Migraine headaches (MH) affect approximately 15% of the global population and are believed to be due to environmental and genetic factors. Neurologist and Family Practice physicians use a mnemonic device known as POUND to differentiate migraine headaches from other forms of primary headaches:
P - Is the headache pulsatile in quality?
O - Is the duration 4-72 hours?
U - Is the location unilateral?
N - Is there associated nausea or vomiting?
D - Is the intensity of the headache disabling?
Migraine headaches are typically managed by medications known as amitriptyline, which has its share of side-effects.
People with MH are treated in different clinical pathways. One of them is referral to a physical therapist for cervicogenic headaches. Cervicogenic headaches can also present with POUND-type characteristics. There are two holistic evidence-supported treatments a physical therapist can recommend to their MH patient, especially the ones with POUND-type complaints. One recommendation is to have your patient increase their daily water intake by 1.5 liters a day (Spigt et al.). The other recommendation is to take 2-3 mg of slow release melatonin at night prior to bedtime (Lyon,Langer). Both treatments have been tested in randomized control trials and have received a Level II in evidence ratings (Goncalve, et al.).
Our Cervical Spine I and II courses, which can be taken in any order, teach clinical pattern recognition of primary and secondary headaches, and also discuss and teach you holistic treatments, including the benefits of specific exercises and manual therapies.
In the related video below you can watch Michael Lucido perform an evaluation of cervicogenic headache.
Upcoming Cervical Spine Courses
Follow the links below for course details and to register.
C-516 Cervical Spine I
- November 16, 2019 in Wilmington, NC
- November 23, 2019 in Portland, OR
- December 7, 2019 in New York, NY
- February 2, 2020 in San Diego, CA
- February 15, 2020 in Boston, MA
- February 22, 2020 in Chicago, IL
- March 8, 2020 in Denver, CO
- April 4, 2020 in Baltimore, MD
- May 16, 2020 in Portland, OR
- July 12, 2020 in New York, NY
- September 20, 2020 in Orlando, FL
- September 26, 2020 in Portland, ME
- October 3, 2020 in Falls Church, VA
- October 10, 2020 in Portland, OR
C-616 Cervical Spine II
- November 16, 2019 in Annville, PA
- December 6, 2019 in Phoenix, AZ
- December 7, 2019 in Dallas, TX
- December 7, 2019 in Falls Church, VA
- January 26, 2020 in Denver, CO
- January 26, 2020 in New York, NY
- April 4, 2020 in Wilmington, NC
- May 1, 2020 in San Diego, CA
- September 15, 2020 in Berrien Springs, MI
- September 19, 2020 in Chicago, IL
- October 10, 2020 in Baltimore, MD
- November 14, 2020 in Portland, OR
- Spigt, M. et al. A randomized trial on the effects of regular water intake in patients with recurrent headaches.
- Family Practice 2012; 29:370–375
- Lyon, C & Langner, S. Consider melatonin for migraine prevention. The Journal of Family Practice MAY 2017 VOL. 66, NO 5
- Goncalve, AL, Martini Ferreira A, Ribeiro RT, et al. Randomized clinical trial comparing melatonin 3 mg, amitriptyline 25 mg and placebo for migraine prevention. J Neurol Neurosurg Psychiatry. 2016; 87:1127- 1132.1