The chiropractic approach to migraine

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Migraine is a complex entity, usually characterized by unilateral head pain of a pulsating or throbbing quality. Clinically, migraine is subdivided into five phases: prodrome, aura, headache phase, headache resolution and postdrome. The prodrome is experienced by about 60% of migraine sufferers and is characterized by mood changes, food cravings, increased or decreased appetite, nausea, numbness and tingling, an inability or difficulty to speak (aphasia or dysphasia) and clumsiness/weakness of one side of the body. This is followed by an aura phase, experienced by about 20% of migraine sufferers, typically characterized by bright dots of lights in the visual field (photopsias) and saw tooth crescents of light (fortifications). Following the aura phase, the headache begins, lasting anywhere between 4-72 hours in the absence of medication. The headache resolution is then followed by the postdromal phase, which is characterized by fatigue, irritability, mood changes and food intolerance.

Various factors can trigger a migraine attack, such as psychological factors (stress, release from stress, excitement), hormonal factors (menstruation in females, use of the oral contraceptive pill, pregnancy), and dietary factors such as red wine, aged cheese, caffeine, dairy products and a number of food additives. Lifestyle situations such as irregular sleeping patterns, and environmental conditions, for example, weather changes can also act as triggers for a migraine attack.

As well as the triggers mentioned above, there is a suggestion or partial correlation between biomechanical dysfunction of the joints of the cervical spine/neck and migraine attacks. Dysfunction of the cervical spine can be related to pain in the head /migraine, via the trigeminocervical complex (figure 1). In simplified terms this involves convergence of the greater occipital nerve (second cervical nerve, C2), with the trigeminal nerve (cranial nerve, V1) as it conveys pain sensation from the periphery towards the brain. This convergence can result in the brain interpreting pain as if it were originating in the head, when actually it may be originating in the joints of the cervical spine, thus resulting in a headache (figure 1).

Figure 1. The trigeminocervical complex

However, it is important to be aware that the cervical spine is only one of the possible causes of a migraine attack.

Chiropractic care is reported to have positive effects in reducing the severity and frequency of migraine headaches, particularly in those patients with a cervicogenic/neck component to their migraine. Furthermore, the amount of medication required by migraine sufferers is often reduced during and following care. Current research studies support the effectiveness of chiropractic care for a migraine sufferer, which includes, but is not limited to, spinal manipulation.

Chiropractors are required by the General Chiropractic Council, the regulating body for chiropractic in the UK, to take a thorough history and carry out a physical examination of every patient, in order to form an appropriate diagnosis and to determine if the patient would benefit from chiropractic care. If the chiropractor identifies a patient who cannot be helped by chiropractic care, normal practice would be to refer the patient to the most appropriate healthcare practitioner for further consultation.

If you require further information regarding chiropractic care for migraine, or would like to arrange a chiropractic consultation, or to organise a talk by Natalie in the Bromley area, please contact:

Natalie Panayides, MChiro
Beckenham and Bromley Chiropractic Clinic
18 Oaklands Road, Bromley, Kent, BR1 3SL
Clinic Telephone number: 02084605800

Anglo-European College of Chiropractic Clinic
13-15 Parkwood Road, Bournemouth, BH5 2DF
Clinic Telephone number: 01202436222

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