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Osteopathy, headaches and migraines
Are you one of the many people who experience headaches? Headache symptoms can range from mild pain and discomfort to a debilitating migraine with neurological symptoms and vomiting. Many people who have headaches and migraines also experience fatigue and brain fog which affects their daily activities.
HEADACHES
Are you one of the many people who experience headaches? Headache symptoms can range from mild pain and discomfort to a debilitating migraine with neurological symptoms and vomiting. Many people who have headaches and migraines also experience fatigue and brain fog which affects their daily activities.
A HEADACHE AT THE BACK OF YOUR HEAD IS JUST ONE OF THE SYMPTOMS
Typical headache symptoms vary but can include:
slow onset of symptoms
pain on both sides of your head
pain that feels like a tight band or vice around your head
pain in the upper neck or back of the head
THERE ARE DIFFERENT TYPES OF HEADACHES
To help you get from pain and discomfort to a point where you can successfully manage your headaches, you will need to get the right diagnosis. There are several types of headaches, including:
tension headache
cervicogenic (from the neck) headache
migraine
cluster headache
TENSION HEADACHES
With this type of headache you may experience the following symptoms:
tenderness in the scalp, neck and shoulder muscles
a feeling of pressure and tightness at the back of the head, forehead or sides of the head.
pain that is dull and aching in nature.
Tension headaches can be described as episodic or chronic
The duration of an episodic tension-type headache can be from 30 minutes to one week.
Episodic tension-type headaches can become chronic. If your headache frequency is more than 15 days per month for at least 3 months, it is considered chronic.
WHAT IS A MIGRAINE?
A migraine is considered to be a neurological disease which affects about 15% of the population, affecting women (18%) more than men (8%)
A migraine headache can cause severe pain and a throbbing sensation on one side of the head. Migraines are the sixth most disabling disease in the world.
MIGRAINE SYMPTOMS
Migraines can be triggered by movement, light, sound or certain foods. Symptoms can last for four hours to several days
Symptoms may include:
tiredness
severe pain on one side of the head
sensitivity to sound and light
nausea, vomiting
visual disturbances
irritability
difficulty speaking
numbness and tingling
temporary loss of vision
MIGRAINE TRIGGERS
hormonal fluctuations
light, including glare and flickering light
certain smells
fatigue, lack of sleep, irregular sleep
weather changes
stress
particular food and drink
dehydration
some medications
WHAT CAUSES MIGRAINES
There is still a lot to learn about the cause of migraines however there appear to be different factors at play, including genetics, environment and lifestyle.
Current theories include changes in the brainstem, trigeminal nerve and serotonin levels. The role of neurotransmitters, including calcitonin gene-related peptide (CGRP) are also being researched.
OSTEOPATHY AND HEADACHES
Your osteopath will take a thorough history and ask you questions about your headaches, including their frequency, location, pattern and any associated triggers. If you have neurological symptoms, recent trauma or a sudden change in your symptoms, a referral for further investigations can be made to your G.P.
On assessment, your osteopath will look for any strain or restriction throughout your body. Common findings with headaches include: restriction of the upper cervical spine, tightness and imbalance of the muscles of the upper back and neck, jaw dysfunction as well as stiffness of the thoracic spine. Additionally, we will address the diaphragm, pelvis and lower limbs. There may be an underlying scoliosis, sinus issues or a history of sleep apnoea which needs to be investigated.
WHAT DOES AN OSTEOPATH DO?
Tension, cervicogenic headaches and migraines are very common conditions that we treat.
We look at your whole body and try to identify issues which may be contributing to your headaches, for example a scoliosis, a history of whiplash, head trauma, sinus congestion or recent dental work.
Osteopathic treatment is based on the following principles
The body is a whole integrated unit
Structure is related to function
Each system is inter-related
The body has self-healing and self-regulating mechanisms
We use a range of hands-on techniques to assist with headaches and bring balance to your whole body, including:
Soft tissue massage and stretching,
Counterstrain (indirect myofascial release)
Functional technique (indirect joint release)
Joint articulation particularly the upper thoracic and cervical spine
Muscle energy technique (MET),
Visceral techniques, including diaphragm release
High velocity low amplitude thrust (HVLA)
Tips for managing headaches
avoid known triggers related to food, lack of sleep or missed meals.
gentle exercise and stretching such as walking and yoga
stress management such as meditation or mindfulness
rest
hydration
When to make an appointment
you’re dependent on drugs to manage frequent headaches
your headaches affect your daily activities
you have pain in your back, neck or jaw
you want to learn how to manage your headaches naturally
If you are concerned that treatment may trigger a headache, please be assured that a good osteopath can use gentle and indirect osteopathic techniques to ease physical tension and calm the sympathetic nervous system.
osteopathy near me
Dr. Michelle Sherriff is an osteopath with 20 years experience and consults at Portland Osteopathy and Wellness Group
RED FLAGS FOR HEADACHES
Seek urgent medical care if you have any of the following
A headache that is severe, abrupt and feels like a thunderclap
headache associated with fever, seizures, confusion, double vision, stiff neck, numbness or weakness in any part of the body (sign of a stroke)
Headache following head trauma or injury
A chronic headache that gets worse on exertion, straining, coughing or sudden movement
Headache presenting after the age of 50 with no previous history
Movement Milestones at 3 months
At three months, your baby's motor strength continues to develop. They will reach for small toys and try to shake or put them in their mouth. You'll notice better head control and lots of kicking and pushing down when their feet are on a hard surface.
Developmental movement Milestones
At three months, your baby's motor strength continues to develop. They will reach for small toys and try to shake or put them in their mouth. You'll notice better head control and lots of kicking and pushing down when their feet are on a hard surface. Here's a quick checklist of baby's Movement Milestones at 3 months
Raises head and chest when lying on tummy
Supports upper body with arms when lying on tummy
Stretches legs and kicks out when lying on tummy/back
Opens and shuts hands
Brings hands to mouth
Swipes at objects/toys with hands
Grasps and shakes small toys
Pushes down on legs when feet on firm surface
Movement milestones Red Flags
If you notice your baby isn't meeting one or more of the following movement milestones, contact your healthcare provider to discuss your concerns
Can't support his/her head well by 3 months
Doesn't reach for and grasp toys by 3-4 months
Doesn't bring objects to his/her mouth by 4 months
Osteopathy and Babies
How can your osteopath help?
Osteopaths take a detailed history and assessment to identify areas of tension or restriction in the musculoskeletal system. We assess:
Primitive reflexes and neurological evaluation
Orthopaedic and osteopathic evaluation
Developmental milestones
Osteopathic treatment aims to restore normal function and optimise healthy development for your baby (Read more about osteopathy and babies).
Dr. Michelle Sherriff works in conjunction with general practitioners, maternal health nurses and lactation consultants and can make a referral when indicated.
osteopathy near me
Dr. Michelle Sherriff consults at Portland Osteopathy and Wellness Group,
Infant Torticollis
Does your baby lie with their head positioned to one side or is unable to feed from both sides equally?The word torticollis is derived from the Latin, "tortus" meaning twisted and "collum" meaning neck. Torticollis is usually related to tightened muscles on one side of the neck.
INFANT TORTICOLLIS
Does your baby lie with their head positioned to one side or is unable to feed from both sides equally?
The word torticollis is derived from the Latin, "tortus" meaning twisted and "collum" meaning neck. Torticollis is usually related to tightened muscles on one side of the neck.
Torticollis in infants is common and is reported to be as frequent as 3 in every 100 babies. It is usually diagnosed within the first month of life.
You may notice the following signs with your baby:
Baby’s head tilts or rotates to one side. More specifically; the head and ear are tilted towards the affected sternocleidomastoid muscle and the chin points to opposite side
They prefer looking in one direction
They prefer breastfeeding on one breast only or have more difficulty on one side
Limited range of motion in head and neck
Asymmetry in baby’s head and face (plagiocephaly)
A small lump in your baby’s neck
What causes it?
Your baby may have been born with torticollis (congenital) or it may present after birth (acquired torticollis)
CONGENITAL (Muscular or postural type)
Symptoms and signs may not become obvious until your baby is 6-8 weeks old and gains more head and neck control. The most common type of torticollis is muscular.
The sternocleidomastoid muscle attaches from the sternum and inner clavicle to the mastoid process of the temporal bone. When it becomes shortened it pulls your baby’s head into a tilt and/or rotation. This muscle can become tight and contracted due to the following factors
Abnormal uterine position, for example breech position
Injury during birth
Forceps or vonteuse delivery
Abnormalities related to the cervical spine.
Rarely, it may result from a congenital disease affecting the nervous system
Babies diagnosed with infant torticollis should also be assessed for Developmental Dysplasia of the Hip (DDH)
Acute onset or torticollis diagnosed after 6 months (acquired) requires urgent further investigations
What you can do?
If your baby's head tilts to one side, they prefer looking in one direction and have difficulty breastfeeding on both sides equally, there are several things you can do to help your baby:
Osteopathy: Make an appointment with your osteopath to address any underlying strains or restrictions related to uterine position and/or birth trauma
Feeding: When feeding your baby, encourage them to turn away from their favoured side by bottle/breast positioning
Sleeping: When putting your baby to sleep, position them facing the wall so they need to actively turn their neck to the restricted side to look out into the room.
Playing: Encourage neck rotation to the restricted side with toys, sounds and singing.
EXERCISES
Two exercises for infant torticollis are tummy time and guppy pose.
TUMMY TIME: position your baby so their head is turned away then encourage your baby to turn towards you by talking or singing . (Tummy Time blog)
GUPPY POSE: support baby on their back over your lap and allow their head to extend backwards, allow the chin to move away from the chest Encourage rotation to the restricted side. This pose releases tension through the front of the neck, and chest.
How can an osteopath help
An experienced osteopath who works with babies will assess for any cranial or facial asymmetries related to torticollis, they’ll assess for restricted cranial articular motion, cervical spine and rib dysfunction. They will palpate the sternocleidomastoid and scalene muscles for any lumps and tightness.
As torticollis may have an impact on the vestibular system and can affect the visual system, your osteopath will also check your baby’s visual tracking.
It’s really important to treat infant torticollis as early as possible. If left untreated, it can lead to functional restrictions of the spine, plagiocephaly and it has also been associated with thoracic scoliosis.
osteopathy near me
Dr. Michelle Sherriff use a very gentle form of osteopathic treatment for babies called Biodynamic Osteopathy to treat infant torticollis. This type of treatment allows your baby to come to a point of stillness, allowing an unwinding and rebalancing of their system. Osteopathic treatment aims to restore normal function, optimise healthy development and assist your baby’s own innate capacity to heal and restore balance naturally.
Subacromial Bursitis
Your osteopath can confirm the diagnosis of subacromial bursitis by taking your medical history and assessment of the shoulder..
What is subacromial bursitis?
A common shoulder condition we see as osteopaths is subacromial bursitis. The subacromial bursa is a fluid filled sac which sits under the acromion and “itis” simply means it is inflamed.
Symptoms of subacromial bursitis
~ shoulder pain, especially on raising your arm overhead
~ shoulder pain that is aggravated by repetitive activity
~ sensitivity and tenderness over the outer shoulder, especially when pressure is applied (eg lying on that side in bed)
~ pain that radiates to the outer aspect of the arm (but not past the elbow)
~ as the condition progresses, you may experience pain at the end-range of all movements of the shoulder.
what causes subacromial bursitis?
The bursa may become inflamed as result of
Subacromial impingement
Repetitive overhead activities/overuse
Direct trauma
Crystal deposition
Subacromial hemorrhage
Infection
Autoimmune diseases (e.g., rheumatoid arthritis)
You may be at greater risk of subacromial bursitis if your occupation or sport involves repetitive overhead activities. It can also be age-related due to increased subacromial impingement. Sub-optimal posture may contribute to poor biomechanics of the shoulder complex.
tips for subacromial bursitis
Conservative treatment of subacromial bursitis include
~ Rest, particularly from overhead, repetitive activities
~ Ice
~ NSAIDs (non-steroidal anti-inflammatory medication)
osteopathy and subacromial bursitis
This first step is to confirm a diagnosis of subacromial bursitis.
Your osteopath can confirm the diagnosis by taking your medical history and assessment of the shoulder.. Subacromial bursitis may present on its own, or in conjunction with other conditions. Often we’ll see subacromial bursitis alongside rotator cuff tendinopathy, biceps tendinopathy or subacromial impingement syndrome. It is also important to exclude the cervical spine as a cause of referred pain.
Once a likely diagnosis of subacromial bursitis is made, the aim is to reduce pain and facilitate healing.
Osteopathic treatment is always based on the following principles
The body is a whole, integrated unit
Structure is related to function
Each system is inter-related
The body has self-healing and self-regulating mechanisms
Osteopaths use a range of techniques aimed to
~ improve biomechanics and range of motion of the shoulder complex
~ address muscle imbalances of the shoulder
~ improve mobility of the thoracic and cervical spine
~ minimise postural strain on the shoulder
~ improve lymphatic drainage and reduce inflammation
~ reduce sympathetic tone and restore balance to the whole.
home exercises for subacromial bursitis
~ You osteopath can provide you with a home exercise program for all stages of subacromial bursitis
osteopathy near me
Dr. Michelle Sherriff consults at Portland Osteopathy and Wellness Group
alternative treatment for subacromial bursitis
Corticosteroid injection under ultrasound or surgery may be performed if your symptoms don’t respond to conservative treatment. We can refer you to your G.P. for further investigations (eg x-ray or MRI)
Faruqi T, Rizvi TJ. Subacromial Bursitis. [Updated 2020 Jun 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541096/
Shortness of Breath in Pregnancy
There are several factors related to shortness of breath during pregnancy. Osteopathic treatment can help your body adjust to some of these changes, allowing an easier more efficient breath.
Shortness of Breath in Pregnancy
An estimated 60-70% of women experience shortness of breath during pregnancy, especially during the last trimester.
There are several factors related to shortness of breath during pregnancy. Osteopathic treatment can help your body adjust to some of these changes, allowing an easier more efficient breath.
Factors to consider:
Uterine distension
Changes in lung volume
Altered thoracic biomechanics
Elevation of the diaphragm
Increased progesterone
Uterine distension from a growing baby causes gradual changes in lung volume due to altered thoracic biomechanics and elevation of the diaphragm muscle. The diaphragm is a large, dome-shaped muscle located at the base of your lungs. It is the principle muscle of breathing and has attachments to the xiphoid process (the bottom of the sternum), the inner costal cartilages of ribs 6 to 10, the arcuate ligament and the lumbar spine. During pregnancy the diaphragm moves up approximately 4 cm from its normal position which leads to mild compression of the lungs. Hormonal changes can also contribute with an increase in progesterone, resulting in a deeper breath.
How can your osteopath help?
Osteopathic treatment may involve joint articulation of the thoracic spine and rib cage to release any restrictions. The diaphragm muscle can be released directly or indirectly to improve function. Osteopathy in the cranial field restores balance to the whole body including the sympathetic nervous system and nerve supply to the diaphragm.
What can you do?
Being mindful of your posture through pregnancy (avoid slouching)
Pillow props in bed or at rest
Diaphragmatic Breathing or (belly breathing)
Stress management including meditation/mindfulness practice
For example Insight Timer Meditation: Breathe to Relax during pregnancy, April Lovett
Listen to your body, don’t overexert yourself if you are feeling short of breath.
If you need more help with managing shortness of breath during pregnancy make an appointment with your osteopath
Read more about osteopathy and pregnancy
osteopaths near me
Dr. Michelle Sherriff consults at Portland Osteopathy and Wellness Group
127 Percy Street, Portland, Victoria
Neck Pain
Osteopaths use a range of hands-on techniques to reduce muscle tension, increase joint mobility and restore balance to your cervical spine. We can also provide with a personalised exercise plan to manage your neck pain at home as well as provide postural advice including workstation setup.
Neck pain is a very common condition treated by osteopaths. The chance that you will have neck pain at some point in your lifetime is nearly 50%. Neck pain peaks in middle age and has a higher incidence in females than males. For most people, an acute episode of neck pain will resolve in approximately 6-8 weeks with conservative management. Chronic neck pain persists in 10-34% of people.
Symptoms include:
Pain aggravated by posture or neck position
Muscle tightness and spasm
Restricted movement
Headache
Altered sensation in your fingers or hands eg pins and needles
Your osteopath will take your medical history, examine your cervical spine and make a diagnosis and treatment plan to assist your recovery.
Causes of neck pain can include:
~ muscle strains
~ osteoarthritis
~ facet joint sprains
~ disc irritation
~ torticollis
~ whiplash
~ other diseases eg rheumatoid arthritis
Treatment
Osteopaths use a range of hands-on techniques to reduce muscle tension, increase joint mobility and restore balance to your cervical spine. We can also provide with a personalised exercise plan to manage your neck pain at home as well as provide postural advice including workstation setup.
Tips for neck pain
osteopathic treatment
be aware of and improve your posture.
stay active with walking, movement and gentle exercise
neck exercises including stretches and strengthening
heat/ice therapy
take frequent breaks if you are travelling in a car or sitting at a computer for extended periods
adjust your workstation including your desk, chair and computer
sleep in a good position with a supportive contour pillow.
When to see your G.P.
Your osteopath is a primary care practitioner who can make a referral to your G.P. or for further investigations if indicated.
Contact your G.P. if your pain is severe, persists for several days without relief, spreads down your arms or legs or is accompanied by headache, numbness, weakness or tingling.
References
The fourth trimester
It is vital that mothers receive support and care following the birth process, especially if the birth was traumatic. Pain and discomfort can be aggravated by postural strain related to feeding, holding, and settling your baby.
⠀Postnatal care
It is vital that mothers receive support and care following the birth process, especially if the birth was traumatic. Pain and discomfort can be aggravated by postural strain related to feeding, holding, and settling your baby. Sleep deprivation, biomechanical, and hormonal changes may also contribute to your pain. ⠀
⠀
Osteopathic treatment is integral to support the wellbeing of mothers during this time. Treatment aims to restore balance, improve mobility, and to release tension in the muscles, joints, and ligaments. Gentle techniques allow a shift in the nervous system to a more restful state. ⠀
⠀
Conditions that may present during the post-natal period:⠀
~ Low back pain⠀
~ Pelvic, sacral and coccyx pain⠀
~ Neck pain and headaches⠀
~ Thoracic spine pain⠀
~ Repetitive strain injury⠀
~ Thoracic outlet syndrome⠀
~ DeQuervain's syndrome⠀
~ Pelvic instability ⠀
⠀
If you are currently pregnant, now is a good time to start building your village of support in preparation for the postnatal period. ⠀
Hip Pain
Ccommon causes of hip pain include: osteo-arthritis of the hip joint, tendinopathy affecting the gluteus medius muscle insertion and trochanteric bursitis. Osteopathic treatment aims to restore balance to your whole body, not just the symptomatic region.
Anatomy
The hip joint is a ball and socket joint. It has a high degree of stability and range of motion.
The “acetabulum” is composed of 3 components of the hip bone; the ilium, ischium and pubis which merge together in a Y-shaped cartilage.
The peripheral edge of the acetabulum is deepened by the acetabular “labrum” (a rim of fibrocartilage) which further enclose the femoral head. The joint capsule attaches around the labrum and to the neck of the femur. The capsule is loose to allow movement but is extremely strong.
Stability of the hip joint is enhanced by ligaments, including:
ligament of the head of the femur (ligamentum teres)
the iliofemoral ligament
pubofemoral ligament
ischiofemoral ligament
How does hip pain present?
Hip pain tends to affect certain age groups more commonly; the young (0 to 15 years old)
and people over 45 years old. Hip pain may present in the buttock, groin, inner thigh or sometimes the knee. The pain can be dull or sharp. There may be associated stiffness, locking or catching of the joint. Pain may be worse lying on the affected side, or at night. The symptoms may be aggravated by prolonged standing, sitting or certain movements such as stepping out of a car or climbing stairs. Hip pain may be acute, or chronic (lasting more than 3 months).
Hip Conditions
There are several common conditions that affect the hip and muscles. However, it is important to exclude referred pain from the spine or other pathology which may require further investigation. During your examination we assess your gait, posture, lower back, pelvis, hip, knee and ankle joints. We use osteopathic, orthopaedic and neurological examination to determine a diagnosis for your symptoms.
The most common causes of hip pain that we see include:
Osteo-arthritis of the hip joint
Tendinopathy affecting the gluteus medius muscle insertion
Trochanteric bursitis
Osteopathic treatment aims to restore balance to your whole body, not just the symptomatic region. We look to:
increase mobility of the lumbar spine and hip joint
decrease myofascial tension of the gluteal, piriformis and ilio-psoas muscles
improve lymphatic drainage
address strains of the pelvis, sacro-iliac and the lower limb joints
restore balance and a sense of neutral to your whole body, allowing healthy function.
Depending on your diagnosis, we may recommend heat, ice or specific stretching and strengthening exercises to to help you manage your pain.
Diaphragmatic Breathing
Osteopaths are interested in the function of your diaphragm because of it's various attachments and influence on thoracic respiration and mobility. Treating the diaphragm with osteopathy has also been shown to have a positive effect on low back pain.
Osteopaths are interested in the function of your diaphragm because of it's various attachments and influence on thoracic respiration and mobility. Treating the diaphragm with osteopathy has also been shown to have a positive effect on low back pain.
Anatomy
The diaphragm is a large, dome-shaped muscle located at the base of your lungs. It is the principle muscle of breathing and has attachments to the xiphoid process (the bottom of the sternum), the inner costal cartilages of ribs 6 to 10, the arcuate ligament and the lumbar spine.
Embryology (development)
The diaphragm and liver are located together during embryonic development.
Where the liver goes, so does the diaphragm. As the brain and spine extend and ascend during this process, the diaphragm is left behind in the thoracic cavity. The muscular tissue of the diaphragm will then grow towards the interior surface of the abdominal wall.
The muscular domes that rise on either side of the central tendon have the ability to push downward on the abdominal viscera - and accounts for the bulging of the upper abdomen known as the “belly breath”.
On inhalation, the diaphragm descends, allowing 3 dimensional expansion of the thoracic cage and lungs. On exhalation the diaphragm ascends.
Benefits
Learning how to diaphragmatic breathe may help;
relax and lower the harmful effects of the stress hormone cortisol on your body
Lower heart rate
Lower blood pressure
Cope with symptoms of PTSD (post-traumatic stress disorder)
Improve core muscle strength
Regulate the autonomic nervous system (ANS) and the many processes under it’s control, including digestion.
How to do it
Lie on your back on a flat surface with your knees slightly bent and head supported. Place a pillow under your knees.
Put one hand on your chest and and one hand on your abdomen
Breathe in slowly through your nose into your abdomen. The hand on your abdomen should rise while your chest remains relatively still.
Exhale slowly with a sigh and your abdomen should fall. Try to allow a longer exhale than inhale to stimulate the parasympathetic (calming) nervous system.
Practice for 5 - 10 minutes, 3-4 times a day
osteopaths near me
Dr. Michelle Sherriff consults at Portland Osteopathy and Wellness Group
127 Percy Street, Portland, Victoria
References: Bryan Freeman Embryology Lecture Series
Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial.
Martí-Salvador M1, Hidalgo-Moreno L1, Doménech-Fernández J2, Lisón JF3, Arguisuelas MD4.
Yoga Anatomy: Kaminoff, L., Mathews, A., 2nd Ed.
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