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For individuals who suffer from migraine headaches, can incorporating physical therapy help decrease pain, improve mobility, and manage future attacks?

Migraine Physical Therapy

Cervicogenic migraine headaches can cause pain, limited motion, or confusing symptoms like dizziness or nausea. They may originate from the neck or cervical spine and be called cervicogenic headaches. A chiropractic physical therapy team can assess the spine and offer treatments that help improve mobility and decrease pain. Individuals may benefit from working with a migraine physical therapy team to perform treatments for specific conditions, quickly and safely relieving pain and returning to their previous level of activity.

Cervical Spine Anatomy

The neck is comprised of seven stacked cervical vertebrae. The cervical vertebrae protect the spinal cord and allow the neck to move through:

• Flexion
• Extension
• Rotation
• Side bending

The upper cervical vertebrae help support the skull. There are joints on either side of the cervical level. One connects to the back of the skull and allows motion. This suboccipital area is home to several muscles that support and move the head, with nerves that travel from the neck through the suboccipital area into the head. The nerves and muscles in this area may be a source of neck pain and/or headaches.

Symptoms

Sudden motions can trigger symptoms of cervicogenic migraine, or they may come on during sustained neck postures. (Page P. 2011) The symptoms are often dull and non-throbbing and may last several hours to days. Symptoms of cervicogenic migraine headache may include:

• Pain on both sides of the back of the head.
• Pain in the back of the head that radiates to one shoulder.
• Pain on one side of the upper neck that radiates to the temple, forehead, or eye.
• Pain in one side of the face or cheek.
• Reduced range of motion in the neck.
• Sensitivity to light or sound
• Nausea
• Dizziness or vertigo

Diagnosis

Tools a physician may use may include:

• X-ray
• MRI
• CT scan
• Physical examination includes neck range of motion and palpation of the neck and skull.
• Diagnostic nerve blocks and injections.
• Neck imaging studies may also show:
• Lesion
• Bulging or herniated disc
• Disc degeneration
• Arthritic changes

Cervicogenic headache diagnosis is usually made with one-sided, non-throbbing headache pain and a loss of neck range of motion. (Headache Classification Committee of the International Headache Society. 2013) A healthcare provider may refer the individual to physical therapy to treat cervicogenic headaches once diagnosed. (Rana M. V. 2013)

Physical Therapy

When first visiting a physical therapist, they will go through medical history and conditions, and questions will be asked about the onset of pain, symptom behavior, medications, and diagnostic studies. The therapist will also ask about previous treatments and review medical and surgical history. Components of the evaluation may include:

• Palpation of the neck and skull
• Measures of neck range of motion
• Strength measurements
• Postural assessment

Once the evaluation is completed, the therapist will work with the individual to develop a personalized treatment program and rehabilitation goals. Various treatments are available.

Exercise

Exercises to improve neck motion and decrease pressure on cervical nerves may be prescribed and may include. (Park, S. K. et al., 2017)

• Cervical rotation
• Cervical flexion
• Cervical side bending
• Cervical retraction

The therapist will train the individual to move slowly and steadily and avoid sudden or jerky movements.

Postural Correction

If forward head posture is present, the upper cervical spine and the suboccipital area could compress the nerves that travel up the back of the skull. Correcting posture may be an effective strategy for treatment and can include:

• Performing targeted postural exercises. 
• Utilizing a supportive neck pillow for sleep.
• Using a lumbar support when sitting.
• Kinesiology taping may help increase tactile awareness of back and neck position and improve overall postural awareness.

Heat/Ice

• Heat or ice may be applied to the neck and skull to help decrease pain and inflammation.
• Heat can help relax tight muscles and improve circulation and may be used before performing neck stretches.

Massage

• If tight muscles are limiting neck motion and causing head pain, a massage can help improve mobility.
• A special technique called suboccipital release loosens the muscles that attach the skull to the neck for improved motion and decreased nerve irritation.

Manual and Mechanical Traction

• Part of the migraine physical therapy plan may involve mechanical or manual traction to decompress the neck's discs and joints, improve motion in the neck, and decrease pain.
• Joint mobilizations may be used to improve neck motion and manage pain. (Paquin, J. P. 2021)

Electrical Stimulation

• Electrical stimulation, like electro-acupuncture or transcutaneous neuromuscular electrical stimulation, may be used on the neck muscles to decrease pain and improve headache symptoms.

Therapy Duration

Most migraine physical therapy sessions for cervicogenic headaches last about four to six weeks. Individuals may experience relief within a few days of starting therapy, or symptoms may come and go in different phases for weeks. Some experience continued migraine headache pain for months after starting treatment and use techniques they learned to help control symptoms.

Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive therapies and functional rehabilitation procedures focused on restoring normal body functions after trauma and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our natural programs use the body’s ability to achieve specific measured goals. We have teamed up with the city’s premier doctors, therapists, and trainers to provide high-quality treatments that empower our patients to maintain the healthiest way of living and live a functional life with more energy, a positive attitude, better sleep, and less pain.

Chiropractic Care For Migraines

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Page P. (2011). Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy, 6(3), 254–266.

Headache Classification Committee of the International Headache Society (IHS) (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia: an international journal of headache, 33(9), 629–808. https://doi.org/10.1177/0333102413485658

Rana M. V. (2013). Managing and treating headaches of cervicogenic origin. The Medical Clinics of North America, 97(2), 267–280. https://doi.org/10.1016/j.mcna.2012.11.003

Park, S. K., Yang, D. J., Kim, J. H., Kang, D. H., Park, S. H., & Yoon, J. H. (2017). Effects of cervical stretching and cranio-cervical flexion exercises on cervical muscle characteristics and posture of patients with cervicogenic headache. Journal of Physical Therapy Science, 29(10), 1836–1840. https://doi.org/10.1589/jpts.29.1836

Paquin, J. P., Tousignant-Laflamme, Y., & Dumas, J. P. (2021). Effects of SNAG mobilization combined with a self-SNAG home-exercise for treating cervicogenic headache: a pilot study. The Journal of manual & manipulative therapy, 29(4), 244–254. https://doi.org/10.1080/10669817.2020.1864960

Everyone experiences stress at some point in their life. In fact, it is becoming a sort of new normal in today’s hectic, fast paced, high pressure society. Chiropractic treatment can help relieve stress symptoms and achieve optimal health!

However, a large percentage of the United States population is feeling a significant impact from the stress in their lives; 77 percent say they experience physical stress related symptoms on a regular basis. Additionally, 73 percent report experiencing stress related psychological symptoms including anxiety and depression. These are not accurate numbers though because many people never seek help for their stress issues.

Stress symptoms should not be taken lightly. It is important to address the symptoms and find ways to reduce the stress. Chiropractic is an effective stress reliever.

What Is Stress?

In literal terms, stress is the state of emotional or mental strain, pressure, or tension that result from difficulties, adverse situations, or extremely demanding circumstances. However, the very nature of stress by definition makes it very subjective. What is an adverse situation to one person may not even faze another. What one person finds to be an extremely demanding circumstance would to another barely warrant a second thought. This makes it difficult to pin down a precise, universal definition. More often, the term stress is more often used to describe the set of symptoms that are caused by stress and those symptoms can be as varied as the people who experience them.

What Are The Symptoms Of Stress?

Stress symptoms can affect the entire body, both physically and mentally. Common symptoms of stress include:

• Sleep problems
• Depression
• Anxiety
• Muscle tension
• Lower back pain
• Gastrointestinal problems
• Fatigue
• Lack of motivation
• Irritability
• Headache
• Restlessness
• Chest pain
• Feelings of being overwhelmed
• Decrease or increase in sex drive
• Inability to focus
• Undereating or overeating

How Do Stress Symptoms Affect Health?

Technically, stress itself does not have a negative impact on health. Some people deal with situations that others would consider to be stressful, yet they never exhibit the first symptom. This again speaks to the subjective nature of stress. Different people experience different symptoms and it is a combination of the stress symptoms and how the person handles those symptoms that adversely affect health.

Ultimately, stress symptoms can lead to some very serious conditions including heart disease, hypertension, diabetes, obesity, and even certain cancers. Psychologically, it can lead to social withdrawal and social phobias. It is also often directly linked to alcohol and drug abuse.

How Can Chiropractic Help Relieve Stress Symptoms?

Chiropractic cannot get rid of stress, but it can help relieve stress symptoms. The more stress the body endures, the more sensitive it becomes to pain and physical imbalances. Chiropractic can help with bringing the body back into balance, aligning the spine, and relieving pain.

On a larger scale, the simple act of aligning the spine helps to relieve stress in the body that the person may not even be aware of experiencing. The physical stress of a misaligned spine can exacerbate stress symptoms and make a person more susceptible to stressful stimuli in their environment.

Chiropractic helps to improve circulation which is essential in relieving muscle tension. This is integral in achieving and maintaining a relaxed, balanced state. It shuts down the fight or flight response that is a common accompaniment to stress, and allows the body to rest and heal.

Stress symptoms are should not be ignored. They can lead to several very serious health conditions. If you are experiencing stress in your life or stress symptoms (you don’t have to recognize that you are under stress to experience its symptoms) pay attention. Those symptoms aren’t likely to go away but instead get worse. Take care of yourself; get help for your stress.

Cervical Pain Treatment

Belly fat is a gateway to back pain/spinal issues that can lead to various health problems. The bulging belly population has grown a bit since the beginning of the COVID-19 pandemic. 37% of individuals have gained weight since it began, according to a global Ipsos survey. If back pain is presenting and there is excess weight around the abdomen known as abdominal obesity, this could be a contributing factor.

Belly fat and posture

When the natural curves of the spine are normal, the core is stable and well-supported. Excessive weight, including a large abdomen, shifts these curves out of correct alignment. Excessive abdominal fat has been associated with lordosis, which is an excessive inward curve of the spine toward the lower back. One study found that severely obese individuals had pain and changes in posture. This was especially visible in the spine, knees, and feet.

Front-loading shift

The back pain felt from a bulging belly can be caused by a shift in posture and body mechanics. Studies show these can have a negative impact on back pain and body positioning. All or most of the weight is placed on the lower back.

Overloaded discs

Abdominal obesity can damage/injure the discs/shock absorbers of the spine. This leads to:

• Increased pressure
• Annular tears
• Herniation
• Pinched/compressed nerves

And a bulging belly can flatten the height of the intervertebral discs.

Fat pollutants in the blood

Fat can accumulate and secrete toxins that contribute to swelling and inflammation that can be painful. Over time, these toxins wear down components of the skeletal system. A study found potential links between obesity and degenerative disc disease. Scientists found a connection in obese men, but not obese women. This is believed to be because men tend to store fat in their bellies, and women tend to store fat in the buttocks and thighs.

Damage to the musculoskeletal system

The bones constantly renew themselves, but when there is excess body fat it can interfere with the process. This has the potential to turn into osteoporosis over time. Studies associate visceral fat with lower bone mineral density, and an increase in the risk of fractures.

Ankylosing spondylitis treatment and fat interference

Ankylosing spondylitis is an inflammatory disease that causes chronic back pain and can cause the vertebrae to fuse. The back can be extremely stiff, and the condition can lead to a permanently hunched posture. There are medications to improve symptoms and slow the disease. However, being overweight reduces the drugs’ effectiveness. This is because belly fat can cause medication absorption problems.

Rare spinal condition linked to obesity

Obesity along with a high Body Mass Index increases the risk of a rare condition called spinal epidural lipomatosis or SEL. This is an overgrowth of body fat in the spinal canal. Spinal epidural lipomatosis can cause various types of back pain. This is why it is recommended to have a doctor examine and evaluate any aches or pains.

Body Composition

Kombucha beneficial for gut bacteria

Kombucha contains a wide variety of bacteria and fungi that helps ferment the sugar in kombucha drinks. It is able to affect the existing microbes in the gut by inhibiting the growth of various gut-dwelling pathogens. These include:

• Salmonella
• Campylobacter
• E. coli
• H. pylori

1. It is a probiotic drink made from fermenting green or black tea
2. It is made up of healthy bacteria that produce acetic acid that is beneficial for blood sugar, insulin levels, and body composition
3. It helps the body process food by lowering insulin levels after a meal
4. It contains polyphenols that reduce oxidative stress, to help fight disease risks
5. It destroys unhealthy bacteria in the gut
6. It helps increase healthy bacteria

Kombucha can be thought of as a natural antibiotic. However, it does not come with the weight-gain side effect. Improving the health of the gut through fermented foods like kombucha help reduce the risk for weight gain/obesity, as well as restore gut health for those trying to lose weight by creating a healthy gut environment.

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Osong Public Health and Research Perspectives. (2016) “Influence of Obesity on Postural Stability in Young Adults.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5194219/

Obesity Surgery. (2005) “Postural changes in morbidly obese patients.” https://pubmed.ncbi.nlm.nih.gov/16105399/

Arthritis Research & Therapy. (2017) “Fat mass and fat distribution are associated with low back pain intensity and disability: results from a cohort study.” https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-017-1242-z

Clinical and Investigative Medicine. (2014) “Visceral fat reflects disease activity in patients with ankylosing spondylitis.” https://pubmed.ncbi.nlm.nih.gov/24895992/

European Spine Journal. (2012). “Rapid progression of spinal epidural lipomatosis.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369035/