In a classical migraine, symptoms are always on one side of the head and throbbing in nature often associated with light sensitivity. The migraine sufferer can also experience zig-zag lines or circles, or blurring of vision. In some cases vomiting may occur although this is not always the case.
If vomiting is a new feature of the migraine attacks, an MRI is strongly recommended as screening for more serious conditions should be considered, especially if the vomiting is projectile in nature.
Migraine headaches are usually defined in 3 groups depending on where the throbbing pain is predominantly focused.
What kind of migraine do you have?
Types of headaches
1. Classical Migraine Headache starts at the temple and spreads to involve that whole side of the head lasting from 30 minutes to several hours.
2. Occipital-Orbital Migraine Headache starts at the back of the head running to the side of the temple ending deep behind the eye. This can be on one or both sides of the head.
The migraine starts gradually but the intensity soon skyrockets, often ending with a hospital visit because the migraine is often described as “bursting” in nature. This migraine can last several days and it is believed to be linked to neck muscle and nerve problems.
3. Orbital Migraine. This type of migraine is often described as red hot needle jabbing the back of the eye and any sudden movement or light provokes the pain. It is suspected to be vascular in nature (blood vessels in spasm) and in some medical fields it has been suggested the contraception pill may contribute to this type of migraine although further research is required before it is conclusive. This type of migraine is commonly seen in young women.
The migraine can be on both sides and is often described as “sinus headaches” or “migrainous neuralgia” that can last over a period of weeks with episodes of exacerbations.
Other Variations
1. Childhood Migraine. This type of migraine occurs in childhood and is often referred to as an”abdominal migraine”, as kids under 10 years of age rarely suffer head migraines. The attacks can cause pallor, nausea, vomiting with occasional complaints of blurred vision that last 20 minutes with complete recovery.
2. Cluster Headaches seen almost exclusively in middle age men precipitated by alcohol occurring late at night and lasting for up to 2 hours.The pain is excruciating and located in the eye causing the eye to become blood shot and teary. The nose is often congested and nasal discharge is also seen. The attacks can occur in a series, lasting for up to 3 months hence the term “cluster”.
Cluster headaches respond extremely well to ergotamines (dihydroergotamine) nasal spray, but be wary of side effect, as it is not a good long term solution but definitely helpful in the short term. Read the pharmaceutical information sheet for full details. Should these attacks persist longer than a year further investigation should be undertaken to exclude the possibility of an aneurysm. Ergotamines do not work as well with other forms of migraines.
3. Exertion Migraines occurs after physical exertion including sexual intercourse. Further test should be done to exclude small bleeding of the sub-arachnoid if this migraine persists.
4. Migraine with Vertigo. In these cases the vertigo is often worse than the migraine.
What Provokes Migraines?
1. Stress and poor posturing that stresses the back of the neck muscles and nerves, can cause migraines.
2. Bright lights. Reduce intensity of lights in your work place without compromising safety. Wear good quality sunglasses when driving in bright sunshine.
3. Blood vessel spasms due to emotional tension or in some cases medications.
4. Physical exertion increasing pressure in the blood vessels.
5. Over sleeping as it is often noted that migraines are more common on weekends when people tend to rest in bed for longer periods.
6. The contraceptive pill. If this is the culprit, a noticeable change occurs after 2 weeks of not taking the pill. The pill has been linked to dangerous vascular accidents such as a stroke episode ( read the manufacturer’s information sheet and warnings), so careful consideration should be made when taking the pill.
Management of Headaches
1. Sleep often ends a migraine attack, so it’s the best first option.
2. Chiropractic care. If the origin of migraines is from tension or from the neck muscles or neck nerves, Chiropractic should be considered as it could help.
3. Analgesics may assist or give little to no relief. Should analgesics work, relief should be noticed within 30 minutes. Relief any time after 30 minutes could simply be due to the Migraine running its course and ending on its own accord.
4. Opiates should never be used due to poor results, provoking vomiting and their serious addictive potential. There are a selection of anti-migraine medications that GPs can prescribe once the full nature of the migraine is understood correctly. Details of drug side-effects should always be considered and the cost-benefit ratio placed in the correct perspective.
Make an appointment at Chiropractor Melbourne or call us on (03) 9388 8237.
