Tag: physical therapy

Chronic Migraine, Treatment

My Jaw’s Contribution to Migraine & Chronic Daily Headache Triggers

Kerrie Smyres

jaw triggers headaches migrainesEating itself often seems the trigger of migraine attacks, not the particular foods I eat (although certain foods are clearly problematic). I’ve explored blood sugar and thyroid angles with no success. Though I’ve had jaw pain forever, I never put the pieces together that jaw tension may be the problem. Fortunately my physical therapist figured it out.

As an outrageously stubborn Type A migraineur, my jaw is locked almost constantly. It has been sore to the touch for as long as I can remember. I’ve worn a mouth guard at night for more than 10 years and even had TMJ surgery* in 1997.

Physical therapy has yielded some key information: The PT’s work on my jaw provides far more immediate relief than when he focuses on my neck. My fascia is healthy, so muscles are the main variable. The tightest, most-difficult-to-relax spot on my neck is where the jaw muscles connect. Ideally, relaxing my jaw will also relieve some neck pain.

Jaw relaxation was a success at my first biofeedback session. Doing it on my own since then hasn’t been so productive. I relax as much as I can, but wish I had the visual feedback so I could know I’m training my muscles correctly.

Treatment plan:

  • Learn to relax my jaw and monitor the problematic spot on my neck in individual biofeedback sessions
  • Avoid crunchy or chewy foods (for a short time)
  • Cut all food into kid-sized pieces
  • Learn to chew up and down rather than in a circular motion
  • Continue to see my massage and physical therapists for jaw work
  • Use self-massage and acupressure to further treat muscles

A guide to jaw and face self-massage is one of my tools. The instructions are clear and graphics show where to focus each technique. The first page of Healing Self-Massage also teaches face and jaw massage. (Full-body self-massage is covered on the next page. I haven’t tried it, but it looks good for overall relaxation.)

This may be a major piece of the puzzle. I’m so confident I’m not even fretting it won’t help. There’s a lot of work before I find relief, but having a concrete and relatively easy-to-implement treatment plan will help. Maybe I’m setting myself up for a fall. At least it is a fall I feel good about.

*My jaw was better for two months before returning to its usual state. I’ve since learned that particular surgery borders on malpractice.

Symptoms, Treatment, Triggers

Physical Therapy: Weak Muscles, Scar Tissue & Posture

Kerrie Smyres

Physical therapy looks like a promising migraine/headache treatment for me. We made progress in the first two sessions and my third tomorrow. His take makes a lot of sense to me.

Weak muscles in my back are partly to blame for neck pain. Envision your back as a lollipop stem. The tasty part of the lollipop will be firmly on top if the stem is solid. If not, the candy will flop around on the stick.

When your neck isn’t sturdy on its stem, it also moves around. Muscles and tissue tighten to compensate, moving muscle, tissue and bone out of place. Strengthening little used muscles, which align the neck and hold its correct position, is part of the solution.

Built up scar tissue on the left side of my neck is another culprit. The scars have essentially fused two muscles, keeping both from working properly. Myofascial release from my physical and massage therapists will loosen the scar tissue, although it is so old that some will remain.

Interestingly, the scar tissue isn’t on the right side, where my occipital nerve stimulator wires were. The physical therapist believes it is connected to car accidents I had in high school. No injuries were treated after the accidents because I didn’t notice any. Yet, he said even the most minor accident could have contributed.

I’m working on my posture too. Instead of pushing my shoulders down, which I’ve always thought was the way to correct bad posture, I’m lifting my sternum to be upright. Looking in the mirror, my “corrected” posture looks strange, but it feels great.

My treatment path is promising. Still, I wonder if I’m just searching for a culprit. Time and time again, anything possibly connected to my migraines becomes my focus. After a particular treatment doesn’t work, I move to the next explanation with as much fervor as the last.

I’m fond of this one for now. It echoes what I’ve learned from yoga and massage therapy and repetition is reassuring. My fingers are crossed and my outlook is good.

Exercise, Treatment

Trying New Treatments: A Long, Long List

Kerrie Smyres

Physical therapy, craniosacral therapy, cognitive behavioral therapy, biofeedback, hypnotherapy, tai chi, pilates, meditation, chiropractic. While my migraines were too bad to keep appointments this fall, I kept a running list of the new treatments and therapies I’d like to try.

I have fantasies of doing nothing else than jumping in and trying all these therapies at once. They’d have to add up to more than 40 hours a week. Reality quickly usurps the fantasy: No blog, no decent meals, no organizing and downsizing. You know, all the other activities of my life.

Prioritizing treatments is more challenging than it seems.

  • My massage therapist’s physical therapist has aborted her migraines and his techniques are different than I’ve had in the past. No question I’m seeing him as soon as possible..
  • I tried a bit of craniosacral last year and the results were promising, so that’s in.
  • Cognitive behavioral therapy, biofeedback and hypnotherapy have common threads. With my depression, cognitive behavioral therapy is the natural starting point. I expect that biofeedback and hypnotherapy will flow from that.
  • Tai chi, pilates and meditation also have similarities. I want to exercise more and learn to be mentally quiet. Pilates is more about relieving pain in my lower back, but tai chi is the perfect fit.
  • Chiropractic is last on my list. Last year’s attempt was a
    bust    , but I’m planning to see a different chiropractor, whose approach
    is quite different than the one I saw last spring. Still, having not
    been effective in the past, I’m in no rush to try it.

Choosing one from each group leaves me with physical therapy, craniosacral, cognitive behavioral therapy and tai chi. Is that still too much? Combined with myofascial release and a yoga home practice, which are having good results, I’m afraid I’m overdoing it.

In fact, I know I am. This “narrowed” list would require appointments four days a week plus three tai chi classes. Ha! Like that’s possible. But they all seem absolutely necessary.

I’m stuck. What do you recommend?