PT for chronic migraines

Read an article online about people with chronic migraines (as well as other types of headache) and how the neck musculature contributes to headache pain.  Asked my NP about it this morning, and she wasted no time writing out a prescription for physical therapy.  This is something I haven't tried before, so I'm excited to see if I get a positive result.  Unfortunately, did not bookmark the article and I can't find it again, so cannot post here.

Michele

Its something good to try. Especially if you get a physical therapist with experience with chronic pain patients. Its quite different from say treating a sports injury. I did it a few years ago.

The biggest thing I got out of it was recognizing that my neck posture was contributing to some of my pain spikes with my constant headache. With the pain I tend to tense up and bring my neck forward & up, so trying to relax my shoulders and bring my neck back & down can help minimize my pain sometimes.

I don't think the strengthening exercises helped me any though, and actually worsened my pain sometimes. So, know your limits, and don't do something that is causing pain (sometimes practitioners say to work through the pain, but I believe in that). Massage therapy is also helpful for my neck symptoms, but not my headache.

Often PT & massage are started at the same time, such as PT twice a week and massage once a week. I also take Tizanadine (a muscle relaxer) at bedtime. My neck symptoms that came with my headache are easier to treat than the headache itself, so I'll take what I can get. Best wishes.

I completely agree with what you said.

I don't think that PT will actually help with eliminating chronic M pain, but it will certainly make you more aware of your body, and how it works. I found that the bad neck posture, and resulting muscle tension contribute to M pain and make it more intense.
Learning how to relax your muscles helps a lot with neck tension and pain.

When M starts we often tense up, and hold our head/neck in most unnatural positions which can contribute to head pain.
Recognising this, and knowing how to relax and control your neck area, is extremely useful.

I also found that using hot water bottle in lower neck area, when it feels painful, helps me to relax and ease the neck and therefore head pain.

Do not expect too much, but in my experience any relief is welcome, and for this reason I found PT very helpful.
Good luck, and let us know how you get on.

I hope it works for you.

Unfortunately I found that it made things worse for me, as the therapists seemed to trigger all my trigger points with their massages. I often left therapy with a whopper.

would be considered an appropriate treatment unless it was something life threatening like that. Plus you have to remember that afterwards you're going to have to take more medications to replace your hormones which could possibly worsen your migraines

I did have 5 or 6 weeks of PT prescribed for my migraines years ago. I don't think it really helped but he did give me good tips on my posture and I thought the PT felt very good actually!

I am currently doing PT for chronic shoulder/upper back/neck pain I have had for 3 years. It began when I did a 2 1/2 month bike ride. After the ride I used yoga to self-treat. I should have seen a therapist years ago.

I always dismissed the idea of my migraines being caused by the neck pain. It was a chicken or the egg argument. But after starting PT treatment, I have definitely noticed a decrease in severity, and, as others have said, learned a lot about how posture has been triggering/worsening my headaches. I have learned new techniques to treat the tension in my neck on my own--mostly through stretching, using heat, and a tennis ball--and I feel much better afterwards.

Though I have had migraine for my whole life, I did not have daily migraine until after the bike ride, and I can only assume that these, for me at least, are linked to my poor posture, weak/spasming muscles, and pain.

Because my case is so bad (worse than most others, my PT has said), he has also recommended that I see an acupuncturist in conjunction with his treatment, to help the muscles relax more. I think this is good advice for all migraine patients, especially those suffering from chronic daily migraine.

I used to believe in only trying one thing, and waiting to see if it worked. But now, I believe a more aggressive approach is best. I'm curious if others share this sentiment.

"I believe a more aggressive approach is best."
I totally share this approach CG.
WE all know that there is no "cure" for migraine, but we can help ourselves a lot, with the support of right neurologist and GP how to manage it best, so it relives at least some of the pain.

Thanks to the above my M are much better then in the past. I also feel better that I am more in control of my own treatment, so I don't feel so helpless. Some things worked better for me, some not - I understand now, that this is nobody's fault, that we react differently to the same treatments and so there is not need to despair, we just have to go on trying and keeping an open mind.

But, of course in order to be able to do that we need understanding doctors, and sadly this is not always possible. At times we need to be assertive (and change your doctors if necessary), at times we need to go against our own judgement (when we mistakenly think that we have tried everything).
It is not easy, especially when we cannot thing straight because our head is trying to explode.

But one thing I have learned over the years here, that we migraneurs, are great fighters. WE fight against all obstacles, we raise families, we study, sometimes we even manage to keep a job. WE are no quitters. WE also get depressed, fed up, hurt, and disappointed, but no matter what, we just keep on fighting.

PT is just one of the tools, we can try. Just make sure that you get a PTherapist who knows what they are doing, and whom you can trust. One important piece of advice: whatever you do, stay clear of ANY PT who claims that they can "cure" migraine, because if they do, it means they do not know what they are doing and can do more damage, then good.

After 13 years of chronic daily migraine that has kept me largely bedridden and immobilized, my muscle strength has gone straight to the dogs. I was very active, athletic, and strong prior to this. The musculoskeletal issues that are clearly secondary to forced inactivity are becoming too numerous for me to list.
I KNOW exercise. I know there are brief movements and "exercises" I "could" do on my own for strengthening.
Constant migraine renders it impossible to follow the consistent, progressive patterns of exercise required for ANY useful result.

Realistically, in-home physical therapy, say twice a week if possible, is "medically necessary" for chronic migraine patients at a low enough functioning level. I base that statement on ME.
This illness is as debilitating as paralysis, as post-surgery, and other conditions that qualify. The focus should not even be on reducing migraine, but instead on saving the rest of our bodies from the devastating collateral damage that many of us are truly helpless to manage alone.

For the first several years of this illness, I was able to continue semi-regular walks, and frequent brief yoga on my own. However, as the years pass and the illness takes more and more out of me, pain & fatigue increase, and strength is overcome by weakness. It's never for lack of trying. It's simple biology. I need help with my deteriorating body for reasons that are alien to our health care system. P.T. will not cure my migraine illness. I've tried it several times & at great length and expense.
P.T. WOULD help my knees, back, neck, shoulders, arm, hands, feet, overall strength, breathing, bone density, etc., etc., etc...
If I had the money, that's what I'd use physical therapy for at this point.

It would be SOOOOOOOOO helpful.
It is, in fact, SOOOOOOOOOOO necessary.
Next stop - osteoporosis???

PT made mine much worse. It triggered a migraine every time they manipulated my neck.

If you want to get muscles and joints working again after a long period of inactivity, I recommend yoga. It's gradual enough to help you build up strength without creating problems that trigger the migraines. You go at your own pace and only do as much as you think you can and feel comfortable with. I found this to be a great transition path to getting fit again after many months in bed.

I have now run out of visits thanks to my fantastic insurance coverage. ugh.

Apparently this is a huge problem with PT, because nobody asks when they are picking insurance, "how much PT do you cover?" I was supposed to get 60 visits a year, but they only approved 15. They won't approve any more because I can perform basic functions "I can walk, poop, sleep, eat" Insurance doesn't care about pain or quality of life.

Eileen, I agree 100% that it should be medically necessary for anyone with chronic migraine to have PT or some type of movement therapy, although insurance will always find a way around it.

On the upside, my therapist referred me to an acupuncturist and Oh My Goodness that was like PT on steroids! It wasn't the most comfortable of procedures, but I left with no migraine, and my upper back/neck perfectly fatigued and relaxed. This continued for at least a few days, including increased flexibility. I can't wait for my next appointment.

I completely agree about yoga. I was an avid and consistent yoga student before the migraines became daily. It was the greatest exercise I had ever experienced, and I thought I would always keep it up. Classes are helpful with motivation, but are too expensive AND too long for my now limited stamina. And after all these years, I can't believe how difficult it is to do it on my own. I have faith that I will get back to it somehow, but haven't managed it so far.

The multi-faceted symptomology of migraine really messes with self-directed exercise, be it due to the pain, fatigue, prodromal & postdromal symptoms, physical weakness from being sick all the time, discouragement and feelings of hopelessness, etc., etc., etc. There are huge swaths of time during which I can't even leave the house. All of these are very real, biological, medical obstacles to my ability to keep a strong, healthy body, resulting DIRECTLY from migraine (at least for me). So when I think of physical therapy, I'm thinking of p.t. with a specific "treatment plan" of addressing the above; - to help and support me in doing some of what my deteriorating body needs, which migraine keeps me from being able to do on my own.

The logic of this is obvious to me because I'm living it. But if such a medical service ever became routine for chronic migraine patients who needed it, I'm pretty sure that research would show big savings down the road, compared to the damage of barely moving for decades on end.

Another issue is money. I did find a very flexible physical therapist a few years ago, who was more than willing to do mild yoga with me, and work on my body strength in ways I'm describing. And my insurance did cover 20 sessions a year - at 80%. That sounds great, except that on disability roughly $20 twice a week is $160 per month. Once a week is $80 per month. Neither is remotely affordable for me. I'm in year 13 of disability, and I can't spend imaginary money anymore. (For the first several years, I begged, stole, & borrowed to try every crazy and not-crazy treatment idea I could find.) -(I also LOVE acupuncture, but money issue is the same there.)

Hey Eileen,
Have you looked on YouTube for yoga videos? If you have a yoga mat at home, you can do them anywhere, and that way you can try yoga even with a headache, in a dark, quiet part of your house. (and they're free )

There are so many practitioners, that you should be able to find something at your level/speed/length, and you can always push pause if you need a break. I've been doing yoga for years via youtube with a woman I love, Sadie Nardini. In particular, I've found her shoulder stretches to be very magical for migraine and posture, and if you follow her breathing, it can be quite relaxing. Definitely get into the archives of her older videos, because lately she has picked up more of an online "persona", and I find her more annoying.

Hope it helps, CG

Thanks CG - I will definitively look into it. I HAVE TO do get moving again somehow, before TOO much longer, so that could be very helpful.

Read an article online about people with chronic migraines (as well as other types of headache) and how the neck musculature contributes to headache pain. Asked my NP about it this morning, and she wasted no time writing out a prescription for physical therapy. This is something I haven't tried before, so I'm excited to see if I get a positive result. Unfortunately, did not bookmark the article and I can't find it again, so cannot post here.



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Read an article online about people with chronic migraines (as well as other types of headache) and how the neck musculature contributes to headache pain.  Asked my NP about it this morning, and she wasted no time writing out a prescription for physical therapy.  This is something I haven't tried before, so I'm excited to see if I get a positive result.  Unfortunately, did not bookmark the article and I can't find it again, so cannot post here.

juttboy, I have a feeling we read the same article.  I too, did not bookmark it, so can't share, but my NP couldn't whip out the prescription pad fast enough.

So far, I've had mixed results.  I usually feel better after a session, which consists of the PT doing gentle stretches to my neck and shoulders, as well as a great massage.  She is also working on my jaw (I have TMJ syndrome), and told me it was no coincidence that the right side of my jaw was worse then the left, and I have right sided headaches.

michele

I also had very tight neck muscles along with the rest of my body. That being the case, I went to a Sports Medicine doctor, who referred me to a physcial therapist.

I did not have much luck with physcial therapy. Later, my dentist who was checking me for TMJ recommended that I try a Myofacial Release therapist, since he felt that my posture was bad. That therapist said that before, she could even touch my neck, she would have to work on the rest of my body. She said that my body posture was completely out of whack.

Since then, I followed that approach with the following therapies: Myofascial Release Direct Pressure (that hurts), Myofascial Release (John Barnes type - indirect pressure), Trigger Point therapy by a Chiropractor, Regular Chiropractor therapy, Acupuncture, NUCCA Chiropractor, Bowen Therapists, Osteopath, and Cranial Sacral Therapists.

I've made the most progress with the Osteopathic Manipulation and Cranial Sacral Therapy.

Headache is still there, but much reduced. However, as I've mentioned in previous posts, I am not migraineur, but suffer from chronic 24/7 headache, which I believe is due to tight muscles.

Looking back, in my case the physical therapist did not look at what impact my body's muscular imbalances had on my neck muscles. The other therapists, that I mentioned, did look at the rest of the body.

You might consider taking a muscle relaxant the night before and the night after each session, that might help. That is what I've been doing with my Cranial Sacral Therapy sessions: it helps.

Just my experience.

Martin