The Role of Myotherapy in Treating Headaches and Migraines

Headaches and migraines represent some of the most prevalent and burdensome neurological disorders worldwide, impacting individuals across diverse demographics and age groups. Understanding the scientific differences between these two entities is crucial for accurate diagnosis and appropriate management. Below, we outline the key differentiators between the two:

• Neurovascular Mechanisms:
  • Headaches: The term “headache” is a broad descriptor for pain or discomfort in the head or neck region. It can result from various causes, including tension, sinus congestion, or other non-specific factors. While the exact mechanisms of tension-type headaches, for example, are not fully understood, they are generally considered to involve muscular tension and contraction.
  • Migraines: Migraines, on the other hand, are a type of primary headache with specific neurovascular involvement. The prevailing theory is that migraines involve abnormal brain activity and interactions with the trigeminal nerve, leading to the release of neuropeptides and vasodilation of cerebral blood vessels. This process is believed to contribute to the characteristic throbbing pain associated with migraines.
• Aura:
  • Headaches: Most headaches, particularly tension-type headaches, do not typically present with auras. Auras are transient neurological symptoms that precede or accompany certain types of migraines.
  • Migraines: Migraines with aura are a subtype characterized by the presence of specific neurological symptoms, such as visual disturbances or sensory changes, preceding or during the headache phase. These auras are thought to be related to cortical spreading depression, a wave of altered neuronal activity in the brain.
• Duration and Intensity:
  • Headaches: Headaches can vary widely in duration and intensity. Tension-type headaches, for instance, are often described as a mild to moderate, non-pulsating pressure or tightness.
  • Migraines: Migraines typically last longer than common headaches, often between 4 to 72 hours if untreated. They are characterized by moderate to severe pulsating pain, often unilateral, and are associated with other symptoms such as nausea, vomiting, and sensitivity to light and sound.
• Triggers and Contributing Factors:
  • Headaches: Triggers for common headaches can be diverse and may include stress, lack of sleep, postural issues or environmental factors. Secondary headaches may have specific underlying causes, such as infections or other medical conditions.
  • Migraines: Migraines often have identifiable triggers, including hormonal changes, certain foods, sensory stimuli, and stress. Genetics also play a role, as migraines tend to run in families.

Manual therapy, encompassing various hands-on techniques, has emerged as a promising adjunct to conventional treatments and offers an alternative to drug consumption (Puledda et al., 2018).

 

• Manual Therapy for Headaches:

1. Peripheral Joint Mobilisation:

• Peripheral joint mobilisation focuses on articulating and mobilising joints outside the spinal region. This technique, often applied to the temporomandibular joint (TMJ) or other peripheral joints, can be effective in addressing musculoskeletal imbalances contributing to certain types of headaches. By improving joint mobility and reducing tension in peripheral structures, this approach may offer relief without direct manipulation of the spine.

1. Active Release Technique (ART):

• Active Release Technique involves combining precisely directed tension with specific patient movements to address soft tissue restrictions. This technique is particularly effective in targeting myofascial trigger points and releasing muscular tension, offering an alternative to myofascial release techniques for tension-type headaches.

1. Postural Correction Exercises:

• Emphasising corrective exercises for postural realignment can be an alternative approach to cervical mobilisation. Strengthening and stretching exercises targeting the neck and shoulder muscles may address postural imbalances, promoting long-term relief from tension headaches associated with poor posture.

1. Myofascial Release Techniques:

• Myofascial release, encompassing soft tissue manipulation and stretching, targets muscular trigger points and fascial restrictions contributing to tension headaches. By releasing myofascial restrictions, these techniques promote improved blood flow and muscle flexibility, potentially providing relief from chronic tension-type headaches.

1. Cervical Mobilisation:

• Cervical mobilisation techniques focus on restoring normal range of motion in the cervical spine. Through gentle and controlled movements, these interventions aim to reduce cervical joint dysfunction, addressing underlying mechanical factors associated with certain headache types.

• Manual Therapy for Migraines:

 

1. Connective Tissue Manipulation:

• Connective tissue manipulation involves gentle stretching and mobilisation of the fascial network throughout the body. This technique aims to improve the mobility and elasticity of connective tissues, potentially influencing the central nervous system and reducing migraine-related hypersensitivity.

1. Manual Lymphatic Drainage:

• Manual lymphatic drainage focuses on gentle rhythmic movements to stimulate the flow of lymphatic fluid. This technique may be beneficial in reducing congestion and promoting drainage, potentially addressing migraines associated with fluid retention or vascular factors.

1. Proprioceptive Neuromuscular Facilitation (PNF) Stretching:

• Proprioceptive Neuromuscular Facilitation involves a combination of stretching and contracting muscles to enhance flexibility and neuromuscular control. Applied to muscles associated with migraines, PNF stretching may contribute to the relaxation of hypertonic muscles and improve overall muscle function.

1. Soft Tissue Mobilisation:

• Soft tissue mobilisation techniques, including massage and trigger point therapy, target muscular tension and trigger points commonly associated with migraines. By promoting relaxation and reducing muscular hypertonicity, these interventions may contribute to a decrease in the frequency and severity of migraine attacks.

1. Neuromuscular Techniques:

• Neuromuscular techniques focus on addressing imbalances in the neuromuscular system. Practitioners apply targeted pressure to specific points, aiming to normalise neural function and alleviate trigger point-related pain. This approach may be particularly beneficial in managing migraines with associated myofascial pain.

 

Bevilaqua et al. (2016) reported a greater reduction in the frequency of the episodes after applying cervical mobilisations and massage and myofascial release twice a week over a 4-week period, and thus, a higher frequency of treatment may have yielded better results. As part of a comprehensive approach to managing headaches/migraines and promoting overall well-being, myotherapists here at HBM may employ these techniques, among others, as appropriate.

 

Listed below are some details of a client dealing with headaches who is seeking treatment here at HBM, which may also serve as a case study:

 

Age: 50+

Gender: F

Symptoms: Pain in suboccipital region causing referral symptoms in the head.

Medical history: No injury to head/neck region, frequent debilitating headaches. Takes Panadol/neurofen to help with pain but they don’t help much usually.

Lifestyle: Works at a desk and sits in front of a screen for long periods. Took up piano lessons recently which places her in a similar position postural-wise.

 

The client has received 5x treatments here at HBM over the past 2 months to manage her headaches, and even after the first treatment has had great improvement on her symptoms. Educating her on the importance of compliance to treatment has made a big difference on her quality of life.

 

If you or someone you know are dealing with headaches/migraines, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

 

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.