Migraines
What is a Migraines?
A transient, recurring neurological condition that occurs when a certain threshold has been reached (i.e. too much of one trigger or a combination of triggers). When this threshold has been breached there is a
temporary change in how the brain functions (i.e. neural firing & neurogenic inflammation), resulting in the signs and symptoms such as; headaches, dizziness, fluctuating hearing loss, ear ringing and pressure, light sensitivity, noise sensitivity, sinus pressure, nausea, confusion,
visual disturbances, and numbness.
Types of Migraines:
According to the ICHD-3 ( International Classification of Headache Disorders) there are 2 major types of Migraines:
1. Migraines without aura. 2. Migraines with aura.
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- Prodrome (an early symtom indicating the onset of a migraine).
- Aura.
- Attack.
- Postdrome (symtoms that linger a few hours to more than a day after headache goes away).
Please note not everyone experiences all of these phases and symptoms may overlap between phases.

Migraine Without Aura
A. At least five attacks fulfilling criteria B–D.
B. Headache attacks lasting 4–72 hours (when untreated or unsuccessfully treated).
C. Headache has at least two of the following four characteristics:
1. Unilateral location.
2. Pulsating quality.
3. Moderate or severe pain intensity.
4. Aggravation by or causing avoidance of routine physical activity (e.g. walking).
D. During headache at least one of the following:
1. Nausea and/or vomiting.
2. Photophobia and phonophobia.
E. Not better accounted for by another ICHD-3diagnosis.
Individuals who otherwise meet criteria for migraine without aura but have had fewer than 5 attacks can be considered: probable migraine without aura.
Migraine With Aura
Diagnostic criteria:
A. At least two attacks fulfilling criteria B and C.
B. One or more of the following fully reversible aura symptoms. Usually occurs before the headache, but it may begin after the headache phase has commenced, or continue into the headache phase:
1. Visual (over 90% of patients).
2. Sensory (usually pins & needles and/or numbness).
3. Speech and/or language (usually aphasia).
4. Motor.
5. Brainstem.
6. Retinal.
C. At least three of the following six characteristics:
1. At least one aura symptom spreads gradually over >5 minutes.
2. Two or more aura symptoms occur in succession.
3. Each individual aura symptom lasts 5–60 minutes.
4. At least one aura symptom is unilateral.
5. At least one aura symptom is positive.
6. The aura is accompanied, or followed within 60 minutes, by headache.
D. Not better accounted for by another ICHD-3 diagnosis.

How Physiotherapy can help:
When dealing with migraines, physiotherapy can play a key role in your journey to better management and relief. As part of a multidisciplinary approach, physiotherapy offers targeted treatments that go beyond simply addressing the pain. Your physiotherapist will provide extensive education about migraines, helping you understand potential triggers and how to avoid them. They can guide you in promoting endorphin release, which acts as a natural pain reliever, and teach you strategies to improve your sleep quality—an essential component of migraine prevention. Relaxation techniques and manual therapy to release tension in your neck and jaw can help alleviate tight and sensitive tissues that may contribute to your symptoms. Additionally, your physiotherapist can provide practical tools to manage visual and motion sensitivity, empowering you to regain control over your daily life.
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