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Migraine is a neurological dysfunction that causes throbbing pain or pulsing sensation that usually happens on one side of the head.

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Migraine pain theory states that it happens due to wave activity by groups of excitable brain cells. These trigger chemicals, such as serotonin, to narrow blood vessels. (John Hopkins Medicine, 2019)

Causes can be: (Mayo Clinic, 2021)
a) Drinks- Alcohol, especially wine or too much caffeine

b) Stress

c) Weather change- barometric pressure

d) Food additives- sweetener aspartame (sugar substitute) and MSG that is found in many foods

e) Hormonal changes in women- fluctuation in estrogen

f) Medications- oral contraceptives and vasodilators

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There is no specific test to diagnose migraines. If you have signs and symptoms regularly keep track of it and make an appointment with your general practitioner so that they can refer you to a neurologist

MRI: helps to diagnose brain tumours, strokes, bleeding in the brain, infection, and other neurological conditions  (Mayo Clinic, 2021)

CT Scan: This helps doctors diagnose tumours, infections, brain damage, bleeding in the brain and other possible medical problems that may be causing headaches (Mayo Clinic, 2021)

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Sign: Throbbing pain or pulsing sensation on one or both sides of the head

Symptoms can progress into four stages: (Mayo Clinic, 2021)

1. Prodrome- one or more days before a migraine

Constipation

Mood changes

Food cravings

Neck stiffness

2. Aura- some people, an aura might occur before or during migraine. They are usually visual but can also include other disturbances

Flashing light

Blind spots on vision

Difficulty speaking

Weakness or numbness in the face or one side of the body

3. Attack/ Headache- migraine usually last from 4 to 72 hours if untreated

Pain that throbs or pulses

Sensitivity to light

Nausea and vomiting

4. Post- drome- after the migraine attack, one might feel fatigue, confused and wash out.

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This is Your Migraine in 2 Minutes | Glamour

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Includes: (Mayo Clinic, 2021)

Family history-  If you have a family member with migraines, then you have a good chance of developing them too

Age- Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.

Sex- Women are three times more likely than men to have migraines.

Hormonal changes- For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

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Treatments (Mayo clinic, 2021)

Pain relieving medication- also known as acute or abortive treatment

Aspirin or ibuprofen

Preventive medications- these types of drugs are taken regularly to reduce the severity or frequency of migraines

Lopressor or propranolol

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Lifestyle Changes for Migraine | American Migraine Foundation

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Learn an easy way to remember some simple lifestyle changes to help manage migraine.

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Our role:

PT: Focus on addressing muscle and joints (Benisek, 2022)
- Treat migraine related musculoskeletal problems (usually in the neck)
- Help ease vestibular symptoms (such as vertigo, dizziness, loss of balance, and sensitivity to motion)

NOTE:
- Each person's response to treatment varies
- Discuss it with your general practitioner first

OT can help with sleep routines, pacing, relaxation techniques, and time management (Migraine Canada TM)

RA: Educate, modify the environment, stress management, be patient

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How a migraine happens. How a Migraine Happens | Johns Hopkins Medicine. (2019, November 26). https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/how-a-migraine-happens#:~:text=One%20aspect%20of%20migraine%20pain,for%20communication%20between%20nerve%20cells.

Mayo Foundation for Medical Education and Research. (2021, July 2). Migraine. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201#:~:text=Hormonal%20changes%2C%20specifically%20fluctuations%20and,drinking%20too%20much%20caffeine%2C%20stress

Alexandra Benisek. (n.d.). Physical Therapy for Migraine. WebMD. https://www.webmd.com/migraines-headaches/physical-therapy-for-migraine

Your Migraine Team: you are not alone - Migraine Canada TM. (2019, October 25). https://migrainecanada.org/posts/the-migraine-tree/trunk/core-skills/your-migraine-team-you-are-not alone/#:~:text=Occupational%20therapist&text=In%20headache%20management%2C%20they%20can

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