev Neurol 17, 501–514 (2021). https://doi.org/10.1038/s41582-021-00509-5

  3. Harris SP. Chiropractic management of a patient with migraine headache. J Chiropr Med. 2005 Winter;4(1):25-31. doi: 10.1016/S0899-3467(07)60109-8. PMID: 19674643; PMCID: PMC2647030.

  4. Pescador Ruschel MA, De Jesus O. Migraine Headache. [Updated 2022 Nov 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560787/

  5. Puledda F, Messina R, Goadsby PJ. An update on migraine: current understanding and future directions. J Neurol. 2017 Sep;264(9):2031-2039. doi: 10.1007/s00415-017-8434-y. Epub 2017 Mar 20. PMID: 28321564; PMCID: PMC5587613.

  6. Walter K. What Is Migraine? JAMA. 2022;327(1):93. doi:10.1001/jama.2021.21857