Migraine

WHAT WE TREAT

Many people incorrectly use the term "migraine" to refer to a severe headache, but a migraine is more than just a headache. It is a debilitating neurological condition with distinct symptoms that necessitate a different treatment approach. Migraines are often accompanied by nausea, vomiting, and heightened sensitivity to light and sound. These attacks can persist for hours or even days, with the pain being intense enough to disrupt daily activities.

Episodic migraine (EM) is defined as having 0 to 14 headache days per month, while chronic migraine (CM) is characterized by 15 or more headache days per month. Research indicates that individuals with CM experience a greater personal and societal burden compared to those with EM. Those with CM are significantly more disabled and have a notably poorer quality of life, both at home and in other aspects of their lives.

Work Cited

Z, Katsarava, et al. “Defining the Differences Between Episodic Migraine and Chronic
Migraine.” NCBI, 15 November 2011,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258393/. Accessed 14 August 2024.

What to expect in an individual with a migraine

Migraines, affecting both children and adults, generally unfold in four stages: prodrome, aura, attack, and post-drome, though not everyone experiences all stages.

Prodrome: This early phase can signal an impending migraine one or two days before the attack. Warning signs might include:

  • Constipation
  • Mood swings (from depression to euphoria)
  • Food cravings
  • Neck stiffness
  • Increased urination
  • Fluid retention
  • Frequent yawning

Aura: Some individuals experience an aura either before or during a migraine. Auras are reversible neurological symptoms, usually visual but sometimes involving other sensations.

Symptoms develop gradually over minutes and can last up to 60 minutes. Common aura symptoms are:

  • Visual disturbances (e.g., shapes, bright spots, or flashes of light)
  • Vision loss
  • Pins and needles sensations in limbs
  • Weakness or numbness in the face or one side of the body
  • Difficulty speaking

Attack: The migraine attack itself can last from 4 to 72 hours if untreated, with frequency varying from rare occurrences to several times a month. During an attack, you might experience:

  • Pain on one or both sides of the head
  • Throbbing or pulsating pain
  • Sensitivity to light, sound, and sometimes smell and touch
  • Nausea and vomiting

Post-drome: After the attack, you may feel drained, confused, or washed out for up to a day. Some people feel unusually elated, though sudden head movements might briefly trigger pain again.

Causes of Migraine

Migraines are understood differently in Western and Eastern medicine, though both recognize a variety of contributing factors.

In Western Medicine, migraines are primarily attributed to genetic predisposition and imbalances in brain chemistry. Abnormalities in neurotransmitters, such as serotonin and calcitonin gene-related peptide (CGRP), and changes in the brainstem’s interaction with the trigeminal nerve are key factors. Hormonal changes, especially fluctuations in estrogen around menstrual periods, pregnancy, and menopause, are also significant. Additionally, environmental factors like weather changes, certain foods, excessive caffeine, alcohol, and food additives, as well as lifestyle factors such as irregular sleep and physical strain, are known triggers.

Eastern Medicine views migraines primarily as a result of internal factors that lead to imbalances within the body that affect the health of fascia surrounding the nerves and blood vessels connected to the brain. For example, an Excessive Liver Yang and Liver Fire describes an overproduction of heat and inflammation from the liver and gallbladder channels that in turn can lead to heat inflammation & swelling into the temporal regions of the head. Deficiencies refer to a lack of adequate fluid, blood, or energy to nourish these connective tissues connecting into the areas of migraine which can be both constitutionally or environmentally induced. This in turns leads to Stagnation, a blocked blood or energy flow resulting in loss of flexibility and resilience of fascia, preventing them from performing its various roles in the body.

External factors, such as extreme weather or damp conditions, are seen as aggravating factors that disturb these pre-existing internal imbalances. They disrupt the body’s energy channels and affect the flow of vital energy (Qi) and blood, which can exacerbate the internal conditions already causing the migraine.

In summary, Eastern Medicine attributes the primary cause of migraines to internal imbalances, with external factors playing a role in intensifying these existing issues. Both perspectives acknowledge the complex interplay of genetics, environment, and lifestyle in the development of migraines, though they approach diagnosis and treatment from different angles.

Western Treatment for Migraine

Migraine treatments in Western medicine include:

  • Painkillers such as ibuprofen and paracetamol
  • Triptans
  • Anti-nausea medications

You may need to try various combinations of these treatments to find what works best. A GP might also suggest lifestyle changes such as eating regularly and reducing caffeine intake to help manage migraines. For severe cases, additional approaches like relaxation techniques or acupuncture may be recommended.

If these treatments are ineffective, a newer class of medication called gepants may be considered, which offers an alternative method for managing migraines.

Be cautious with painkiller use, as overuse can lead to medication-overuse headaches. This risk is particularly high with aspirin, acetaminophen (Tylenol), and caffeine combinations. Overuse headaches can occur if painkillers are used excessively—more than 14 days a month for aspirin or ibuprofen, or more than nine days a month for triptans. These headaches happen when medications start causing headaches instead of relieving them, leading to a cycle of increased medication use and worsening symptoms.

How do we treat Migraine at Complete Balance?

In Eastern Medicine, proper diagnosis through syndrome differentiation is crucial for developing an effective treatment plan. The type and location of headache pain, along with triggering factors, guide the treatment approach.

For headaches that start at the occipital area of the neck and radiate into the head, the issue is often related to structural misalignment, deficiencies, and stagnation. In such cases, acupuncture and herbs are used initially to reduce inflammation in the neck, followed by realignment and exercises for positional correction.

If the pain presents as a band-like pressure across the forehead and temples, it is typically linked to digestive issues and Dampness stagnation in the body. Dietary changes and treatments to reduce Dampness are recommended in this scenario.

Headaches around the temples (unilateral or bilateral) may stem from Qi and Blood deficiencies, stagnation, or Liver Yang rising. Treatment involves addressing lifestyle triggers such as stress and diet, along with herbal prescriptions and acupuncture to regulate and strengthen circulation. Additionally, manual or scalp massage using a Good Ball is often included to hydrate and release stuck scalp fascia and enhance treatment outcomes.

Acupuncture sessions for migraines usually require longer needle retention, and patients may need 1-3 months of regular treatments, depending on the duration of their migraine history.

Achieving a positive prognosis for migraines involves incorporating lifestyle changes, including behavioral adjustments, dietary modifications, and a shift in perspective on one’s condition.