Migraines

Migraines

Migraines are a very painful type of recurring headache that may start on one side of the head and spread to incorporate both sides. Common symptoms associated with migraine headaches which distinguish them from other types of headaches include: visual aura (sparkling lights, spots or lines in the visual field) preceding the headache, pounding or throbbing pain around the forehead, and lingering neck and shoulder tension and pain. Migraine sufferers may also experience symptoms in other areas of the body, such as nausea and vomiting, dizziness, irritability, changes in appetite, fatigue, numbness, tingling, or weakness, and sensitivity to lights, sounds, and/or odors. Migraines can last anywhere from a few hours to several days.

While there is no clear consensus as to what causes migraines, the collection of migraine headache symptoms suggests multiple nervous and vascular system structures and functions may be altered in migraine sufferers. Genetics may play a role in migraine development as well. Regardless of the exact physiological cause, migraine triggers may include foods, alcohol, changes in sleep patterns, excess stress, environmental or food allergies, changes in temperature or atmospheric pressure, hormone level, exercise, bright lights and loud noises.

Types of Migraine

There are two major types of migraines: migraine with aura (classic migraines), and migraine without aura (common migraine). Classic migraines, in which head pain is preceded by sensorial “auras” (sparkling spots in the visual field, strange odors, ringing in the ears) occur for approximately 15% of migraine sufferers. These types of migraines have been associated with an increased risk for cardiovascular disease and stroke, especially in women. Common migraines, or those that exhibit intense head pain and other migraine symptoms, but without aura, occur approximately 85% of the time. Both types of migraines are thought to be caused by, and triggered through, similar mechanisms. A small number of migraneurs suffer from familial hemiplegic migraine, a rare type of migraine linked to a genetic mutation, and exhibiting additional symptoms such as seizure, fever, and prolonged weakness.

If You Have Been Diagnosed with Migraine

Once diagnosed with migraine headaches there are a variety or treatment options available depending upon the type and severity of your condition. You may be advised to identify and avoid potential triggers, as well as recommended medicine and other therapeutic treatment modalities. Medical treatments, both pharmacological and behavioral, are aimed at preventing migraine development and/or treating acute symptoms. Certain medications can be utilized to prevent the onset of migraines, as can therapies such as Botox injections. Other medications can be used during an acute attack. Migraine pain that cannot be controlled at home may require a visit to the emergency, or in rare cases, hospitalization. It is important to note that if you feel you are experiencing the “worst headache of your life” and are experiencing confusion, numbness, loss of coordination and/or trouble speaking and understanding, you should call 911 immediately as these may be an indication of stroke.

A Whole Health Perspective

Looking at migraine through a Whole Health model, we explore the individual’s unique presentation from the Five Aspects of Whole Health™ perspective.

1. Physically – Migraine headaches may be initiated by changes in the vasculature, nerve cells, and/or chemicals within the brain. All of these factors may be influenced by the migraine triggers listed above. The adrenal glands, which sit atop the kidneys and are responsible for the “fight or flight” stress reaction, produce hormones which will cause irritation/tension within the vascular system and nervous system. Thus, in pathologies such as migraine which can be triggered by changes in the vascular and nervous systems, modifying the adrenal gland activation of the stress response may decrease migraine attacks. Additionally, migraine may result after head or neck injury, and particular therapies may be beneficial in these cases. Aside from medication, migraine symptoms may also be alleviated or prevented by Complementary Alternative Medicine techniques, such as physical therapy, osteopathic manipulation (especially if there is a history of previous trauma to the neck, head, or spine), acupuncture, and biofeedback. Particular herbs have been found to be helpful as well, but should be guided by an experienced practitioner. Lifestyle modification and stress management also may impact migraine development and perpetuation. Since stress is a major trigger for migraine development, utilizing techniques to relax the body and calm down the nervous system can be beneficial. Other factors which may influence migraine include changes in sleep patterns and hormonal imbalance, thus, during times when sleep and/or hormonal levels may be disturbed it is especially important to decrease exposure to migraine triggers. For women, menstruation can increase migraine frequency and intensity, and particular therapies to address menstrual migraines may be helpful. Pregnancy and use or oral contraceptives, as well as menopause, may influence migraine frequency and intensity. Smoking greatly influences migraine pathogenesis as well. Overuse of common medications such as Tylenol or ibuprofen can compound migraine pain, thus use of these over the counter medications should be guided by an experienced practitioner.

2. Emotionally – Biochemical changes within the brain (such as neurotransmitters like serotonin or dopamine) may be triggered by anxiety, depression, unresolved stress and/or emotions of fear and anger. These changes may then trigger migraines. Chronic stress and difficult emotions also increase muscle tension, which can exacerbate or trigger migraine. Stress reduction techniques such as breathing exercises, cognitive behavioral therapy, biofeedback, or meditation may decrease migraine symptoms by decreasing stress and through regulating the nervous system. Living with the chronic pain and dysfunction that accompanies migraine can also increase stress. Finding supportive relationships and opportunities to connect with other people with this disorder may help alleviate stress.

3. Nutritionally – Certain nutritional deficiencies may be implicated in migraine development, testing and supplementation should be guided by a practitioner. Common food related triggers include those foods that contain the amino acids tyramine and phenylalanine, histamine, alcohol, and/or artificial additives and preservatives, and alcohol. Food allergens such as gluten, corn, eggs, dairy and/or soy may also compound migraine symptoms. Dehydration and skipping meals are also implicated in some migraine attacks. Caffeine can sometimes be helpful in reducing pain associated with migraine, but should be used cautiously as it can also contribute to dehydration and withdrawal headaches. The accumulation of stress associated with chronic migraine/pain requires additional nutrients to assist the body in responding and healing. These nutrients include: cholesterol, protein, vitamins A, C, E, and B complex, essential fatty acids, and essential minerals.

4. Environmentally – Environmental triggers may include bright or flashing lights, loud noises, odors, overall air quality, and temperature and humidity changes. Altering the home, work, and/or school environment to diminish these triggers may result in decreased migraine symptoms. Calm, supportive relationships and environments may calm the nervous system and decrease stress related migraine triggers, thus decreasing frequency and severity of headache symptoms. Since tobacco smoke is a common trigger for migraine, smoking cessation and limiting exposure to second hand smoke will be important.

5. Beliefs, Values and Worldview – also identified as Spirituality – Feeling isolated, or possible feelings of lack of purpose or harmony with the natural world can potentiate symptoms. Identifying and cultivating feelings of belonging and value within the community may help decrease migraine attack frequency and severity. Spiritual or contemplative practices have the potential to decrease headache symptoms.

For assistance determining when and where to find a specialist the treatment of migraine headaches, contact The American Headache Society, or consult with your local primary care physician.