Migraines – I love them. Not having one, but treating them. They are complex, the causes are poorly understood and they often appear to have a mind of their own – they can be life changing and can present differently from person to person. Even someone with a long history of migraines can describe symptoms which change and move, so they never quite know what they are going to get.
Migraine is often the name given to any head pain, but the sub categories are vast. Tension headache, migraine with and without aura, hemiplegic migraine, cluster headache, cervicogenic headache. These are the most common we see within our practice, but no matter which ‘label’ you have for your head pain, there is usually one common thread – they can be debilitating and can severely affect function – be it school, work, hobbies or sport. There is no getting away or putting a brave face on – typically when people see us, they can only gain some relief with high levels of medication (which usually comes with its own issues of side effects and sometimes inducing headaches themselves) or lying down in a dark room – which isn’t always a practical solution! Mood can be affected, as well as energy levels, sleep and appetite, further amplifying symptoms.
A migraine can, and will stop you in your tracks – I recall a patient who suffered with severe migraines with dysphasia (problems forming words during an attack) – she was driving when an attack came on, so pulled over to the side of the road – a well meaning passerby came to assist and when she couldn’t talk properly, she was whisked off to casualty with a suspected stroke – all the while in her head she was shouting I’m having a migraine, it will pass. Would you like to know how we deal with migraines at Taylored-fit Physio?
When you attend your first appointment, we will ask you lots of questions to help us understand the origin of your symptoms and how they behave. We will ask you to describe it, where exactly it is, asking you to give your pain a number on a scale of 0-10, if there is anything which worsens or improves it, and if you have any associated symptoms like dizziness, nausea, tinnitus, vertigo, problems with speech, swallowing or balance. We will ask you about any previous history of injury or trauma, including whiplash, head injury, back pain, birth trauma or emotional stress/ trauma. We will also ask about any other symptoms you may be having (commonly associated with headaches are back pain, TMJ (jaw) pain, poor sleep and energy levels. We will ask about past medical history to give us a picture of your general health and wellbeing. We will also ask about your previous treatment or management of your symptoms to date, further building a picture for us.
All these questions are really important. They give us an idea of the origin of your symptoms and how they behave (often described as severity, irritability and nature) and also help us to exclude things which we may be concerned about, or would need to refer you onwards for further investigations.
We always aim to start treatment on the first session – which is why your first assessment is a little longer (usually 45 minutes).
Depending what we find on assessment and examination, your expectations/ goals of treatment/ our opinion and your preferences, treatment may involve physiotherapy (involving the treatment of the joints, muscles, tissues around the head/neck spine using manual “hands on treatments”, soft tissue release work, proprioceptive strapping – treating what we find, re-evaluating and progressing as appropriate. Acupuncture is a modality we use frequently and this can be really helpful in alleviating your symptoms.
We will also generally, if appropriate, give advice and specific exercises which may help. Typically postural and ergonomic advice is given, to help alleviate pressure on painful structures. Often strength needs to improve around the deeper postural ‘holding’ or ‘stabilising’ muscles around the neck and spine. We try and look at the whole picture and not treat everyone the same.
We also specialise in craniosacral therapy, which we have found really effective in helping lots of patients. This gentle, safe, hands on treatment assesses and releases tensions within the craniosacral system (basically the membranes and tissues that make up the skull, brain, spinal cord and nervous system). I have seen profound improvements in children and adults alike, typically in those who have not responded to typical medical intervention and medication.
At every session, we will review how things are going, if you feel a change – typically the reason people come to see us is their pain – but commonly as pain improves, so too does mood, appetite, sleep and ability to move and do more. Often it is breaking that vicious circle, and with treatments, we do not have a ‘formula’ – how one person responds will vary from the next. But as physiotherapists we have lots of clinical skills to help you.
We are passionate about helping you achieve your goals. For some people, they want a way to self manage their symptoms, to regain control lost. For others it is becoming pain free, for some, alleviating their symptoms to allow sport/ hobbies or simply making school or work an easier environment to be in.
You are in safe hands. Let us care for you and your family.
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