What it is
Migraines are a neurological disorder. A migraine is a recurrent headache disorder with moderate to severe attacks, often one‑sided and throbbing, and commonly associated with other symptoms such as light or sound sensitivity, nausea, and sometimes aura (a collection of neurological symptoms that can precede a migraine, such as visual disturbances, tingling sensations, weakness, pins and needles or difficulty in speaking). Neck sensitivity and trigger patterns frequently coexist.
Management combines trigger control, abortive medication plans, lifestyle strategies, and neck conditioning. The aim is to have fewer, shorter, and less intense attacks, along with reliable functioning between them.
What happens when it occurs
Brain networks become sensitised. Triggers such as poor sleep, stress, dehydration, or specific visual environments lower the threshold for an attack. Early, specific medication reduces severity. Conditioning and routines raise the threshold over time.
Common causes, triggers and risk factors
- Family history
- Hormonal cycles
- Stress, sleep disruption, dehydration, and visual strain
- Neck sensitivity and posture habits
- Skipping meals
- Food and drink triggers such as caffeine, alcohol and cheeses
- Sensory stimulation, such as bright lights and strong smells
- Sexual intercourse
Who is most affected
Women are affected more often than men in Australia. Onset commonly begins in adolescence or young adulthood.
Typical symptoms
- One‑sided throbbing headache with light or sound sensitivity
- Nausea, with or without vomiting
- Aura in some people
When to seek care
Urgently for first or worst severe headache, new neurological symptoms, or head injury. Seek review if attacks increase in frequency or change in character.
How we diagnose
History against migraine criteria, screen for secondary causes, and neck examination. Imaging is used selectively for atypical features.
Management
- Personalised acute medication plan and early use at onset
- Preventive strategies: sleep, hydration, stress skills, regular meals, aerobic exercise
- Neck conditioning for endurance and posture
- Medical preventives are considered for frequent or disabling attacks
Rehabilitation milestones
Phase 1 weeks 0–2: trigger diary, acute plan, gentle conditioning.
Phase 2 weeks 2–8: endurance, aerobic routine, refine triggers and workplace setup.
Phase 3 months 2–6: consolidate routines, performance goals between attacks.
Readiness to progress
- Reduced attack days and intensity
- Recover faster with an acute plan
- Stable routines for sleep and hydration
Prevention
- Regular sleep and meals
- Hydration and aerobic activity
- Neck endurance and stress skills
Australia snapshot
- Common in primary care and among working‑age Australians
- Women present more often than men by several fold
- Most benefit from a combined medical and rehabilitation approach
Latest insights
A written acute plan, plus routines, is more effective than either alone.
Neck conditioning complements medical care and reduces triggers.


