Migraine

Neurological disorder causing headache attacks, often accompanied by nausea or sensitivity to light and sound.

Lire cette fiche en français

Understanding the mechanism

Migraine is a neurological disorder involving recurrent attacks, with or without aura. Sensory and trigeminovascular mechanisms are involved; it is not simply caused by a displaced vertebra. Neck pain can be part of the attack itself. Recognizing migraine helps distinguish its management needs from a headache genuinely secondary to a cervical disorder.

Symptoms and warning signs

Pain is commonly moderate to severe, sometimes throbbing and worsened by activity, with nausea or sensitivity to light and sound. A typical aura develops gradually and is reversible, but any new or unusual neurological symptom needs assessment. A headache that reaches maximum intensity immediately or a sudden neurological deficit requires emergency care rather than assuming another familiar migraine attack.

Diagnosis and investigations

Diagnosis is usually clinical, based on the course of attacks and classification criteria. A diary helps track frequency, possible triggers and medication use. Imaging is not routinely required for a typical presentation without secondary warning signs. A sustained change in pattern, a particular risk context or an abnormal examination can nevertheless justify further investigation.

Treatment and outlook

Management includes acute treatment and, depending on frequency and disability, prevention. Medication choices require a prescriber to consider contraindications, including cardiovascular and pregnancy-related issues. Regular sleep, appropriate activity and identifying personal influences support the plan. Frequent use of acute medication can contribute to medication-overuse headache and should be reviewed without abruptly changing prescribed treatment independently.

The role of TAGMED care

At TAGMED, associated musculoskeletal symptoms can be assessed, but spinal decompression, laser and shockwave therapy are not universal reference treatments for migraine. Improvement in neck tension does not demonstrate cure of the migraine disorder. Support should preserve access to medical follow-up and measure migraine days and functional impact rather than relying only on temporary relief during a clinic visit.

Practical follow-up

The diary can record migraine days, acute medicines and missed activities. It supports discussion of prevention and medication overuse with the prescriber. Possible triggers should be explored without imposing excessive, non-individualized dietary restrictions or avoidance of otherwise appropriate physical activity.

Frequently asked questions

Does migraine always affect one side?

No. One-sided pain is common but is not required in every attack.

Is aura necessary?

No. Many people experience migraine without aura.

Does neck pain prove a spinal cause?

No. Neck discomfort may be part of the migraine attack itself.

Is MRI required for confirmation?

Usually not in a typical presentation; the indication depends on associated findings.

When should prevention be discussed?

When attacks are frequent, disabling or inadequately controlled, considering preferences and individual risks.

Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.