Tuesday, 27 November 2018 10:15

TREATMENT OF MIGRAINES WITH MANUAL OSTEOPATHY

Nearly 30 millions of Americans suffer from migraines, They can strike both young and old, but a majority of sufferers are women, between the ages of 35 and 55. The World Health Organization has classified migraines as a leading disability among women.

Generally speaking, #migraine is thought to be a disorder of the Central Nervous System, most likely originating in the brain stem. One hypothesis is that a wave of neurotransmitters racing across the cortex can directly stimulate the trigeminal nerve, setting off a chain reaction that ends in the transmission of pain signals.
Another theory claims that a migraine is caused by vascular changes in the brain and researchers determined migraines are preceded by a blood flow increase of nearly 300 percent.
Nutritional deficiencies can contribute to the intensity of migraines. Nutrients of particular importance are vitamin D, magnesium, Coenzyme Q10 (CoQ10) and riboflavin (vitamin B2). Deficiencies in one or more of these nutrients are quite common. The fact that nutritional deficiencies worsen a migraine and supplementation can ease it may explain another theory that migraines may be linked to a mitochondrial disorder (organelles producing ATP -units of energy necessary for the proper physiological function of the human body).
Migraine medications only work about half of the time in 50 percent of those taking them. They can also cause severe side effects, including medication overuse headache. The best bet would be to avoid any potential triggers and to find the root cause of this dysfunction. 
Osteopathic adjustments have helped many of my patients suffering from migraines. As stated above, migraines can be linked to the dysfunction of the Central Nervous System. I noticed that majority of my patients suffering from migraines have a very specific cranial dysfunction involving one of the temporal bones, occiput and sphenoid. It creates a tension of the dura mater which is a thick membrane and the outermost of the three layers of the meninges surrounding the brain and spinal cord. It covers the pituitary gland positioned in Sella Turcica, a saddle-shaped depression in the body of the sphenoid bone. The pituitary gland is the master gland controlling hormonal system function. Hormones secreted from the pituitary gland help control growth, blood pressure, certain functions of the sex organs, thyroid gland, and metabolism as well as some aspects of pregnancy, childbirth, nursing, water/salt concentration at the kidneys, temperature regulation and pain relief.
Dural membrane forms the dural venous sinuses, venous channels found between the layers of dura mater. Venous sinuses receive blood from veins of the brain, receive cerebrospinal fluid (CSF) and mainly empty into the internal jugular vein (begins in the posterior compartment of the jugular foramen, at the base of the skull - the important fact when addressing Occipito-Mastoid suture).
When there is a dysfunction in the cranium indicating tension of the dural membrane (for example compaction and different strain patterns of SBS, Occipito-Mastoid suture dysfunction affecting position and motility of temporal bones and occiput, etc), it may affect the functioning of the pituitary gland and hormonal system (possibly the cause why women suffer from migraines most frequently) and can also affect the blood flow to the brain and drainage of the blood from the brain through the internal jugular vein. These are two main internal causes of migraines indicated by research.
Sensory innervation of the dura mater membrane is via small meningeal branches of the trigeminal nerve and via upper cervical nerves. While most brain regions do not register or transmit pain signals, the trigeminal nerve and cervical network do. Pain is relayed through the trigeminal network to an area in the brain stem called the trigeminal nucleus. From there, it is conveyed to the sensory cortex in the brain that is involved in awareness of pain and other senses. 
Dura Mater attaches to all of the bones of the cranium (cranial dura mater) and to the upper cervical vertebras - C1, C2, and C3 (cervical dura mater). In 2011, researchers discovered a connective tissue bridge from the rectus capitis posterior major and minor (suboccipital muscles in the upper neck) to the cervical dura mater. In my observation, migraines may be linked to this anatomical relationship between bones of the cranium, cervical joints and suboccipital muscles. It can also provide the possible explanation why chiropractic manipulation of the upper cervical joints and massage of the neck muscles can temporarily relieve migraines and tension headaches. But to produce long lasting results cranial bones dysfunctions need to be addressed prior to the release of sub-occipital structures as it is, in my opinion, the source of the problem. Another benefit of the osteopathic dural release is the fact that after it is done any corrections of dysfunctional joints in the upper cervical region can be achieved by using gentle osteopathic techniques, like Muscle Energy Technique, that eliminate the need of forceful and unsafe HVLA manipulation.
These connections and relationship of the dura mater to the blood and CSF flow (the role of the artery is absolute), hormonal and musculoskeletal systems (the body functions as a unit) led me to develop a method of treatment integrating cranial osteopathic manipulation (releasing cranial dura mater-falx cerebri, tentorium cerebelli, venous sinuses release), osteopathic upper cervical joint correction (releasing C1, C2, C2 and cervical dura mater) and soft tissue techniques to release upper cervical muscles that have dural connection (structure governs function). This can be done by using integration of structural and functional osteopathic techniques, including cranio-sacral corrections (position of the sacrum and pelvic bones should also be addressed since the dural sac attaches near the coccyx and can change the position and movement of the sacrum and pelvic bones- the body functions as a unit principle again), osteoarticular adjustments, MET, Strain -Counterstrain, Myofascial Release and Soft Tissue Techniques. When all of this is corrected the body has an ability to auto-regulate and pain may disappear (the fourth osteopathic principle)
This approach respecting osteopathic principles became very effective in relieving migraines. The addition of Low Intensity Laser Therapy applied to the craniocervical junction makes this method even better by addressing previously mentioned possible mitochondrial disorder, improving blood flow and helping with the healing of inflammation.
I have treated many patients that suffered from migraines. This is one of the most recent testimonials posted on #OsteoKlinika Google reviews:

"I came to Andrew with terrible migraines and they were getting worse. I was getting treatment from a chiropractor for about a year with no improvement. Then I found Andrew. He got to the root of my migraines. I have never had a migraine again. The treatments also solved my TMJ problems. Then I developed lower back problems and again Andrew is the only one that helped me. If it wasn't for Andrew and his training in osteopathy I would not be functioning today. Thank you, Andrew."

- Joni W.

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