The study ofeffective techniques for migraines is justified by its high prevalence; a
systematic review (Woldeamanuel and Cowan, 2017) concluded that it affects 1
out of 10 individuals worldwide, with preference in gender for females in
comparison with males, in a ratio 2:1.
One of the reasons
that promotes the use of physical therapy in the treatment of these patients is
the concurrence of musculoskeletal dysfunctions in the neck in patients with
migraines; a recent study concluded that 89% of the patients with
migraines included in the study reported local or referred pain in the head
during the realization of pressure on the high cervical segment. In a study
about the prevalence of neck pain in patients with migraines observed it was of
76% during the year of the study.
In the most recent
study about this topic findings from the exploration of the cervical spine
in patients with migraine and controls were compared and concluded that
significant differences existed in the number of active trigger points, in the
flexion-rotation test, joint mobility in the high cervical segment, in the
crane cervical test and in the reproduction and resolution of symptoms during
sustained pressure; also, 93% of the patients with migraine presented at least
three cervical musculoskeletal dysfunctions .
The
neurophysiologic relation between the cervical spine and headaches in migraines
is found at the Trigeminal-Cervical Complex (TCC). This complex is in charge of
transmitting sensorial, visceral and nociceptive information of the head and
orofacial region to superior centers like the thalamus, hypothalamus, and the
primary sensorial cortex this complex receives afferent nociceptive
signals from cervical structures; this convergence of nociceptive signals seems
to be the cause of the central and peripheral sensitization phenomenon present in migraine. The concurrence of peripheral nociceptive mechanisms and
the central sensitization can justify the results from Watson & Drummond
(2014); in this study, 20 patients with migraine received sustained pressure on
C1 and C2; in 19 cases it reproduced the symptoms of their migraine.
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