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This powerful method is currently revolutionising the way Physiotherapists prevent and rehabilitate injuries. Clinical Pilates is a system of exercises that integrates the traditional Pilates Method with modern research into musculoskeletal dysfunction.


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Migraine Pain And Treatment

As with all headache type scenarios our primary goal initially is to make sure there is nothing more sinister going on, checking the nervous system for subtle signs that something may be wrong, once this has been taken off the table we can focus on what the problem is.

Migraines are recurrent/episodic moderate or severe headaches that are usually unilateral, pulsating, aggravated by routine physical activity, and are associated with either nausea, vomiting, photophobia, or phonophobia.

Once we have established that it is a migraine, through case history and examination, we then need to consider any triggers, the most common being chocolate, red wine, cheese and hormonal with women, around their menstrual cycle. We also need to consider stress management and other psycho-social factors as these can also be a trigger to migraine.

A Cochrane review (Bronfort et al 2004) concluded that spinal manipulation is an effective option for the care of migraine headache, with Nelson et al, (1998) stating that there is moderate-quality evidence that spinal manipulation has an effectiveness similar to first-line prophylactic prescription medication (amitriptyline) for the prophylactic treatment of migraine. A more recent review of the evidence (Bryans et al, 2011) also indicated the benefits of spinal manipulation for adults with episodic/chronic migraine and cervicogenic headache.

Bryans R, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg R, Shaw L, Watkin R, White E: Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011, 34:274–289.
The International Classification of Headache Disorders. Cephalalgia , 2 2004, 24(Suppl 1):9-160.
Bronfort G, Nilsson N, Haas M, Evans R, Goldsmith CH, Assendelft WJ, et al: Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev 2004, CD001878.
Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV: The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headaches. J Manipulative Physiol Ther 1998, 21:511-519.
Bronfort, Haas, Evansm Leininger, and Triano. Effectiveness of manual therapies: the UK evidence report; Chiropractic & Osteopathy 2010, 18:3
Clar, Tsertsvadze, Court, Hundt, Clarke and Sutcliffe. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report: Chiropractic & Manual Therapies 2014, 22:12