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MIGRANES AND HEADACHES

By: Dr. Sushma Shah - Naturopathic Doctor

Treating Migraines And Headaches

TREATING MIGRAINES AND HEADACHES

Approximately 45 million Americans suffer from chronic headaches, and of them, 28 million suffer from migraines. Did you know that people who suffer from chronic daily headaches appear to be nearly three times as likely to be habitual snorers as those who only get headaches once in a while and that 9 in 10 sinus headaches are actually really migraines. Headaches and migraines can be caused by a diverse range of factors including stress, food allergies, poor ergonomics and bad lighting.

DEFINITION

A headache involves pain in the head which can arise from many disorders or may be a disorder in and of itself. Headaches are classified and ultimately treated depending on the category they fall under. The various types of headaches are:

TENSION-TYPE also called "muscle contraction headache" and originates with neck and muscle pain. Muscle stiffness, most of ten caused by stress and certain physical ailments such as injuries to the neck and shoulders, fixated spinous processes, brings about these headaches. Many agents used to treat migraine (vascular headache) work well to control and eliminate tension headache pain. Tension headaches are generally a 2-sided, band-like, pressing pain and generally do not seem to get worse with activity (unlike migraines). The pain is usually mild to moderate in nature. 70-90% of the population suffers from the occasional tension-type headache.

CLUSTER / "suicide headache" or "ice-pick headache" due to the extremely excruciating stabbing pain felt in the eyeball area of the sufferer. These headaches come in a series or succession for months at a time. Most cluster sufferers experience a period of remission, where the headaches mysteriously disappear (months or years) and then to only re-appear. Occasionally, the chronic form develops referred to as "chronic cluster headache". Cluster headaches have been connected to REM sleep and are caused because of a lack of oxygen and dilated blood vessels. A teary eye and a blocked or discharged nostril are also common symptoms. Due to the mysteriousness and ferocity of these headaches, many sufferers suspect, or are advised, of a pinched nerve, or neck injury. Nasal surgery has been incorrectly performed in some cases of mistaken headache diagnosis.

REBOUND / MEDICATION-INDUCED: Many sufferers develop "rebound headaches" from taking too much pain medicine, too often. The daily or frequent use of over-the-counter (OTC) medicines can often lead to this condition. Medications with caffeine or ergotamine are particularly at fault.

The pain associated with rebound headaches is a pressing, dull, diffuse pain that is typically felt all over the head (much like tension-type). Rebound headaches are usually worse in the morning hour and often can be felt on the front or top of the head. Typically, a cycle of medication use, followed by partial headache relief, followed by another headache, can be suggestive to "rebound / medication-induced headaches".

SINUS: Many people falsely suspect they suffer from "sinus headaches" since they feel headache pain in the facial area. Similarly, a blocked nostril or stuffy feeling leads many sufferers to self-diagnose themselves with sinus headaches. Headaches caused from sinus infection are usually associated with a low grade fever and can be detected from an x-ray of the sinus cavity. Migraine pain typically causes pressure and headache in the facial area and can be confused for sinus pain.

HEAD INJURY: These headaches are typically felt as a steady ache affecting both sides of the head and occurring daily or almost everyday (similar to chronic tension-type headache). The pain is usually of slight to moderate intensity. Bouts of severe or moderately severe headache may also occur and these are often similar to, if not identical, with "migraine" (one-sided throbbing pain with nausea and sensitivity to light and noise). Dizziness, ringing of the ears, vague blurring of vision, depression, anxiety, and sleep disturbance are only a few of the associated complaints surrounding "head injuries". Headache immediately following a head injury usually clears after minutes or days, but occasionally "post traumatic headaches" develop from months of headache suffering.

RARE HEADACHES: Rare headaches can be secondary to some underlying disease or medical ailment. Usually, once the condition is stopped - the secondary headache goes away. Some examples of rare headaches may include:

  • Chronic Paroxysmal Hemicrania: cluster headache-like symptoms found almost always in females. It is normally short-lasting, multiple attacks that may last 2-10 minutes several times a day


  • "Ice-Cream Headache" / "cold stimulus" headache because it occurs between the eyes after eating or drinking something very cold. It does not last any longer than five minutes and may be prevented by eating ice cream slowly, small amounts, and by letting it melt in the mouth before swallowing


  • Sex or Exertional Headache (Coital Headache): Mostly a male problem - this benign headache is usually a sudden, severe, throbbing pain over the back of the head or over the entire head. This condition usually only lasts for a few minutes and can be associated with sexual exertion


  • Ice-Pick like Pains or "Jabs and Jolts": These stabbing brief episodes of pain can be felt at anytime, anywhere in the head area. The cause of these headaches remains to be a mystery


  • Migraine Equivalents (Migraine without the headache). These stroke-like symptoms can occur at any age. These headaches are more common in children than in adults and therefore are difficult to diagnose. People with the classical migraine (migraine with aura), they may find that the aura symptoms continue to recur, as they age, but often without the subsequent headache


  • Migraine Headaches : Migraines are pounding or throbbing headaches that start suddenly, last for hours and usually occur with other symptoms such as nausea. The headaches usually occur between ages 10 and 30, often vanishing after age 50 or, in women, after menopause. More women than men have migraines

SIGNS AND SYMPTOMS

  • Throbbing or pounding pain on one side of your head (or both)
  • Nausea and vomiting
  • Disturbances in your hearing or vision (such as flashes of light) that often start 10 to 30 minutes before the headache
  • Parts of your body may feel numb, weak, or tingly
  • Light, noise, and movement - especially bending over - make your head hurt worse; you want to lie down in a dark, quiet room
  • Your feet and hands feel cold and may look bluish

MIGRAINE TYPES:

  • Migraine with Aura is the "classic migraine"; it is accompanied or preceded by an aura (neurological symptoms). Approximately 10% of all migraine sufferers fall under the category "migraine with aura". Bizarre sensory disturbances, 10-30 minutes prior to the headache phase, suggest migraine with aura. The "aura" can be zigzag lines or spots/halos in the field of vision, tingling of the skin, dizziness, confusion, or blurred vision. The headache usually lasts 4-72 hours, but may be completely absent-suggestive of a condition known as "migraine equivalents" (which many think of as a stroke)

  • Migraine without Aura - "common migraine" occurs mostly in women, like the classic migraine (up to 75% rate). Largely due to the hormonal connection with oestrogen. Headaches associated directly with the menstrual period are referred to as menstrual migraine). Typically lasts 4-72 hours, is most-often one-sided, and is frequently associated with nausea and vomiting. The pain sensation is generally throbbing or pounding in nature, with a moderate to severe quality. Most migraine sufferers fall under this category. Studies at major headache clinics suggest 60% of migraine sufferers have never been properly diagnosed. Over-the-counter pain medicines (typically designed for tension-type headaches) used to treat migraines, can sometimes lead to rebound headaches or a new headache condition referred to as daily chronic headache

WHAT CAUSES IT?

No one knows for certain what causes migraine. It could be familial. Various triggers cause the blood vessels in the head to tighten and then expand, a process that irritates the nerves surrounding those blood vessels. These triggers include:

  • Abnormal blood levels of the neurotransmitter serotonin
  • Medicines for high blood pressure, angina, and arthritis
  • Sensitivity to certain foods and alcohol; missing meals; too much sun; sleeping too little or too much
  • Hormones and menstruation
  • Certain odours, such as perfume or cigarette smoke
  • Stress

DIAGNOSIS

Because headaches arise from many causes, a physical exam assesses general health and a neurologic exam evaluates the possibility of neurologic disease that is causing the headache. A detailed headache history includes: its frequency and duration, when it occurs, pain intensity and location, possible triggers, and any prior symptoms.

The following warning signs indicate the need for prompt medical attention:

  • Headache accompanied by one-sided weakness, numbness, visual loss, speech difficulty, or other signs
  • Headache that becomes worse over a period of six months, especially if most prominent in the morning or if accompanied by neurological symptoms
  • Sudden onset of headache accompanied by fever and stiff neck

Headache diagnosis may include computed tomography scan (CT scan) or magnetic resonance imaging (MRI).

Allopathic treatment: Tension-type and migraine headaches can be treated with aspirin, acetaminophen, ibuprofen, or naproxen. Extra-strength Excedrin is indicated for mild to moderate migraines. Antidepressants and muscle relaxants can treat tension-type headaches, and ergotamine tartrate or sumatriptan can relieve migraines and cluster headaches. Cluster headaches may also be treated by inhaling pure oxygen.

NATUROPATHIC TREATMENTS FOR MIGRAINES

Under the concepts of naturopathic medicine, assessment is oriented toward determining what is impeding your body's ability to function normally. While some of the conventional medical approaches may help in this determination, they may not necessarily apply to a functional approach.

TREATMENT OPTIONS

  1. Avoid known migraine triggers if possible

  2. Put an ice pack on your forehead when headache strikes

  3. Regular aerobic exercise can reduce the frequency and intensity of migraine episodes

  4. NUTRITION
    • Avoid food allergens. Some common allergens are alcohol (especially red wine), cheese, chocolate, citrus, cow's milk, wheat, eggs, coffee, tea, beef, pork, corn, tomato, rye, yeast, shellfish, food additives (preservatives and coloring), foods containing MSG and nitrates
    • Avoid caffeine because it is a vasodilator
    • Essential fatty acids may be helpful. Supplementing with fish oil or flaxseed oil may also be helpful.
    • Magnesium increases muscle relaxation. Injections of 1,000 mg of magnesium by a physician can terminate an acute migraine headache within minutes
    • Omega-3 oils (EPA and DHA, average dose 14 g daily) greatly reduce intensity and frequency of migraines
    • Vitamin B2 (riboflavin) has been shown to reduce migraine frequency by two-thirds
    • Vitamin C, vitamin E, vitamin B6, choline and mixed flavonoids seem to have some effect on reducing migraines as well

  5. HERBS
  6. Various combinations of herbs such as Feverfew, hawthorn, skullcap, ginger, gingko,goldenseal, valerian, passionflower, and cayenne have been used help to alleviate migraines.

  7. HOMEOPATHY
  8. One of the most common reasons people seek homeopathic care is to relieve the pain associated with chronic headaches. Interestingly however, only one out of four studies included in a recent review concluded that individually prescribed homeopathic remedies significantly reduces the frequency, severity, and duration of migraine symptoms. Professional homeopaths may also recommend various treatments based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account the individual's constitutional type i.e. his or her physical, emotional, and intellectual makeup in order to determine the most appropriate remedy for a particular individual.

  9. CHIROPRACTIC
  10. In one study including 127 people with migraine headaches, 22% of those who received chiropractic manipulation reported more than a 90% reduction of migraines, 49% reported a significant reduction of the intensity of each episode, and 59% reported a significant reduction in neck pain.

  11. MASSAGE
  12. Massage may help release chronic neck and shoulder tension and maintain an even blood flow to the head.

Please ask your doctor or naturopath before starting on any supplements. Its is better to first identify the cause and then treat it with the right remedies, even though those mentioned above have minimal side effects.

The information on this handout is the property of SUSHMA SHAH N.D., and is not intended to treat, diagnose or cure any disease. For any questions, or concerns, please contact me at 416 913 4325 (HEAL) or email me at info@naturesintentionsnaturopathy.com


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