What is a migraine?

A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head, or can transfer the pain to another side also. This neurological disorder is often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for 4 to 72 hours a day or continue for days, and the pain can be so severe that it interferes with your daily activities. About 30% of people experience symptoms before the starting of their headache. Migraine headache Malaysia symptoms change over hours or even days. 

Stages of migraine: 

  • 1) Prodrome phase (before the migraine)
  • 2) Aura phase
  • 3) Attack phase
  • 4) Postdrome phase (after the migraine)


1) Prodrome

The Prodrome phase gives the early signs. It lasts a few hours, or it can last days. You may or may not experience it as it may not happen every time. In this period many people may feel, 

  • - Unusually energetic and excitable
  • - Depressed
  • - Irritable
  • - Thirsty
  • - Cravings for specific foods
  • - Sleepy, with a lot of yawning

These symptoms before the headache can help doctors diagnose the pain as a migraine.


2) Aura

The aura phase can last as long as 60 minutes or as little as five. It may not happen with every headache, as most people don’t experience an aura, and some have both the aura and the headache at the same time. About 1 in 3 to 1 in 4 people with migraines get an "aura". An aura can include:

  • - Changes in vision, such as a flickering, jagged arc of light, may have a complicated shape.
  • - A blind spot in your field of vision makes it hard to drive or focus your eyes on small objects.
  • - Feeling tingling or "pins and needles" in the body during an aura. It may also cause numbness, which expands to spread out in the whole body within an hour.
  • - Trouble in understanding and expressing thoughts when you speak or write.


3) Attack phase

The main period for headaches lasts from 4 hours to 72 hours. Sometimes it’s mild, but usually, it’s described as drilling, throbbing, or feeling the sensation of an ice pick in your head. Mainly, it starts on one side of the head and then spreads to another side. During this phase, the patient probably wants to rest quietly and finds it hard to do normal activities. Some common symptoms of this phase are:

  • - Usually begins above the eyes, along with the head, It may also affect the lower face and the neck.
  • - Unusual sensitivity to light, sounds, and smells.
  • - Nausea and vomiting.
  • - Throbbing is worse during physical activity or when leaned forward.
  • - Feeling very warm or cold.


4) Postdrome

The postdrome stage goes on for a day or two. It’s often called a migraine “hangover” as after enduring the most severe phase of the migraine, the patient may not feel well for up to a day. Almost 80% of those who have migraines experience this hangover. Symptoms of this post-migraine phase may include:

  • - Extreme tiredness
  • - Sluggishness
  • - Head pain that flares up when leaned over, moving quickly, or getting a rush of blood to the head.


How does physiotherapy help in migraine? 

Migraine disorder causes neurological symptoms that affect the central nervous system, which includes the brain and spinal cord. It also affects the peripheral nerves and the blood vessels. Experts refer to conditions like this as centrally mediated pain disorders. Unlike medications, physical therapy focuses on treating the muscles and joints outside the brain and spinal cord. These techniques can help temporarily lessen the headache during a migraine attack. Though these techniques for migraine can vary, depending on the person and symptoms. Physical therapists assessing and treating patients with migraine focus on two primary aspects:

(1) Neuro-Musculoskeletal dysfunctions, and (2) Vestibular symptoms/postural control impairment.


At VL Therapy, through various effective techniques, professional therapists serve their best to heal the pain and make it sustainable. Some techniques are as follows:

1) Stretches

Physical therapy can involve stretching and guidance on body mechanics as well as posture. This can help people position their head and neck in a better way, minimizing tension and odd positioning. In turn, the muscles are not as strained or tense, potentially helping to reduce migraine symptoms.

2) Tissue Mobilization

A soft tissue mobilization by massage is also a tool that physical therapists use in the treatment of migraine, which helps relieve tension in the trigger points that worsen migraine headache symptoms.

3) Joint Mobilisation

This Migraine headache treatment usually includes the gentle manual mobilization of the facet joints of your upper neck and back.

4) Neural Manipulation

As migraine can be caused by the nerve restriction, physiotherapist who practices neural manipulation will check and perform the treatment to facilitate the neural gliding and restore the proper signalling to the compromised structures/ areas.


Other therapies that proved helpful: 

  • - Manual therapy focuses on the structural connections between the head and neck.
  • - Therapeutic exercises/ Postural approach, which strengthen and stretch neck and shoulder muscles that are considered a cornerstone in the treatment of headaches
  • - Temporomandibular rehabilitation works on the jaw and associated muscles, treat bruxism and swallowing disorders
  • - The cranial approach focuses on the skull and cranial nerves
  • - Oculomotor rehabilitation works on muscle dysfunctions associated with eye movements (convergence)
  • - Dry needling reduces muscle tension by acting on trigger points. Pain can in turn cause reflex muscle tension. When the muscle is persistently contracted, it can develop trigger points.

In addition, long-term improvement will usually require some active efforts on your part. To enjoy a painless life please consult with our highly recommended experienced physiotherapist and visit our official website to understand our services better.