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WORKING WITH HEADACHES, PART 2 Understanding Migraines and Vascular Headaches What is a migraine? Good question. We don't quite know what causes migraine headaches, but we know how to recognize one. Although many people will call any severe headache a migraine, some of the distinguishing characteristics of true migraines are that they 1) tend to primarily affect one side of the head; 2) throb or pulse; 3) recur after pain-free intervals; 4) and, are almost always accompanied by either nausea, photophobia (light hypersensitivity), phonophobia (sound hypersensitivity), or aura (visual disturbances). Visual disturbances and/or hypersensitivity to sound are two of the distinguishing characteristics of migraines. Left: Migraine, Helen Donis-Keller, 2003. Digital/graphite. www. helendonis-keller.com. Used with permission. Right: an illustration by John Tenniel from Louis Carroll's Through the Looking Glass. Carroll himself suffered from migraines. Migraines vary a good deal in their severity and accompanying symptoms, and are sometimes "commingled" with tension/musculoskeletal headaches. However, in the absence of head injuries or other medical conditions, chances are very good that your client is dealing with a migraine or vascular- type headache if your client reports the four signs listed above. Since migraines respond differently to hands-on work, being able to recognize migraines and vascular headaches will make your interventions more effective. This article continues the discussion begun in "Working With Headaches, Part I: Musculoskeletal Headaches" (Massage & Bodywork, July/August 2010, page 110). In this installment and Part 3, I'll explain hands-on techniques from Advanced- Trainings.com's Advanced Myofascial Techniques seminars that we have found particularly effective for relieving and preventing vascular headaches and migraines. Here, our focus will be on understanding and recognizing migraines and cluster headaches. connect with your colleagues on massageprofessionals.com 109