Migraines, cervicogenic and tension-type headaches are common types of headaches and have a great impact on physical, social and occupational functioning (Pourahmadi et al. 2019). Although less common than a tension-type headache, migraine is the most common type of headache leading patients to consult a doctor (Pryse-Phillips et al. 1998).

How is a migraine different to a ‘normal’ headache?

We can describe Migraine as a common disabling primary headache disorder, ranking the third highest cause of disability worldwide in both females and males under the age of 50 years. Migraine is classified as a disorder manifesting in attacks lasting 4-72 hours. The headache is one-sided, pulsating, with a moderate-to-severe intensity aggravated by normal physical activity and is associated with nausea and/or light and sound sensitivity (Arnold et al., 2018). It is a physiological disorder, which is genetically based, has neurochemical instability of the nervous system triggered by different intrinsic or extrinsic factors, or both (Pryse-Phillips et al. 1998).

While migraine sufferers can usually manage this condition with medication, some patients do not tolerate migraine medication due to side effects or would prefer to avoid medication for other reasons. Research shows that most patients benefit from a combination of non-pharmacological and pharmacological intervention for controlling this headache disorder. A review of randomised controlled trials suggests that physiotherapy may be equally efficient as medication in the prophylactic management of migraine (Chaibi et al. 2011). These trials found that using physiotherapy is beneficial because cervical (neck) dysfunction is relevant in the origin of migraine (Pryse-Phillip et al. 1998).

Physiotherapy and Migraine

Hertogh et al. and Chaibi et al. suggest the following physiotherapy interventions to be beneficial in migraine treatment:

  • Cervical joint mobilisation techniques
  • Low load exercise focusing on cranio-cervical flexion
  • Muscle relaxation techniques including massage, trigger point release and myofascial release
  • Muscle stretching techniques
  • Cervical mobilisation exercises
  • Postural correction

The primary aim of physiotherapy is to decrease pain, provide rehabilitation for patients to regain lost function and minimise the frequency of migraines. For optimal assessment and treatment for your migraines, use the contact form to request that one of our physiotherapists assists you.

Kate Lamprey, Practice Manager at the Douglasdale and Fourways branches of Lamberti Physiotherapy, submitted this article.

1. Arnold, M. (2018) Headache classification committee of the international headache society (IHS) the international classification of headache disorders; Cephalalgia, 38 (1): 1-211.
2. Chaibi, A; Tuchin, P; Russel, M (2011) Manual therapies for migraine: a systematic review; Journal Headache Pain, 12:127-133.
3. Hertogh, W; Vaes, P; Devroey, D; Truijen, S; William, D; Oostendorp (2007) Management of headache disorders: design of a randomised clinical trial screening for prognostic patient characteristics; BMC Musculoskeletal Disorders, 8:38-46.
4. Pourahmadi, M; Mohseni-Bandpei, MA; Keshtkar, A; Koes, BW; Fernandez-de-Las-Penas, C; Dommerholt, J; Bahramian, M (2019) Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review; Chiropractic Manual Therapy, 26:27-43
5. Pryse-Phillips, W; Dodick, D; Edmeads, J; Gawel, M; Nelson, R; Purdy, R; Robinson, G; Stirling, D; Worthington,I (1998) Guidelines for non-pharmacologic management of migraine in clinical practice; Canadian Medical Association Journal, 159:47-54.