(The Osteopath magazine, Oct/Nov 2016)
Osteopaths for Progress in Headaches and Migraines (OPHM) is a new group that aims to raise the standing of osteopathy in the treatment of headaches. One of its founders, Helena Bridge, explains how and why it was formed, and what it has to offer.
Each of us at OPHM had a different path into our shared interest in headaches – and some, like Director Cliff Lomas, have been studying headaches for decades. For me, it started in 2014 with a migraine patient at the European School of Osteopathy (ESO) student clinic, where I was starting to tutor after a long break.
In more than 20 years in practice, I’d had reasonable success rates with headache patients, but this one had such severe symptoms, and was so distraught, that I felt disconcerted: I realised I had no real process, no reliable way to help manage her pain or assess or manage her overall situation.
This led me to undertake a PGCE in Clinical Management of Headache Conditions – and then, with support and advice from the ESO and many others, we launched a headache clinic at the ESO in April 2016. It now attracts a wide variety of patients every Wednesday evening.
This type of project can be done locally by any osteopath wanting to study headaches in depth. We at OPHM are on a mission to enable our colleagues to obtain education and support so they can broaden their practices to encompass safe and effective headache management.
Sadly, there are fewer than 50 medically managed headache clinics across the UK, and waiting lists can be many months long. By the time patients arrive at a specialist centre, most have medication overuse headache as well as their original headache, and need high-level medical management. Yet all the evidence shows that, with adequate practitioner training, most headaches can be screened and managed at primary care level.
Guidelines developed by the charity Migraine in Primary Care Advisors (MIPCA) say that physical therapies should be offered as part of a multi-disciplinary migraine management plan. This is encouraging, although working in a multi-disciplinary environment presents challenges – and effective headache management requires many skills, such as knowing which questions quickly lead to a diagnosis, and how to spot when a patient needs a medication review. Reassuringly, many resources are available to guide us, if practitioners can be made aware of them.
While I was a relative newcomer to this field, several osteopaths with much more experience of it were also convinced that there should be more focus on headache management in osteopathic education. And so a few colleagues met for the first time in January 2016, drawn together by the sense that something had to be done.
Across the world, understanding of headaches is improving, as are treatments – from triptan drugs to stress management. But most sufferers, when asked, reach for their necks and yearn to have someone take hold and release the built-up tension.
Looking at evidence for manual therapies’ efficacy in migraine prevention, and at our eclectic range of techniques for releasing especially the neck and shoulders through holistic treatment approaches, we were excited to feel that osteopaths might hold some kind of key to a lock. We all knew of osteopaths who successfully helped patients with headaches, ourselves included, yet the research on this aspect of osteopathy was sparse. What if this could be changed?
If osteopaths can capitalise on their ability to treat the structural aspects of headaches by also understanding the other contributory factors, we believe the profession will have a real feather in its cap. If they combine this knowledge with a multi-disciplinary approach that encompasses patients and practitioners working together to calm headache conditions, many people’s lives can be transformed. And if supporting evidence can be gathered, osteopathy can become a more central part of headache management within our medical communities.
Our first step in setting up OPHM was painstaking but largely enjoyable: to form a nucleus of osteopaths who were willing to steer a new shared interest group. This basically meant contacting osteopaths whose websites said they treated headaches, with a view to involving them as founder members or perhaps as teachers with particular specialisms. We are still looking, so please email email@example.com if you feel you have a contribution to make!
We also made use of the Osteopathic Development Group’s guide for regional societies (see bit.ly/odg-regional-guide) – this is a valuable resource for anyone looking to establish a new community of practice, whether based on geography or a shared clinical interest.
Additionally, the GOsC and the Institute of Osteopathy (iO) can help to advertise your group’s events and developments. The iO’s other services for groups include a free website, details of potential speakers for events and a forum for discussing ideas and issues with fellow group leaders – you can find out more at: www.osteopathy.org/regional-societies
OPHM exists to promote progress in:
- educating and inspiring osteopaths to treat people with headaches
- creating a lively online education hub using links to MIPCA and Migraine World Summit
- making other healthcare professionals and the public aware that headache conditions can be expertly managed by headache-educated osteopaths
- researching the musculoskeletal side of headaches.
To date we have held three meetings, but our first big event will be on Saturday 26 November at the iO Convention in Windsor. In a four-hour teaching stream, we will introduce you to an array of approaches to headaches: medical and osteopathic management, psychological and nutritional. But this is only the beginning…
We now have a core of expert headache clinicians to support your learning, with a telephone support line and a discussion forum on our website at: www.ophm.org – which, besides a blog and events calendar, will also contain a guide to common headache types, their screening, diagnosis and management, and common pitfalls of headache management. And soon we will be launching postgraduate headache seminars with respected organisations both within and outside our osteopathic schools.
Please visit the website to see what we currently offer and find out about our future plans – and if you’re at the iO Convention, I hope to see you there!