Osteopathy and Headache

Everyone has a headache now and then. It usually goes away on its own, with or without a paracetamol. But not all headaches are the same. Patients who suffer from tension headaches and migraine can be greatly affected by them.

Tension headaches and migraine are common complaints in an osteopathy practice. Osteopathy can help reduce the symptoms.

In osteopathy we look at the causes of the headache. The osteopath always examines the whole body in order to treat and resolve the headache. The osteopath looks for movement restrictions in the body that cause complaints and will try to release those restrictions.

Types of headache

In this article we distinguish between two types of headache:

1. Tension headache

  • The pain is pressing and is usually felt on both sides of the head
  • Patients describe ‘a tight band’ around their head
  • The pain does not get worse with moderate activity (in fact, moving sometimes helps)
  • The neck and shoulders may feel painful
  • There may be mild nausea
  • There is no sensitivity to sound or light

A tension headache can develop into a migraine.

2. Migraine

Migraine is more than a bad headache and certainly not something people make up. Women in particular are affected. The symptoms can be so severe that daily life suffers. Patients regularly have to call in sick or cancel social activities. Migraine can therefore be a real burden, and a lack of understanding from others makes it even harder to cope with.

Symptoms of migraine

  • The pain comes in attacks with a clear beginning and end
  • The headache is intensely pounding or throbbing
  • The pain is usually on one side of the head, sometimes behind one eye
  • The eyes may water
  • There is sensitivity to light, sound and sometimes smells
  • Exertion makes the pain worse
  • During an attack, patients can often do nothing but lie still in a dark, quiet room
  • Migraine is almost always accompanied by nausea and vomiting

A migraine attack can be preceded by an aura: the patient sees spots or stars, loses part of their field of vision and sometimes also experiences weakness and tingling on one side of the body. Speaking can also be difficult.

An attack can last from a few hours to a few days. Afterwards the patient usually falls asleep. On waking, the headache has gone or is only mildly present. After an attack the patient often feels very tired for a few days and finds it hard to concentrate.

Causes of migraine

A great deal of scientific research has been done into migraine, but no clear causes have yet been found. In women, hormones probably play a role (an attack often occurs shortly before menstruation), as may a genetic predisposition. Some patients try cutting out certain foods (wine, chocolate, nuts, coffee), but the results vary.

What does an osteopath do for headaches?

Treatment of tension headaches or migraine always starts with an intake, in which the osteopath asks about the nature of the headaches, the patient’s medical history, lifestyle and previous treatments. Often the patient has already been treated by a GP, a physiotherapist and sometimes a neurologist, but the complaints have not gone away.

After the intake the osteopath will examine the neck and head, but also the rest of the body, to see how the mobility of muscles, tissues and organs is affecting the complaints. Sometimes the cause of the headache is not in the neck but elsewhere. With tension headaches we often see that the muscles around the neck and shoulders are tense, but there may also be restricted function of the hip or pelvis, or reduced mobility in the upper or lower spine.

Migraine is often accompanied by complaints in the upper abdomen. Many patients also suffer from irritable bowel syndrome (IBS). The vagus nerve, the tenth cranial nerve, runs between the abdomen and the brainstem. When the abdomen is disturbed, a kind of short circuit – the migraine – can occur in the brainstem. That is why an osteopath will almost always treat the area around the diaphragm in migraine patients: the liver, the large intestine and the stomach.

Once the osteopath has found the cause of the reduced mobility, treatment will focus on restoring that mobility. The complaints then usually ease and the patient feels better.