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Carole’s Story: Physical Therapy for Chronic Migraines

Discover how Carole found relief from chronic migraines through physical therapy at UPMC. Learn about her journey and the treatments that transformed her life.

Migraines are not new for Carole H. — she’s dealt with them for decades. 

“I would wake up with a chronic headache for weeks and weeks,” says Carole, 46, of Mars, Pa.

Daily naps became the norm. But even then, Carole was still exhausted at the end of a workday in her home office. When her 12-year-old daughter returned from school, Carole was too tired to join her on a walk or play pickleball. 

“I wasn’t able to enjoy my life at all,” she says.

Carole tried many different therapies to treat her migraines. But massage therapy, deep tissue stimulation, chiropractic care, acupuncture, injections, and tablets offered no relief. 

Botox injections around her scalp and down her neck offered the only bright spot. They lessened the migraines’ severity, allowing other medications to start helping more. 

Then, a significant, positive change came when Carole’s neurologist, Laurie Knepper, MD, suggested physical therapy (PT) to help with her chronic migraines. 

Physical Therapy for Migraine Relief

At first, Carole was skeptical about physical therapy.

“Now, I am so grateful that Dr. Knepper recommended it to me. It’s changed everything," Carole says.

Carole started meeting with Amy Seeley, PT, a physical therapist at UPMC Rehabilitation Institute in Mars. During their sessions once or twice a week, Amy focused on instrument-assisted soft tissue mobilization, manual therapy, posture and core retraining, and functional strengthening.

“Amy has improved my quality of life so much,” says Carole, noting that it helped that Amy can empathize since she, too, is a longtime migraine sufferer. “She’s knowledgeable and always in tune with my needs. That makes her a true lifesaver.”

For instance, when exercises made her sore for the next session, Amy would course-correct. She tailored every appointment to Carole's needs that day — something Carole hadn’t experienced with other physical therapies. 

“I’m not waking up with headaches like I had been, and she’s significantly increased the range of motion in my neck,” she says.

A Tool to Aid in Massage

One therapy brought Carole the most relief — instrument-assisted soft tissue mobilization (IASTM), which Amy received specialized training in several years ago.

According to Amy, IASTM often helps with migraines as well as with cervicogenic headaches, which start in the neck and radiate to the head.

“People with migraines and cervicogenic headaches traditionally have tight upper trapezius muscles in the back and base of the neck,” Amy says. “Trigger point therapy and deep tissue massage can actually make it worse.”

After learning Carole's work requires her to be on a computer all day, Amy thought she might respond well to IASTM.

“People who work at desks are notorious for having tight neck muscles,” she says.

With IASTM, the physical therapist uses small stainless-steel tools and an emollient lotion applied to the skin to gently massage the soft tissue.

“The beveled metal tool is held at a 30-degree angle and moved along to work the muscle from its origin to its insertion, and vice versa,” says Amy.

In Carole's case, Amy uses the tool around Carole’s neck and shoulders. As she works the muscle and connective tissue, Carole combines movement, such as slowly turning her head.

The tool and massage combo have worked well for Carole. “The skin would look inflamed like a sunburn afterward, but it never hurt — it’s one of the most useful things she did for me,” Carole says.

A recent fall at one of her daughter's soccer games caused bruised ribs, and Carole has had to take time off from physical therapy. But with her faith in PT restored, she plans to return soon and add therapy for longtime chronic low back pain she hasn't faced head-on.

“I’ve never been able to get the low back pain under control, but I know if anyone can help me, it’s Amy,” Carole says.

In Tune with Her Needs

On top of her chronic pain, Carole was recently diagnosed with lupus after two years of being treated for rheumatoid arthritis.

“I’ve started to get all of the lupus symptoms, too, so I’ve got a lot going on,” she says.

But with a new medication from her rheumatologist and upcoming physical therapy appointments with Amy, Carole has never felt more confident in managing her pain — and feeling like herself again. 

“I’ve got a great combination of people looking out for me, and my experience with Amy and Dr. Knepper has been incredible,” she says. 


Carole’s treatment and results may not be representative of all similar cases.

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