Sensitisation in Headache and Migraine
I have mentioned in my previous blogs that sensitisation of the brainstem has been demonstrated in migraine, tension headache, menstrual migraine and cluster headache.
What I may not have made clear is that this sensitised state is present even when you are free of your headache or migraine, that is, your brainstem is sensitised constantly.
Then what happens is that you eat or drink something, your hormonal levels change, you smell a perfume – and this triggers your headache or migraine. These events lead to increased (but normal) activity of structures (including blood vessels) inside your head.
This increased activity is wrongly interpreted as being much more than what it actually is and pain results. If it wasn’t for your sensitised brainstem, what you eat, drink, smell or hormonal fluctuations would not result in the disabling headache or migraine.
If you are going to be free of your headache or migraine, the source of sensitisation has to be determined. Whilst the triptans desensitise the brainstem and are effective for many of you, they do not eliminate the cause of the sensitisation.
Information from neck disorders can sensitise the brainstem and of all the various investigations you may have for your headache of migraine, a skilled examination of your upper neck is relatively inexpensive and non invasive, and may change your life significantly.
Cheers
Dean
Consultant Headache and Migraine Physiotherapist; Adjunct Lecturer, Masters Program, School of Physiotherapy, University of South
Australia; PhD Candidate, Murdoch University, Western Australia
Tension Headache
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