Migraines: Why we are getting tremendous results with Chiropractic Neurology

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April 5, 2016

To understand Migraines, you need to understand the mechanism that causes them. So often, I am puzzled by the care that I see Migraine sufferers receiving in an attempt to "control" migraines. I have since realized that there aren't many practitioners out there that truly understand migraines and their cause. Migraine pain is severe, often one sided, creating pain in and around the orbit, temple, forehead, scalp, neck and base of the skull. These patients often have sensitivity to light, sound and smell, nausea, dizziness, imbalance and visual disturbance. In women, they can be worsened before and during menstrual cycles, spiking hormonal levels that exacerbate an already predisposed system. They are often mildly subdued with caffeine and most of these people prefer dark, quiet rooms to sleep it off. Then there's the after effects, or the "migraine hangover" as people often describe it. 

So what causes a migraine? There are multiple causes of a migraine, often occurring simultaneously, which is why they can be so difficult for some practitioners to treat. Often, we see a neurological component, biomechanical component(joint and muscle), nutritional and global postural issue involved with migraine sufferers. So let's break them down.

Neurological components consist of signaling and pattern errors within the vestibular and cerebellar systems that connect to the brain stem and cortex. Now, this creates a major problem for migraine patients because the middle part of the brain stem (pontomedullary region) controls autonomics, or pain and vascular(blood vessel) response. This means that there will be less control as your blood vessels dilate and constrict, causing over dilation and thus a constriction reflex to ensure we don't over-expand our blood vessels and "burst the pipes."  Throbbing, migraine pain is caused by excessive dilation (*pain sensitive nerves wrap around the blood vessels and are activated during expansion of arteries and veins) and constriction of these affected blood vessels, which must be addressed by retraining the signals and patterns within the brain stem and cortex. This is often why people also experience nausea and dizziness as these regions of the brain stem are the main control centers for balance, coordination, nausea and eye movements. Wait, eye movements? Yes, our eye movements are controlled by the brain and people often suffer from visual disturbances, not only due to blood flow issues, but also due to errors in eye movements and difficulty keeping their focus on targets (gaze instability). With eye movement errors, we experience inappropriate muscle activation, or compensation in the cervical spine, resulting in worsening migraine pain.

Biomechanical components usually consist of problems at the base of our skull, known as the suboccipital region, contributing to compression and irritation of blood vessels and nerves that are exiting the skull through muscle and joint to traverse our scalp. This is highly affected by cervical misalignment, thoracic misalignment (upper back) and rib expansion. Our rib motion is extremely important to the biomechancis of our shoulders, upper back and neck, but also for inhaling the appropriate amounts of oxygen necessary for function. If we do not receive enough oxygen, our body responds by attempting to push more blood to our brain, resulting in blood vessel constriction and dilation (reflexes) that create migrainous pain, yet keep us alive and our brain function alive as oxygen is essential to life. However, oxygen levels are essential to Migraine-free living as well, so we must address the oxygen components through our biomechanical work as well as in the cervical (neck) and occipital (base of skull) regions. 

Appropriate posture is essential for migraine headaches as poor posture results in head forward positioning, causing strain on our neck, shoulders and upper back along with creating excessive extension of the occiput, further compromising the blood vessels and nerves exiting that region. It also limits rib, or chest expansion that is necessary for oxygenation and overall biomechanics of the upper thoracic and cervical regions, as discussed previously. 

Nutrition is important as it is not so important as to what we ingest, as what we don't ingest. For example, reducing diet soda, processed foods, dairy, dye and sugar are extremely important as we try to limit the predisposition towards migraines. Birth control and other medications are also known contributors, which you should talk with your primary care physican if you have questions. Magnesium, B-vitamins and other supplements are often helpful in the management of migraines.

Why is combining biomechanical treatment, neurological rehabilitation and nutrition so effective, both short and long-term? It creates a greater chance for neuroplasticity, or change to occur within our nervous system (brain) and its control of body structures that contribute to migraines. When we treat all of the affected areas, we have a much better chance of a positive result. And, by creating a barrage of new, correct information to a faulty system, we are able to recalibrate the aberrant signals and patterns and create a long-term, healthy pattern.

Portland Chiropractic Neurology is unique in that we are able to combine Neurological, Chiropractic, Physical Therapy and Nutritional diagnosis and treatment into one paradigm. This allows us to diagnosis the true, underlying cause(s) of your migraines and treat them with a variety of different methods, ensuring all the affected areas are accounted for, resulting in migraine-free patients.

As the only Chiropractic Neurology practice in the state, we are happy to offer these services to Southern Maine and New England. We are conveniately located right off I-295 in Portland, Maine.