What is a Migraine?
Migraines are more than just bad headaches; they are a complex neurological condition that can significantly affect daily life. They can cause throbbing head pain, sensitivity to light or sound, nausea, and sometimes visual or sensory changes known as auras.
While medication and lifestyle management play important roles, physiotherapy can be a highly effective treatment for certain types of migraines, particularly those with a cervicogenic (neck-related) component. Understanding how migraines develop and how they relate to the neck can help you take control of your symptoms and improve your quality of life.
What are Migraines With and Without Aura?
Migraines are typically divided into two main categories:
- Migraine with Aura
- Migraine without Aura
Migraine With Aura
About 25–30% of migraine sufferers experience an aura before or during the headache phase.
A migraine aura is a set of reversible neurological symptoms that develop gradually over several minutes and usually last between 5 and 60 minutes.
Common aura symptoms include:
- Visual changes: flashing lights, zigzag lines, or blind spots
- Sensory disturbances: tingling, numbness, or “pins and needles” sensations
- Speech difficulties: trouble finding words or slurred speech
- Muscle weakness or imbalance (in rare cases)
Interestingly, it is possible to experience an aura without any headache pain afterwards — this is known as a silent migraine.
Migraine Without Aura
This is the most common type of migraine. The pain often starts on one side of the head and can be moderate to severe, throbbing, and aggravated by triggers. It may last from 4 to 72 hours and is usually accompanied by symptoms such as:
- Nausea or vomiting
- Sensitivity to light (photophobia) and sound (phonophobia)
- Fatigue or difficulty concentrating/ brain fog
How Physiotherapy Can Help
Physiotherapy can play an important role in managing and reducing migraine frequency and severity, especially when neck involvement is present. A skilled physiotherapist can identify postural, muscular, and joint-related issues that may be contributing to your migraines.
Treatment may include:
- Manual therapy: gentle joint mobilisations to reduce stiffness in the upper neck and upper spine is the main component of our treatment approach
- Central desensitisation
- Postural education: improving sitting and standing posture to reduce strain on cervical structures
- Exercise therapy: strengthening and mobility exercises to support neck alignment and reduce future episodes if indicated and needed
- Relaxation and breathing strategies: to help manage stress, a common migraine trigger
Physiotherapy also provides long-term self-management strategies, empowering you to take control of your symptoms rather than simply reacting to them.
In Summary
Cervicogenic migraines, whether with or without aura, can be debilitating, but they’re also treatable. By addressing the musculoskeletal factors that often underlie or worsen migraine symptoms, physiotherapy offers a safe, effective, and holistic approach to headache management.
When to Seek Professional Help for Migraines
If you experience frequent or severe migraines, especially those with new or unusual symptoms, it’s important to speak with your GP or a healthcare professional to rule out other causes. Once medically cleared, working with a physiotherapist who understands headache and migraine management can make a significant difference in reducing your symptoms and improving your quality of life.
The Headache Neck and Jaw Clinic are experts in the diagnoses and treatment of complex migraine and headache issues, including migraines with and without aura. Book an appointment today.
Lisa Eisfeld is a trained physiotherapist from Germany. She has also studied advanced Manual therapy and finished her Osteopathy Diploma in 2018 at the School for Manual Medicine Berlin. Lisa has also attained her Watson Headache Institute Level 1 Foundation and Level 2 Consolidation courses. Read more about Lisa.