Migraines: A Neuromuscular Approach -Nerve and Muscle

Migraines, is there more going on?

Missed days of work, nausea/ vomiting and, irritability are just a few issues that exist when you have migraines.  Is it a vascular migraine?  A migraine related to hormones?  Or is it neuromuscular migraine?

Let me be clear, I do not treat vascular migraines or migraines caused by hormonal issues.  I have had two vascular migraines and ended up at the eye doctor’s office.  I thought my retina was detached after seeing flashing rectangular figures and feeling intense pressure in my head.  After a  complete exam the doctor reassured me I had what was called an ocular migraine, a type of vascular migraine but otherwise I was healthy.  I was given instructions to lie down and take a couple ibuprofen.  When the same thing happened a year later I knew what was going on and indeed, the pressure and flashing rectangles passed.


Let’s look at the Neuromuscular Migraine which includes structural issues including the teeth, the jaw joints (TMJ) and muscles of the head and neck.   One of the first questions I ask is, where does your migraine start and, secondly, where does it go? This gives me insight into determining if your migraine is structural in nature and how I can help you.


Muscle Dysfunction

Many of us clench and/ or grind our teeth, not just at night but during work or when we are focused on something.  Don’t believe me?  Set your watch timer to go off every 15 minutes, when the buzzer goes off make note of whether or not your teeth were together.  Also, take a look in the mirror, do you notice wear or flat shiny spots on any teeth?  Yep, you have, at some point been clenching or grinding your teeth.

Myofascial Pain

When we clench and grind our teeth we place a considerable amount of stress on the muscles used to chew and eat.  The muscles and fascia, the tissue surrounding the muscles, shortens and becomes tight.  You may find you cannot open your mouth fully, your jaw aches, you have sensitive teeth, and you develop a throbbing    migraine. 

A few questions I will ask you are:

1. How often do you experience migraines? What triggers them?

2. Where does the migraine start and where does it go?

3. Are you engaging in activities that contribute to the migraine?  (this includes the type of work you do as well as sports).

3. Assessing the way your teeth fit together.

4. Evaluating the health of your jaw joints.

5. Examination of muscles of the head and neck for knots.

6. Asking about your stress level- this is not to be nosy!!  But rather to understand how stressed out you are and knowing that your adrenal glands are in overdrive!!  Remember the term, Fight or Flight?



Depending on what we find with your exam, I may recommend soft tissue therapy for muscles and fascia, also known as Myofascial Release. 

Other types of therapy include CranioSacral and a Chinese technique called Gua Sha.  All of these therapies are performed with a light tough.

More advanced treatments include Botox, which when injected into muscles prevents them from contracting completely, giving you relief that can last several months.