HEADACHE AND MIGRAINE CLINICPrevention, diagnosis, treatment and long term management
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There are many different types of headaches but they all share at least one thing in common — they cause pain. Many headaches also cause other unwanted symptoms, including nausea and vomiting. It is of great importance to get a proper diagnosis of what is causing YOUR headache.
There are many causes and triggers for headaches, some linked to our posture and movements and some related to lifestyle issues eg diet and stress levels. Once identified, the frequency and severity of headaches can often be reduced without having to resort to medications. See below for a list of common types of headache.
Our team is dedicated to helping you to get rid of your pain and debilitation and to return you to your usual activities as quickly as possible and have an excellent record when it comes to the longterm management of pain and health conditions.
We are registered with ALL healthcare insurance providers. Please let the team know if you are using health insurance when you make your appointment.
Common Types of Headache
Migraine is a severe headache type and can have a considerable impact on the daily life of sufferers and affects between 17 per cent of women and 6 per cent of men, although estimates vary. Accurate diagnosis of the different presentations of migraine is the foundation of effective prescribing, management and treatment.
Diagnostic pointers for migraine:
- Attacks last from 4 to 72 hours
- Patients are usually symptom-free between attacks
- Headache is at least two of the following
- Unilateral (on one side)
- Moderate to severe
- Aggravated by routine activities
- Accompanying symptoms may include
- Photophobia (more sensitive to light)
- Phonophobia (more sensitive to noise)
- Nausea and Vomiting
In any medical condition it is of paramount importance for the diagnosis to be accurate and this can only be made by your health professional or neurologist who knows your private medical history in detail. Only after this has been achieved can an appropriate management plan be established. In the late 1980s, the International Headache Society (IHS) formulated a classification for migraine, which has helped us to determine the correct patient groupings for migraine clinical trials. If five headache attacks meet the criteria, the patient is given the diagnostic label of “migraineur”. It is important to realise that not all four main symptoms have to be present. It is quite possible for the patient to have a mild headache which is bilateral, but still have migraine.
Recently clinicians have realised that it is helpful to ask questions of patients with acute or intermittent headaches. Information about their quality of life and ability, or otherwise, to perform normal activities is very important. High impact, acute headache would, therefore, tend to have a default diagnosis of migraine and the IHS classification is used to confirm this.
The main part of the classification is concerned with the headache phase of the attack. However, approximately 10 per cent of patients will have reversible sensory symptoms in the hour preceding the headache. These symptoms are known as aura and will often include visual changes, such as zigzag lines or scotoma (holes in the vision), but a variety of other symptoms may also occur.
Other symptoms include, dizziness, numbness and “word salading” (words being mixed up). About 40 per cent of patients describe more vague symptoms of aura that can last substantially longer. In the day or two before an attack, prodromal symptoms, such as cravings and lethargy, can be observed. From within these two groups of symptoms, useful warnings can be identified and patients taking simple treatments during such a warning may have success in heading off a migraine before it has started.
Often ignored is the postdrome phase of migraine. Once the headache has subsided the postdrome usually involves the patient feeling quite washed out or hung-over. A few patients may feel entirely the opposite, almost as if they are super-human. Relatively little can be done to alleviate these prodromal symptoms, the cost in terms of disruption to work, relationships, and social activities, which can result from this phase of the attack can be considerable.
Trigger Factors For Migraine
Environmental factors: Build up of tiredness over the working week, emotion and stress (eg, anger), missed meals (hypoglycaemia), smoke, strong odours (eg, perfume, paint), too much/little sleep, weather changes, bright/flashing lights.
Hormonal changes: Hormone replacement therapy (HRT), menstruation, oral contraceptives, pregnancy.
Exercise or exertion: Eye strain, head injury, irregular/no exercise.
Food/ingredients: Alcohol, artificial sweeteners, caffeine, chocolate, cultured dairy products fermented/pickled foods, fruits, mature cheese, monosodium glutamate, nitrates (eg, in cured meats), sugar, sulphites, vegetables, yeast.
Cervicogenic Headaches (related to the NECK)
Estimates of the prevalence of cervicogenic headache vary from 1% to 4% in the general population and as high as 17•5% among patients with severe headaches. The prevalence is thought to be as high as 53% in patients with headache after whiplash. The most reliable features for diagnosis are considered to be pain that starts in the neck and radiates to the fronto-temporal region, the ipsilateral shoulder and arm and pain that is made worse by neck movement. Pain is of varying duration or a fluctuating continuous pain, moderate, non-throbbing pain, and associated with a history of neck trauma.
All of our osteopaths have undergone Masters degree training to be experts in assessing and treating your headache. Click below to book a consultation at a time that suits you.
We have appointments available with our specialists:
8am – 8pm Monday to Friday
8am – 4pm on Saturdays.
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0845 116 2102
0207 720 9644
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How many sessions will I need?
What is involved?
We will carry out a full case history and physical assessment to take in all the possible contributing factors to your current symptoms. Our movement assessment is very thorough as we hope to be able to identify any areas of weakness, tightness and imbalance, even in areas of the body away from your symptoms as these can commonly be significant. We will also carry out a full assessment of your diet and lifestyle in order to identify any habitual postures/toxins that may be contributing to your issue.
Following the assessment, we will be able to identify what structure is causing your pain and symptoms as well as the underlying cause of why it has happened. This information will guide the nature of the treatment and rehabilitation plan going forwards. At this stage we may be able to give a prognosis of how long your recovery will take.
Treatment plans will vary greatly depending on the cause of your issue but will definitely include work to alleviate your symptoms, such as soft tissue work and spinal manipulation as well as techniques to address any mechanical issues which may be causing the strain to the tissues which are in pain. In addition, at this stage any nutritional and lifestyle factors will be addressed.
Following the treatment and rehabilitation of your injury, you will be given a management plan that may consist of continued rehabilitation exercises, lifestyle/postural changes and possibly future check ups to ensure the problem does not recur.
What's the next step?
- ongoing treatments to maintain physical health
- exercise programmes to improve fitness / weight levels
- nutritional plans to optimise health levels