Migraines and Headaches

Up to one quarter of the population has a migraine headache at some time in their life and about 10 percent have them regularly. They usually start in childhood or adolescence, are at their worst in the 30’s and 40’s and then decline. Very often they run in families. The classic migraine begins with a warming “aura” – flashing lights in one eye, blurring, blind sports, distortion of vision, and tingling of the arms or face. After about 30-60 minutes the headache begins, usually on one side but sometimes all over. It is a pounding, excruciating pain which usually lasts for four to six hours.

The more common “common migraine” may lack the warning symptoms, and the headache may be far longer lasting, although equally awful. The patient can feel irritable or depressed for hours or even days beforehand. But symptoms vary widely – periods of paralysis, dizziness, or even loss of consciousness are all reported.

Attacks may be triggered off by all sorts of thing. Common ones include: food – alcohol in general and red wine in particular, chocolate and caffeine; fasting: stress – strong emotional reactions and fatigue; changes in the weather or altitude; hormonal changes such as those caused by menstruation or taking birth control pills. Slightly more women than men suffer with migraines.

Although the cause is not known, the pain and other symptoms seem to be related to changes in the size of the blood vessels feeding the brain.

Other types of headache: the most fearsome sort are the cluster headaches which happen frequently – daily or several times a week – for weeks or months and then stop for months at a time. They are much more common in men, usually young men. They last for about an hour and the pain is almost exclusively on one side of the head, often around or behind the eye. It is so severe that sufferers often run around in despair and may even commit suicide.

The common “tension headaches” which nearly everyone gets sometimes are caused by involuntary tensing of the face and neck muscles over a long period, usually after concentrating hard or because of stress. The pain is a steady ache, which can last for hours or days, around the back of the head and neck, in the forehead, and around the eyes.

The Orthodox Approach

The main treatment for migraine or cluster headaches is with drugs such as ergotamine, which constrict the blood vessels. Taken in the warning stage, they can stop a headache within minutes. But patients who have regular attacks may be put on a course of these drugs, whose side-effects include sever blood vessel obstruction and angina. Narcotics may be given to relieve the pain. The latest development is to use calcium channel blockers such as Nifedipine.

Treatment fore tension headaches involves hot or cold compresses, relaxation or meditation, and simple pain relievers such as aspirin, acetaminophen or ibuprofen.

The Hale Approach

Any severe, protracted or recurrent headache should be reviewed by a physician with referral to a neurologist if the physician is not certain of the diagnosis. Once migraine has been fully diagnosed a variety of complementary options are safe, effective and aim at a cure, whereas orthodox treatment tends to alleviate the discomfort by a direct chemical effect on the blood vessels or pain receptors.

As we will see in this section there are many different approaches to migraine – which makes it more than usually difficult for a patient to know which treatment to choose.

The first thing to realize is that migraine symptoms may be similar for many people, but that the aggravating cause may differ from individual to individual. For example, some migraine headaches are the result of a fall or accident which affected the spinal structure, so osteopathy or chiropractic would be the most appropriate therapy. Alternatively, the migraine may be the result of a food allergy, in which case nutrition or naturopathy would be effective. In another case, the patient may have a blocked meridian in the body, so acupuncture would be the best treatment, or very bad posture, in which case we would recommend the Alexander Technique. Migraine is often exacerbated by hypoglycaemia, poor diet, bad posture, and/or hyperventilation.

For stress-related migraines there are treatments aimed at relaxing the patient, such as hypnosis, yoga, Chi Kung and aromatherapy. Patients can be given self-care programs based on these treatments to alleviate their stress.

At the clinic I would recommend a migraine patient to see our consultant in complementary medicine, for guidance on the right treatment. Where this is not practical, try to choose the treatment on the basis of the information given here – e.g. if you had a fall even 20 years ago, see an osteopath or chiropractor; if you notice the headache occurs after you have eaten a particular food, try nutrition therapy or naturopathy; if it is due to other factors, choose one of the relaxation techniques.

Herbal Medicine

Acupuncture

Migraine may be caused externally by the invasion of wind and damp, or internally by blood stasis. There are different sorts of migraines depending on the meridians involved. For instance, pain in the neck is related to the urinary bladder meridian, while pain in the forehead is related to the stomach meridian. Treatment involves avoiding cold and damp and stimulating the relevant meridians. Sometimes herbs are used as well. Many patients claim that this reduces the number of attacks they suffer and for many the migraines completely disappear. Six to eight sessions are usually sufficient to being about a marked improvement.

Chiropractic

Studies have found that restoring normal function to stiff joints by making precise adjustments of the spine can reduce the pain from the associated muscle spasm, but there is controversy as to whether it makes the number of attacks less frequently.

Bioenergetics

By testing the patient bio-energetically and prescribing homeopathic remedies, the causative factors of migraine can be treated successful. This unique approach design a treatment programme that pinpoints the probable toxic trigger, be it food additives, heavy metals, mercury poisoning, dental material, or toxicity. Additionally attention is given to the circulation, which is supported when necessary, as many congestive headaches are ultimately due to impaired circulation.

Osteopathy

In considering the treatment of migraine, most osteopaths will take into account not only the more obvious physical causes, but also physiological ones relating to diet and lifestyle. For instance, if the migraine seems to be triggered by food or drink, this will be the first line of treatment. You may be encouraged to cut down on your intake of, or completely eliminate, certain foods such as caffeine, shellfish, citrus fruits etc. You will also be advised to eat at regular intervals to reduce the risk of hypoglycaemia.

Bearing in mind the link between low levels of certain neuro-transmitters in migraine attacks, the osteopath will try to facilitate the best possible balance in the neural pathways by encouraging spinal relaxation through deep muscle massage, stretching techniques, and manipulation. You may be asked about your work and home environment, as easily overlooked factors such as excessive heat, light, or noise may be contributing to the problem. Sleep patterns will also be considered: migraine may be triggered by too much or too little sleep.

Cranial osteopathy – gentle manipulation of the bones and soft tissues of the skull – can relieve tension caused by traumatic events in the past (including birth trauma), head injury or general muscular tension affecting the head. It can also be used to achieve a balance of hormonal activity. An imbalance of hormones – such as that caused by the onset of puberty or by taking the contraceptive pill or hormone replacement therapy (HRT) – is another major cause of migraine.

Visceral osteopathy works on the abdomen to release underlying tension in structures surrounding organs, to improve local blood supply and gastro-intestinal function. This reduces some of the physical stresses which can lead to migraine.

Nutrition and Naturopathy

The link between food and migraine is well established and in some patients can be completely cleared simply by removing the foods which cause an allergic reaction from their diet. The most commonly troublesome ones are: alcohol, cows’ milk, wheat, chocolate, cheese, citrus fruit, and shellfish.

How they trigger attacks is not clear. It could be that substances in certain foods have a chemical effect and the levels of the enzyme that normally removes them is low. What is known is that food allergies can affect levels of serotonin – a “feel good” compound in the brain – and these are low in migraine sufferers. Fatty acids may also play a part, so reducing animal fats and increasing the amount of fish you eat is a good idea.

To identify the source of an allergic reaction you should go on an elimination diet and then, when you are symptom free, gradually reintroduce foods to see which produce the problem. You should also include in your diet foods which reduce the amount blood cells stick together – vegetable oils, fish oils, garlic and onion.

Certain vitamins and food supplements have been found to be helpful in cases of migraine. Bioflavonoids are compounds found in green plants which help in the treatment of many diseases. One, called quercetin, reduces inflammation and may help to combat the effects of food allergies.

Niacin has the effect of dilating the blood vessels and some studies have found it effective in reducing migraine symptoms. It is not recommended for the treatment of cluster headaches.

Magnesium is involved in blood irregularities found in migraine patients; low levels of magnesium are also linked with a collapse of one of the mitral valves in the heart – a condition found in some migraine patients. Magnesium occurs naturally in wholemeal bread and cereals, many green vegetables, nuts and seafood; it is also available in mineral supplements.

Ayurveda

In Ayurvedic lore headaches are more common on Sundays and get worse as the sun rises, which is why they are called Surya (meaning sun) Vata (meaning the force in the body that creates pain). They stem from too much acid in the blood due to eating acidic foods. Treatment involves changing the diet and the use of various detoxifying techniques (known as panchakarma) such as enemas, herbal inhalants and shiro dhara, dripping warm oil on to the forehead and massaging it into the scalp.

Marma Massage

There are points on the neck and legs that can be massaged to relieve migraines, but they vary slightly with each individual. Once you have learned where they are you can make use of them to treat yourself.

Supportive Treatments

Hypnotherapy

Severe headaches can be a way of avoiding things, according to one hypnotherapist. Whenever the person is threatened or asked to do something they don’t like, an attack is a good, if drastic, way of ducking responsibility. When it has worked successfully once, perhaps by accident, the chances that it will happen again increase. Hypnosis can help people to see the psychological pattern underlying their attacks.

Keeping a “diary” of migraine aeir life and about 10 percent haat these are triggered by tension and anxiety, perhaps because the sufferer is unable to deal with problems individually and sees them all as being linked and therefore one and the same. Hypnosis enables a sufferer to separate problems and deal with them one at a time. This avoids the build-up of tension and pressure which results in migraine.

Yoga

Some causes of headaches centre on negative feelings – anxiety, depression, unrelieved stress. Yoga can help to deal with the way the body tenses up in response to those feelings. Sluggish circulation can cause headaches, and yoga improves blood supply around the neck and shoulders, the route of circulation to the head. The emphasis on breathing can also bring a sense of control over the way you react to events in your life and in your body.

Chi Kung

Special exercises can direct energy to the affected area. There are over 1,500 exercises, and once you have mastered which are most suitable for you, this is an ideal therapy to practice at home.

Shiatsu

With cases of migraine and other types of recurrent headache, Shiatsu can offer both immediate relief and prevention. The effects of the massage can be further enhanced by specific diet and lifestyle advice.

Alexander Technique

This therapy io changes in the size of the bloale Clinic. In migraine cases the balance of the head, the neck and the back is all wrong and needs realigning, since bad posture creates increased tension.