For Health Professionals

Thank you for your interest in The Headache + Migraine Clinic either for your own interest and research, for your patients, or maybe even for yourself. We not only treat a variety of patients and health professionals (HP’s) but commonly get referrals from and work with Pain Specialists, Neurologists, GP’s, Physiotherapists, Psychologists and other HP’s to get the best outcomes for patients.

For us, there is almost no greater joy than to see a migraine patient who has suffered terribly at the hands of daily headache or debilitating migraine to be living free of pain and the prison that these conditions bring. No more loss of time and money from copious days off work, no more missing important life and family events. Life is hard enough without a headache to face every day as well, that is why we love taking the headache out of life for our patients… literally, and we see this reality every day in our clinics.

We are partnered with the international NFP and World Health Organization initiative Lifting the Burden: the Global Campaign against Headache. We have shared goals to relieve the suffering and burden of headache and migraine patients globally, removing the stigma and myths about all headache conditions and providing access to quality and expert assessment and treatment to give those suffering their quality of life back!

Why are we so confident about our unique Combined Therapy Approach and the Success we can achieve for Your Patients?

The answer doesn’t come from our many happy patients alone but in the science and statistics for success rates with the interventions we employ. To give you an idea of the kind of improvement or success you can expect for your patients, or for yourself, below we have a brief list of some of the evidence and results of a few of the components that make up our unique Combined Therapy Approach:

(ie. You put all the benefits of each stand alone intervention together that you see below and you get an idea of why we are having so much success combining these at the right time for the right patient – and all this without including any pharmacological interventions which the patient may or may not be finding useful as well.)

First and foremost, and in keeping with the objectives of the “Lifting the Burden” global initiative, success is providing access to quality assessment and appropriate diagnosis for sufferers. Global statistics reveal 54% of all true headache and migraine sufferers have never actually had a proper assessment or diagnosis by a health professional¹. So just by being available to provide this for any of the 12 million+ headache sufferers (or any one of the up to 2 million+ migraine sufferers) in Australia, we deem a success already…this really is the first step to living life headache free.
Secondly the internationally recognised Watson Headache® Approach (our Headache Consultants are expertly trained in) commonly boasts 70%-90% results as a stand alone treatment ^{2 a, b}.
Add to this the safe and effective, evidenced based nutritional approach we integrate boasting 50-68% reduction in severity, duration and frequency of migraine^3,4,5,6,7 (even some research involving children with migraine⁷) as a stand alone treatment.
We combine Acupuncture to reduce nervous system sensitivity, muscle spasm, neurogenic inflammation and improve central nervous system inhibitory action up to 80%-90% ⁸ including the limbic, DNIC and serotonergic systems (key in headache and migraine relief). Other high level studies ⁹ have shown decrease in additional symptoms often associated with migraine like nausea and dizziness with an expert review¹⁰ and a Cochrane review¹¹demonstrating that Acupuncture can reduce headache and migraine frequency, pain intensity and in some cases can perform significantly better than some main migraine medications.
We combine the safe and effective and readily available Exercise interventions that the science shows can instantly improve quality of life for sufferers and can actually reduce migraine attacks and days per month with migraine from 17% – 40% while concurrently reducing medication use¹². Other studies show reduction in migraine pain intensity measures with regular exercise¹³ even equal to some migraine medications.¹⁴
We also combine the recommendations found in Bronfort’s Cochrane review where they assessed ‘Non-invasive physical treatments for chronic/recurrent headache’. The researchers found “both neck exercise (low intensity, endurance training) and spinal manipulation are effective in the short term and the long term” for chronic recurrent headache sufferers.¹⁵
Add to this specific and targeted therapeutic exercises for the neck as outlined and studied by Jull^16,17and others^15,18shown to reduce frequency, duration and pain intensity for certain type of headaches.
For neck-related headache and migraine we correct the imbalance of muscles around the neck and base of the skull shown repeatedly in research^17,18 to be a feature. Especially the pattern of weak deep neck flexors and overactive pecs and superficial neck flexors, particularly sternocleidomastoid and the scalene muscle groups, have all been positively associated with recurrent headaches.
We utilize the amazing abilities of Positive Psychology, Emotional Freedom Technique, Cognitive Behavioural Therapy, and Chronic Pain Counselling that help reduce chronic pain of all kinds and help retrain the brain and CNS.
We also frequently use safe and effective medical LASER interventions often used in pain medicine (Dr Roberta Chow, Liisa Laakso et al). One study on Chronic Tension Headache showed decrease in Headache pain intensity and number of attacks by up to 70% with a course of Laser therapy¹⁹. Interestingly there are over 15,000 research articles on LASER (not all for headache of course but effects on pain modulation generally) and is majorly underutilized as a modality all the while being an incredibly safe alternative to drug/ medication interventions especially for young children suffering with chronic migraine or headache. Some breakthrough research concluded that “LASER acupuncture can provide a significant benefit for children with headache and migraine with active LASER treatment” ²⁰.
We combine the latest (and amazing) neuroscience education and techniques^21,22 that assist in the retraining of the brain and facilitating a mindset shift to break the chronic “pain cycle” – basically de-sensitizing the nervous system from within – with techniques and theory popularized by Lorimer Moseley, David Butler and other game changers in this field²³. “Explaining Pain has become one of the world’s most effective and inexpensive treatments for pain. It is now the cornerstone of modern pain treatment and rehabilitation – with clinical studies showing its benefits across cultures, conditions and communities”²¹.
The research favours a combined therapy approach for effective headache and migraine management. As seen above, we seek to achieve this with many different interventions. Encouragingly, one study¹⁶ by Jull et al. in 2002 looked at the effect of combining even just two of these single interventions from the above list (Manual Therapy and Exercise combined approach). What they found were notable and statistically significant decreases in neck pain, headache frequency and intensity ranging from 50% better to complete resolution. Interestingly, the combined therapy group showed up similar to what we see in practice in that “Medication use decreased in all groups (except the control group) and in the combination group medication use decreased by an impressive 93%, underlying the efficacy and importance of a combined therapy approach in the treatment of cervicogenic headaches”¹⁶.

IMPORTANT CLINICAL NOTE: All these interventions listed (and any others we employ) are simply targeted to de-sensitize the brainstem and nervous system, turning “down the volume” at the overactive “headache headquarters” and therefore causing a patient to have less headache/ migraine symptoms BUT also less headache proneness or tendency at all…complete resolution is our realistic goal.

Now, even at a glance, if you add or combine all those percentages and success from the various individual interventions that show satisfactory research evidence for improvement (reduction in frequency, duration, pain intensity and reduction in associated symptoms) for headache and migraine…combining these for the right person at the right time for the right headache type….is very powerful indeed.

Success is just a logical outcome.

If you want to contact us or one of our Headache Consultants to discuss anything further or find out more information for yourself or your patients please call us on 1300 HOPE 4 YOU or feel free to email us at info@theheadacheandmigraineclinic.com

References:

Steiner T.J. et al, (2010) Lifting the Burden: The first 7 years. The Journal of Headache Pain 11:451-455
Watson, Dean. (2015). The Watson Headache® Institute, course proceedings Level 3 Certification program, Feb. 2015.
Watson, D. Drummond, P.D. (2012). “Head Pain Referral During Examination of the Neck in Migraine and Tension-Type Headache”. Headache. 52: 1226-1235
Lea et al. (2008) The effects of vitamin supplementation and MTHFR (C677T) genotype on homocysteine-lowering and migraine disability
Schoenen, MD, PhD, J. Jacquy, MD and M. Lenaerts, MD. Effectiveness of high-dose riboflavin in migraine prophylaxis A randomized controlled trial. NEUROLOGY;50:466-470 (1998)
Schoenen, M. Lenaerts, E Bastings. High-Dose Riboflavin as a Prophylactic Treatment of Migraine: Results of an Open Pilot Study. Cephalalgia, Vol. 14, No. 5, 328-329 (1994)
Kopjas TL. (1969) The use of folic acid in vascular headache of the migraine type. Headache. 8(4):167-70.
Di Rosa G, Attinà S, Spanò M, Ingegneri G, Sgrò DL, Pustorino G, Bonsignore M, Trapani-Lombardo V, Tortorella G. (2007) Efficacy of folic acid in children with migraine, hyperhomocysteinemia and MTHFR polymorphisms.Headache. 47(9):1342-4.
Wang et al (2008) Acupuncture Analgesia: The Scientific Basis. Anaesthesia and Analgesia 106 (2); 602-610
Sun et al (2008) Acupuncture for the management of Chronic Headache: a systematic review. Anaesthesia and Analgesia 107(6); 2038-47
Endres HG et al. (2007) Role of Acupuncture in the treatment of Migraine. Expert Review of Neurotherapeutics. 7 (9); 1121 -1134
Linde et al. (2009) Acupuncture in Migraine Prophylaxis. A Cochrane Review
Varkey E et al (2008) A study to Evaluate the Feasibility of an Aerobic Exercise Program in Patients with Migraine. Headache: The journal of Head and Face Pain. 49 (4); 563-570
Busch V and Gaul C (2008) The Evidence for Exercise in Migraine Therapy –is there any evidence for efficacy? A critical Review. Headache. 48 (6); 890-899
Varkey E et al (2011) Exercise as a Migraine Prophylaxis: A Randomized Study using relaxation and Topiramate as controls. Cephalalgia 31 (14);1428-1438
Bronfort G, Nilsson N, Haas M, et al. (2004) Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev. 2004;(3)
Jull G, Trott P, Potter H, et al. (2002) A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002;27:1835–1843
Jull G, Amiri M, Bullock-Saxton J, Darnell R, Lander C ; (2007)‘Cervical musculoskeletal impairment in frequent intermittent headache. Part 1: Subjects with single headaches’ Cephalgia 2007; 27:793–802
Zito G, Jull G, Story I. (2006) Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther. 2006;11:118–129
Ebneshahidi N et al. (2005) The effects of Laser Acupuncture on chronic Tension Headache –a randomised controlled trial. Acupuncture Medicine 23 (1);13-18
Gottschling et al. (2008) Laser Acupuncture in children with headache: A double blind, randomized, bicenter, placebo-controlled trial. Pain 137 (2); 405-412
Butler D and Moseley L (2013) Explain Pain 2^nd
Butler D and Moseley L (2014) Explain Pain Handbook: Protectometer.
http://www.noigroup.com/documents/noi_explain_pain_2nd_edn_evidence_base.pdf

For Health Professionals

Why are we so confident about our unique Combined Therapy Approach and the Success we can achieve for Your Patients?

If you want to contact us or one of our Headache Consultants to discuss anything further or find out more information for yourself or your patients please call us on 1300 HOPE 4 YOU or feel free to email us at info@theheadacheandmigraineclinic.com

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