Treating migraines

[the sex]

Hi everyone,

Lately I have been getting lots of migraine sufferers through the clinic door. I am (more or less) consistently successful in treating tension headaches, but I'm blind when it comes to understanding how to approach treatment for migraines, primarily because I do not get them myself.

I would love to hear of any treatment protocols, techniques, insights, learnings, etc that have stood the test of treating real clients.

Warm regards

Henry

 

[Pompal 09.]

I have a focus on migraine relief in my practice, partly because I get them myself.

A lot of my clients have classic levator-scapula triggerpoints and/or occipitals triggerpoints. Releasing those, even partly (and many of them never fully release), gives those clients immediate and sometimes eventual long-term relief. Teaching them self-therapy helps them maintain gains.

The TP client set overlaps somewhat with another set who have chronic fascial "thickening"-type adhesion tendencies through the low back & hips (incl. lateral rotators) -- the kind you feel with folks who sit at a desk for hours & hours & hours. Lengthening & freeing that area, as well as encouraging exercise to keep the pelvic diaphragm free, can help a lot, and a lot of the time the client is pleasantly surprised, since low-back tension & migraine are not a much-talked-about pair.

Consider asking your clients frequently about their meds, as sometimes pain-med regimens will change frequently (beta blockers, other BP meds, anti-seizure meds, Imitrex, self-treatment with pot, etc.). You probably already know that some migraines will not respond positively to touch, or at least not all the time. And you might find some mig. sufferers resisting if you enthusiastically offer a lot of hope for relief -- we're so used to doctors insisting that This New Thing is the very thing that will fix our poor heads forever, that we can be a very skeptical bunch. But some *will* get good relief, and there is no client more grateful, or more loyal, than one who gets fewer migraines.

 

[Person]

Hi BJP-LMP,

Thank you for such a comprehensive reply. I'm not sure which exercises to prescribe to keep the pelvic diaphragm free, but I am currently whipping through the web to get info so please don't waste your time listing them here...

However, could you help me understand which of the lateral hip rotators do you find most effective to treat in the context of migraines? Piriformis, Gemellus Superior, Obturator Internus, Gemellus Inferior, Obturator Externus, Quadratus Femoris?

Thank you so much for your help.

Warm regards

Henry

 

[Unknown Truth]

There's another thread on this same topic, which you may also find helpful:

http://www.massageplanet.com/forum/viewtopic.php?t=3112&highlight=migraines

 

[Nes S]

Piriformis and psoas wll both be major contributors. Lots of folks won't believe it. "what does my pelvis have to do with my migraines or headache" Nearly everything.

 

[man of steel]

Mick, I agree. I am not a migraine sufferer, but I had a course on treating migraines and other headaches a couple of months back. The instructor talked about the diagnal effect and how low back muscles and the glutes can have an effect.

 

[confusedlady.]

Treating migraines

I have had several migraineurs in the past and my SO suffers from migraines. Most of these persons have a HNP-herniated nucleus pulposus- in their cervical spine. I have found it best not to treat them when they are in a migraine.
My wife's headaches are so bad at times it requires a trip to the ER for a strong drug cocktail of morphine and an anti-nauseau shot. She then sleeps off the headache and usuallly it's gone. 8) With the strong nausea, light sensitivity, etc. I can't see why someone with a migraine would benefit from massage. Sleep seems to be the best remedy. I have also heard cautions from over treating with medications that can cause a rebound headache.
Migraines seems to be a neuro-vascular episode where the arteries in the head contract and expand on their own. I find massage great for tension headaches and I'll pass on working on an active migraine.
By the way-I've been able to start a migraine with overworking the suboccipitals and the posterior cervical spine :
I learned the hard way.
Cheers,
rubmyster

 

[Delauria]

I'd like to ditto what rub said, (except for the HNP stuff because that's a totally new one I've never heard... I'll have to look into it.)

As someone who has suffered since early childhood with migrained, I would say do not treat with massage when someone is in acute migraine. Last thing they need is more vasodilation or any inflammation as a result of massage. Ditto on the acupuncture. Possibly a chiropractic adjustment if the migraine hasn't reached extreme and there is not yet accompanying nausea.

But massage, applied properly, can reduce the severity and frequency. Applied properly means between attacks, not during. And that's a difficult situation because many of us are in denial about migraines... as in, "If I don't think about this, maybe the next one won't happen!" Which is utterly ridiculous, but there it is. Kind of like the man who wouldn't fix his leaky roof because it was a lovely day.

Overworking the suboccipitals and post c-spine can start off a migraine, thanks for mentioning that too, Rub. But working splenius c/c and spinalis can help tremendously, if not pushed too far. Also, naturally, the anterior neck muscles, omohyoid, and skin rolling of the platysma.

Getting the shoulders back by opening the chest, pecs, subclavius, and strengthening rhomboids can make quite a difference, as it helps prevent subluxation of C-7, which can really mess with the OA joint.

And then of course, remembering that there are some people (like me) who have a congenital reason for the migraines to occur, so management rather than elimination is the goal. Don't get discouraged when your client inevitably has another migraine. If you've helped lessen them, you did great.

Stacey (coming down off the "drug cocktail" received from spending most of yesterday in the ER with a migraine.)