In the last of our 3-part blog series, we will talk you through the most common headaches we see at the clinic, how to differentiate them, and how our osteopaths and myotherapists can help you tackle them.

This weeks blog is about migraines. Even though migraines are less common compared to cervicogenic and TMJ/tension headache, they tend to be more severe in nature. There has recently been an explosion in migraine diagnoses since COVID-19.  

Migraines are a genetic, incurable neurological condition that affects approximately 4.9 million Australians according to the World Health Organisation (WHO).  



A migraine is a chronic neurological disorder depicted by episodic attacks of head pain and associated symptoms. They can cause severe throbbing or a pulsing sensation, usually on one side of the head but can also occur bilaterally (although the side can change between attacks). According to the National Institute of Neurological Disorders and Stroke, about one in three individuals with migraines report experiencing an aura before the headache.  



People who have migraine episodes with auras might not experience an aura every time. Migraine episodes can occur in four distinct phases – though not everyone experiences all phases. Migraines occur most frequently in the morning, especially upon waking. Some people have migraines at unavoidable times, such as before menstruation or on weekends following a stressful week of work. 

Premonitory phase 

Includes non – painful symptoms that occur hours or days before the headache.  

This can include: 

  • Unexplainable mood changes 
  • Food cravings
  • Stiffness of the neck 
  • Frequent yawning 
  • Constipation or diarrhea 
  • Sensitivity to light (photophobia) and/or sound (phonophobia) 


Aura phase 

Auras can affect a person’s visual, sensory, motor and sometimes movement pathways that occur before or during a migraine attack. 

  • Visual symptoms can include seeing spots, flashing lights, zig zag lines and being aware of blind spots 
  • Motor symptoms include slurred or jumbled speech, difficulty understanding others, difficulty writing and having problems thinking clearly 
  • Sensory symptoms include tingling, pins and needles and/or numbness 
  • Movement problems can reduce coordination, dizziness and speech disturbance

Headache phase

Migraine headaches can range from mild to severe. People who have a severe migraine headache may need to seek emergency medical treatment. Physical activity and exposure to light, sound and smells worsen the pain. People can have migraine episodes without developing a headache and are commonly symptom-free between attacks.  


Postdrome phase 

The postdrome phase occurs after the headache subsides. People may feel exhausted, confused, or generally unwell during the postdrome phase. This phase can last anywhere from a few hours or several days. 

The main factors that contribute to a migraine are – pain in our cervical structures and serotonin. Migraine triggers such as stress and an increase in anxiety and depression is a main lead of this explosion. Research has shown that sufferers of a common migraine (without an aura) and cervicogenic headache share similar symptoms.  


Migraines can be managed and many people who live with migraines are able to control their infrequent attacks. The most effective way to manage it is ‘hard and fast’. Getting on top of the attacks quickly with effective hands-on treatment from your Osteopath or Myotherapist, medication and healthy lifestyle factors can allow the attack to be managed acutely. Unfortunately, the more we try to mask our migraines with painkillers or just letting them ease on their own, the more frequent and severe those migraine attacks become, until they are completely debilitating. 

Treatment to the cervical spine for patients suffering from migraines can lead to significant long-term effects. Your Myotherapist or Osteopath will take a comprehensive assessment of the cervical spine and the surrounding structures. This will allow us to work on the distressed structures that are impacting the headache. We will use a variety of hands-on techniques to provide you with symptomatic relief. 

Furthermore, we can help our patients identify what lifestyle factors may be predisposing them to their headaches eg. posture/set up at work or pillows which will help us provide a management plan best suited to the individual. This could include relaxation and breathing techniques, postural strengthening, stretches, stress management techniques to reduce the relapse and even taking a routine 5-minute work/study break. We can also help our patients with the appropriate referrals and investigations should we believe there may be a non-musculoskeletal cause for their symptoms. Correctly differentiating between headaches and types of migraine headache can lead to a faster, more effective treatment. 



Migraines occur in both children and adults but affect adult women three times more than men. There have been several factors identified with higher risks of migraines but can differ from person to person. These include: 

  • Being female – the start of a menstrual cycle or during pregnancy, during menopause 
  • Having a family history of migraines 
  • Mood disorders, such as depression, anxiety, or bipolar disorders 
  • Sleep disorders, not enough sleep or too much sleep 
  • Caffeine and/or caffeine withdrawal 
  • Diet – processed foods, types of alcohol, cheese and yeast  

 Most people will experience a headache at one point in their lives. Not all headaches are the same, as they range in severity, frequency, and cause. 

Headache disorders can significantly impact a person’s ability to function and reduce their overall quality of life. This is why accurate diagnoses are so important. 

Hopefully lockdown number 6 is the last that Victorians will go through and we can get back on track with our health and wellbeing in 2022.


About the author

CSSM Myotherapist Adele Agius feels that analysing the main components of people’s everyday lifestyles and interests allows her to identify and provide specialised ways for a specific individual to help aid in strengthening, rehabilitating and maintaining a healthy lifestyle. Adele enjoys working with people to help get them back to the activities they love. Adele executes this through a “hands-on approach”, which includes trigger point therapy, dry needling, cupping, myofascial release and treatment of musculoskeletal pain and dysfunction. Adele is a firm believer on educating her clients about their condition and what their recovery process will entail to improve their ability to manage, maintain and overcome their injuries.




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