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  • Writer's pictureSam Kelokates

Finding Relief with Holistic Migraine Treatment Approach

Do you or someone you know suffer from painful headaches or debilitating migraine attacks?

You're not alone. Many people experience these challenging conditions that can disrupt daily life. But there's good news!

Physical therapy can be a powerful ally in the fight against headaches and migraines.

Hello! I'm Dr. Sam Kelokates, PT, DPT, and I am a physical therapist that specializes in treating headache and migraine disorders.

When it comes to migraine management, physical therapy might not be the first solution that comes to mind. Typically, people associate physical therapy with rehabilitation for injuries or improving mobility after surgery.

However, the reality is that physical therapy can be an effective approach for managing migraine for many people, especially when they're associated with neck pain.

Physical therapy as a treatment for migraine may seem surprising, but it's grounded in a deep understanding of the complex mechanisms at play in migraine attacks.

Migraine is not solely about head pain. It involves the entire nervous system, and often, neck pain can play a crucial role in the severity of the condition.

In this blog, I'll explain how physical therapy can make a real difference in managing and reducing the impact of migraine and tension-type headaches.

I'll also share a few tips on optimizing your therapy journey for the best results.

Understanding Migraine

To truly appreciate how physical therapy can help with migraine, we first need to understand what migraine is and how this condition affects those who experience attacks.

Migraine is not just a regular headache; it is a complex neurological condition characterized by recurrent, severe headaches that can be intensely painful. While headaches are a common symptom, migraines often come with a range of other debilitating symptoms.

These can include:

  • Nausea and/or vomiting: Many migraine sufferers experience stomach upset, which can exacerbate the overall discomfort.

  • Sensitivity to light (photophobia): Even normal levels of light can be excruciating during a migraine attack, leading to the need to retreat to a dark room.

  • Sensitivity to sound (phonophobia): Everyday noises can become unbearable during a migraine attack, further limiting activities.

  • Aura: Some individuals with migraine experience sensory disturbances known as auras before or during the headache. Visual is the most common, and can include flashes of light, blind spots, or other visual anomalies.

Episodic vs. Chronic Migraine

Migraine is typically categorized into two types: episodic and chronic.

People with episodic migraine experience infrequent migraine attacks. These attacks occur less than 15 headache days per month. These attacks can be sporadic and unpredictable but generally allow individuals to enjoy headache-free periods in between.

Chronic migraine is a more debilitating form of the condition, and is defined by having headaches on 15 or more days per month for at least three months, with at least eight of those days being migraine attacks.

Chronic migraine can be relentless, impacting an individual's daily life, including work, family, and social activities.

How Physical Therapy Provide a Holistic Approach

So, why consider physical therapy for migraine management, especially when neck pain is involved?

The rationale behind using physical therapy in the holistic treatment of migraine is grounded in addressing both the underlying musculoskeletal issues and the broader factors contributing to migraine progression.

Recent research has shed light on the prevalence of musculoskeletal dysfunctions in migraine patients. These dysfunctions often involve issues like reduced cervical range of motion, trigger points, and strength deficits in the neck region.

Additionally, individuals with migraine frequently experience heightened sensitivity to pain, both locally and centrally, which can further intensify their condition and disability.

Physical therapy can effectively address musculoskeletal dysfunction and heightened sensitivity to pain in migraine patients through a combination of tailored interventions.

Here's how:

Manual Therapy Techniques: Skilled physical therapists can employ various manual therapy techniques to target musculoskeletal dysfunctions. These hands-on methods include:

  • Myofascial Release: This technique involves applying sustained pressure to release tension in the fascia, which is the connective tissue surrounding muscles. It can help alleviate trigger points and muscle tightness commonly found in migraine patients.

  • Joint Mobilization: Joint mobilization techniques aim to improve joint function and mobility. In the case of migraine patients, this can involve addressing restrictions in the cervical spine and other relevant joints.

  • Soft Tissue Mobilization: Therapists may use soft tissue mobilization to manipulate soft tissues such as muscles, tendons, and ligaments. This can help reduce muscle tension and improve circulation in affected areas.

Physical therapist performing manual therapy for migraine treatment

Exercise Interventions: Physical therapists can design exercise programs, both specific and generalized, tailored to the individual needs of migraine patients.

  • Neck Specific: strengthening exercises for the neck, shoulder girdle, and upper back can help improve muscle imbalances and support proper posture, reducing strain on the cervical spine.

  • Generalized: where aerobic or resistance training, both exercise strategies can have significant benefits multiple areas. Exercise can improve sensory processing, pain processing, sleep regulation, increased mitochondria, and neuroendocrine response to stress.

Pain Modulation Techniques: Heightened sensitivity to pain (due to peripheral and central sensitization) is a common issue for migraine patients. Physical therapists can employ pain modulation techniques to help desensitize the nervous system and reduce pain perception. These techniques may include:

  • Desensitization Exercises: Gradual exposure to touch, pressure, or temperature changes can help the nervous system adapt and become less sensitive over time.

  • TENS (Transcutaneous Electrical Nerve Stimulation): TENS units deliver low-level electrical currents to the skin, which can interfere with pain signals and provide relief.

  • Education: Physical therapists educate patients about pain physiology and provide strategies for managing pain, reducing fear and anxiety associated with migraines.

It's essential to remember that physical therapy for migraine is not a one-size-fits-all solution. Each person's experience with migraine and neck pain is unique, and treatment plans should be tailored to individual needs.

However, the promising aspect of physical therapy is that it offers a holistic approach to migraine management, addressing not only the symptoms but also the underlying factors that contribute to the condition.

That's why personalized treatment plans are crucial for success.

Holistic Assessment and Personalization

As a specialized physical therapist in migraine treatment, my approach involves a thorough assessment of each patient's condition and needs. Here's an overview of how the assessment and personalization process typically unfolds:

  • Patient History: We start by taking a detailed medical history, including the frequency and intensity of migraine attacks, any associated symptoms, and known triggers.

  • Physical Examination: A physical examination helps identify musculoskeletal issues that may contribute to migraines, such as muscle tension in the neck and shoulders.

  • Lifestyle and Stress Assessment: Lifestyle factors, stress levels, and daily routines can all impact migraines. Understanding these aspects helps tailor advice and strategies accordingly.

  • Goal Setting: We work together with the patient to establish clear goals for migraine management. These goals can include reducing the frequency of attacks, improving pain management, or enhancing overall quality of life.

  • Treatment Plan Design: Based on the assessment findings and patient goals, a personalized treatment plan is designed. This plan may include a combination of manual therapy, exercise programs, relaxation techniques, and lifestyle modifications.

  • Regular Monitoring: Throughout the treatment journey, progress is closely monitored. Adjustments to the plan are made as needed to ensure that patients receive the most effective care.

The goal of this personalized approach is to empower patients to take an active role in managing their migraine condition.

By understanding your unique triggers, learning techniques to reduce pain and tension, and making informed lifestyle choices, you can gain greater control over your condition.

Take the First Step Towards Holistic Treatment

If you or someone you know is struggling with headaches or migraines, seeking help from a specialized physical therapist like me could be the key to a better quality of life.

Don't let headaches hold you back—take the first step toward relief by scheduling an appointment with a headache and migraine specialist today.

Remember, you don't have to face this challenge alone. With physical therapy, you can regain control and say goodbye to those painful headaches and migraines. Here's to a brighter, pain-free future!

Optimizing Your Physical Therapy Journey

Now that you understand the incredible benefits of physical therapy for headaches and migraine, let's explore some tips to optimize your therapy journey for the best results:

1. Seek a Specialist: Look for a physical therapist who specializes in headache and migraine disorders. Their expertise in this area will ensure you receive the most effective care.

2. Open Communication: Be open and honest with your therapist about your symptoms, triggers, and any previous treatments you've tried. This information helps them tailor your treatment plan.

3. Set Clear Goals: Work with your therapist to establish clear, achievable goals for your therapy. Whether it's reducing the frequency of headaches or improving your overall quality of life, having goals in mind can motivate you.

4. Follow the Treatment Plan: Consistency is key. Stick to the exercises and techniques your therapist recommends, both during your sessions and at home. This commitment will yield better results.

5. Stay Informed: Educate yourself about headaches and migraine. Understanding your condition empowers you to make informed decisions and actively participate in your treatment.

6. Patience and Persistence: non-pharmacological treatments take time! Be patient with yourself and the process. If a particular technique doesn't yield immediate results, discuss it with your headache physical therapist to see if that is normal or an adjustment to treatments is needed.

7. Regular Follow-Ups: Schedule regular follow-up appointments with your therapist and neurologist to track your progress. Adjustments to your treatment plan may be necessary as you move forward or encounter life changes.

8. Support System: Don't hesitate to lean on your support system—friends and family—for encouragement and assistance during your therapy journey. Find a Migraine Support Group for more support!


Physical therapy offers a ray of hope for those struggling with the pain and disruption caused by headaches and migraines.

By understanding the benefits of physical therapy, seeking specialized care, and actively participating in your treatment, you can take significant steps toward a brighter, pain-free future.

If you or someone you know is battling migraine, and the burden of musculoskeletal issues and heightened pain sensitivity, don't hesitate to reach out.

I'm here to help you on your journey towards a pain-free life and improved quality of life.

Contact Information:

Don't let migraine hold you back any longer. Take the first step towards a better, pain-free tomorrow. Get in touch today, and let's start your journey towards a migraine-free life.

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