SPECIAL TREATMENTS

Migraine is the second most common cause of chronic pain in the adult human after low back pain. Symptoms can last from 4 to 72 hours. The pain is usually unilateral, throbbing, worse with pressure or increased effort, and usually causes sensitivity to light, sound, smells.

The diagnosis of migraines is usually made after the evaluation of the symptoms. Lifestyle changes (diet, exercise, sleep), medication, B-blockers, antiemetics always help in the treatment of migraines.

Tension type headache is the most common type of headache. It has reached 78% of occurrence in various surveys This type of headache despite its high epidemiological appearance has not been examined as much as it should and we have incomplete data on its appearance and treatment.

We try to categorize tension-type headaches according to their frequency.

• Rare occurrence: one headache per month, of moderate intensity, with little effect on the daily life of the adult. The pain is usually on both sides, very often at the base of the skull. This pain is not affected by physical activity, does not cause nausea and very rarely brings photophobia or phonophobia.
• Frequent appearance: more than 2-3 times a month. It can take minutes or even days. This pain is not affected by physical activity, can cause nausea and can bring photophobia or phonophobia as well as scalp sensitivity.

This type of headache is usually associated with some underlying pathology. Patients who have this symptom should have further tests.

This type of headache affects the functions of the autonomic nervous system and causes tearing, rhinorrhea, myositis / fall. The international headache community includes this type of cluster headache (around the eye), paroxysmal migraine, and short-term neuralgic headaches, unilateral, accompanied by conjunctivitis and tearing.

These headaches are due to specific foods, stress, medication, muscle tension, hormonal fluctuations, nerve compression or cervical spine or temporomandibular joint dysfunction.

When the patient comes to the physiotherapist for diagnosis and treatment, a detailed history should be given as well as a thorough evaluation. A headache diary would be very helpful in ranking the headache.
In history we often ask if there is a family history, if there are stressors in everyday life and who they are. We will need information about the medical history and if there are or were any conditions that may be contributing to the headache. Falls and head injuries should be reported. The frequency, intensity and duration of the headache should be recorded. Finally a history of heart disease should be reported as well as the assessment of pressure and pulse in case of arterial stenosis.

After the evaluation is completed, the physiotherapist will proceed with the treatment. The treatment aims at treating the symptoms, reducing the episodes but also at their overall treatment if it does not come from an underlying disease. In case the physiotherapist is worried about the patient then he will advise him to proceed with medical examinations and then he will proceed with the treatment.

Treatment for headaches / migraines usually includes massage techniques, myoperitoneal release, trigger point release, manual therapy, acupuncture as well as a stretching and strengthening program.