Comprehensive Migraine Education Program: Part I

Are you one of the 36 million Americans who suffer from migraines?

Last weekend I attended the Comprehensive Migraine Education Program (CMEP), put on by the American Headache Society in Denver, CO.  I’ve had a special interest in the treatment of headaches since I graduated from physical therapy school, which you can read more about here.

Below is Part I in a series of posts covering some key points of the CMEP.

While there is no cure for migraines, the goal of treatment is decreasing the frequency of headaches and stopping individual headaches when they occur.


The first step in finding the most appropriate treatment is determining what type of headache you have (more info on that here.)

Migraines tend to have the following presentation

  • Headache that is moderately or severely painful
  • Headache pain gets worse with physical activity
  • Headache pain that is throbbing and may be worse on one side of your head
  • Increased sensitivity or light or sound with your headache
  • Headache lasts 4-72 hours (if untreated)
  • Headache may be accompanied by nausea or vomiting

If you have several of these features you may want to talk to your physician about your headaches.

There are a multitude of factors that can predispose someone to having migraines.

A statement that sums it up nicely is

“Migraines are genetically driven and environmentally mediated.”


Migraines are more common in women and things like stress, previous head or neck injury, depression, obesity and anxiety can put you at greater risk of developing chronic migraine.

So while you can’t change your genetics, you can change many things in your environment that will have an enormous effect on the amount of headaches you get.

First things first, regular exercise, healthy diet and adequate sleep are imperative.

If you aren’t getting these on a daily basis, start here!


There are countless benefits to regular exercise. Regular exercise reduces stress and improves sleep, it also releases endorphins which are the body’s own painkillers. All benefits that are important for people with headaches!  Secondly, there are some surprising links between food and migraines. Certain foods can trigger migraines and other foods can help in the prevention of them. Read more about migraine and diet here. Lastly, there are connections between migraines and sleep. Too little or too much sleep can be headache triggers. Getting consistent, adequate sleep is proven to improve headache frequency.

Additionally, there are non-pharmacologic interventions including relaxation training, biofeedback and manual therapy that are all useful migraine treatments and have been shown to be as effective as migraine medication in several studies.

Relaxation training and biofeedback help to “wind down” the brain and nervous system. They also help reduce anxiety and improve sleep.

Manual therapy (joint and soft tissue mobilization from a physical therapist) targeting the neck and upper back helps to decrease muscle tightness, which has a dramatic positive effect on the nervous system.

In summary, migraines are complex.

Effective treatment often requires several medical professionals working together with you to determine the best combination of treatments for your specific needs.

Next up…Part II: Prepping for your visit

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