Fact or Fib?  Migraines are the worst kinds of Headaches??

FIB!  Yes, migraines are awful.  But true migraines will STOP in 2 – 72 hours.  Imagine having that same intensity of pain, maybe even with the visual disturbances and nausea, several days a week, WEEK AFTER WEEK.   While this looks and acts like a migraine, it won’t respond well to migraine medications. What is it??

To find out, please ask yourself these questions:

– Do your Headaches worsen toward the end of your work day?

– Do you get tightness at the base of your neck or across the top and back of your shoulders?

– Do you have “Migraines” but they don’t seem to respond to your Migraine medication?

– Do you have tightness or tenderness at the base of your skull near the hairline?

– Do you have a job where you are sitting or looking down most of the day?

– Do you have a headache that never seems to fully go away?

 If you answered “Yes” to any of these, you may find the rest of this article helpful in finding a solution for your pain.

For the longest time, even most MD’s and neurologists considered Migraine to be the “worst” of the headaches they typically see.  Let’s take a look into what a Migraine is.  Migraine is a neurovascular condition (i.e. affecting Nerves and Blood Vessels of the brain).  A Migraine will STOP within 2-72 hours and typically WILL RESPOND to Migraine medication.  It is often associated with debilitating pain and autonomic symptoms such as nausea and/or visual disturbances.

Now let’s look at Cervicogenic Headaches (headaches that originate from issues in the neck).  You have small nerves that are responsible for sensation of your head that originate at the base of your skull.  These nerves may be pinched, irritated, or compromised due to posture, injury, or stress.  When this occurs you may feel a VICE-LIKE PRESSURE like wearing a too-tight headband, or PAIN ACROSS YOUR FOREHEAD, or even STABBING ICE PICK like pain above or behind your eyes.  Some people feel pain in the back of the skull, but often they do not.  This type of debilitating pain can be associated with sensitivity to light, visual disturbances, nausea, and other autonomic symptoms.

If this type of Headache is treated like a Migraine, usually the patient will not get very much relief from the medications and will actually notice that the Headache actually gets worse over time and can become more frequent.  Once this type of Headache is correctly diagnosed, there are options to relieve, ease, and prevent the symptoms.

So how do you tell the difference?  Currently, there is not a “test” or an MRI that will give you a definitive answer, although sometimes people will end up having an expensive CT Scan to check the vessels in the brain.  You may trial different medications and see different doctors and specialists.  These are expensive and time-intensive options that may or may not help, and in the meantime, you are still experiencing pain.

Luckily, there is another option. A Hands-On Headache Screening by a Certified Orthopedic Manual Therapist (this is a Physical Therapist with advanced training in hands-on techniques and orthopedic assessment) can show you in about 2 minutes where your Headache is coming from.  You just answer a few questions and lay down and with < 2 minutes gentle hands-on assessment, you and your therapist can feel the targeted areas that bring on your Headaches.

Once we have a better idea where your Headache is coming from, your Certified Orthopedic Manual Therapist (COMT) can not only help to alleviate your pain, but also help you to correct underlying causes to actually FIX THE PROBLEM, not just the symptoms.

Now you can seek out REAL RELIEF, not just the partial, short term, coverup of pain medications or a massage here and there to help you get by.  A COMT can give you the HANDS-ON relief you want and the education to prevent the pain from coming back.  If you suffer from Headaches, and the medication just doesn’t seem to fix it, let us help you.  Now is the time to get relief; now is the time to call Marino Physiotherapy.


Alaina Marino of Marino Physiotherapy
This Blog presented by:

Alaina Rae Marino, PT, DPT, cDN, CMPT, COMT2, OCS, FAAOMPT

Alaina has been helping people out of pain without medications, injections, or surgery since 2005.  She is a board certified Orthopedic Specialist and completed a 3 year Fellowship in Orthopedic Manual Therapy.  When not helping patients in the clinic, she enjoys teaching PT students for both South College and Lincoln Memorial University, hiking with her pups and family, and tinkering in the kitchen.