“Information for your Headache”
What is a Migraine?
Headaches are a common health problem. A migraine is a severe headache that usually begins on one side of the head “Often behind the eye” and spreads to the whole head. Migraine’s are more than “just a headache”. It is a complex neurological condition, which can affect the whole body and can result in many symptoms, sometimes without a headache at all. For most people the main feature of a migraine is a painful headache. However, there are other associated symptoms that can prevent an individual from continuing with daily life, some of these symptoms include Pulsing or throbbing Pain “Mild too Severe, Sensitivity to light or sound, Nausea, Vomiting and more.”
What causes a Migraine?
In recent years the understanding of migraines within the medical world has greatly improved, involving many aspects of physiology including the central nervous system, neurotransmitters and other chemicals within the brain. The actual “cause” of a migraine is still unclear, some studies suggest that a migraine is caused by swelling of the blood vessels in the scalp and tissue around the brain, causing more blood to pump through the brain changing “inter cranial pressure” causing pain, however another current study has linked people with a DNA variant on chromosome 8 between two genes – PGCP & MTDH/AEG-1 and have been found to have a significantly greater risk of developing migraines. It appears that the DNA variant regulates the levels of glutamate – a chemical, known as a neurotransmitter, that transports messages between nerve cells in the brain; an accumulation of this chemical in the brain can cause migraines. Other researchers have found that Spontaneous over activity and abnormal amplification in pain and other, predominantly sensory, pathways in the brainstem, lead to migraines. Yet another research group has found that a feedback loop through innervation of cranial arteries in the trigeminovascular system may have a relative deficiency of 5-hydroxytriptamine. Research has lead to relevance of Calcium Channel abnormalities and peptides such as calcitonin gene related peptide abnormalities may be the true cause of migraines.
What does all this mean? “There is hope” and research continues.
Types of Migraines:
There are two main types of Migraines, Migraine’s “With” Aura and Migraine’s “Without” Aura.
Migraine “Without Aura”
Formerly called a “common migraine” or a migraine without aura or visual distortions can last between a few hours and up to a few days “commonly 4 to 72 hours“ even up to a year, accompanied by gastrointestinal symptoms or heightened special senses “sensitivity to light / sound / off putting tastes”. Pain can be mild to severe or generalized “not restricted to one side of the head”. The largest thing that separates a Migraine from a Tension Type Headache is that the victim is unable to keep focus and is distracted due to the pain making it difficult in maintaining exercise, hard work, or excessive movement.
- Pain on one side of the head
- Pain that radiates from neck “into one side of the head”
- Pain with a pulsating or throbbing quality
- Moderate to intense pain affecting daily activity
- Nausea or Vomiting
- Sensitivity to light or sound
- Increased pain with exertion or movement
- Pins and needles in the limbs
- Inability to concentrate
- Difficulty in speaking
- Loss of consciousness “very rare cases”
Migraine “With Aura”
Aura Migraines are classified as such due to the visual disturbance that sufferers experience prior to the onset of migraine symptoms “typically aura may begin 15 to 45 minutes before the full migraine effects take hold“. Aura migraines are characterized by a visual distortion with kaleidoscopic effects, typically starting out small like a blinking light then growing and looking like fortifications off the peripheral vision “looks like a fortified kaleidoscopic town from above”. These distortions are like jagged figures, lines arranged at right angles to one another beginning from a para-central area which gradually spread outwards leaving visual loss behind. There are often white, gray or colours similar to a kaleidoscope in a semicircle or “C” shape surrounding the area of visual loss. There may also be flickering lights, spots, or lines, or may be accompanied by speech disturbances. These symptoms are usually “fully reversible” and will leave once the full onset of pain or migraine symptoms begin.
“Aura Migraine Symptoms are the same as above”
Early Warning Signs
Noticing early warning signs and taking immediate action can potentially prevent or reduce the severity of the migraine. Migraines can often be proceeded by symptoms “called prodrome symptoms” that can serve as early warning signs. These symptoms typically occur 6-24 hours prior to headache and may include:
- Mood changes including depression, euphoria, increased irritability
- Increased thirst
- Fluid retention
- Food cravings or loss of appetite
- Sensitivity to light and sound
- Restlessness “excessive energy spike”
- Difficulty using or understanding words “I just cant remember the word”
- Talkativeness “hyperactivity”
- Neck stiffness
- Light headedness “Spaced out”
Many migraine sufferers know the “fear” associated with even the word “Migraine”, this has led many to seek out the root cause, or “Triggers” that may influence the frequency and severity of migraines. Triggers may not be the same for all sufferers, you would need to consult your physician or create a “migraine diary” which may help you track the triggers which make your own Migraines appear.
- Stress or the relief of stress including strong emotional response
- Hormonal changes – periods, hormone pills and menopause
- Lack of Food or infrequent meals
- Mild Allergic Response “histamine release” – Nuts / peanut butter, smoke, perfume or chemical odours, aspartame artificial sweetener, sardines, anchovies, pickled herring, MSG, freshly baked yeast products, chocolate, sour cream or yogurt, caffeine, alcohol – Red wine, beer, cheese, oranges, tomatoes: and more. This is attributed to the inflammation of cells within the sinuses and soft tissue within the head, stomach and intestinal tract changing cranial pressure. “A mild over the counter antihistamine has been shown to improve symptoms.”
- Light “glare, flickering lights, florescence, bright light”
- Eye Strain
- Weather Changes
Migraines vary between people and so does the treatment, there are many new treatments that can be used for a migraine, which ones work for you would depend on your own body and particular migraine. If a migraine is in the early stages, simple medications such as NSAIDs “non-steroidal anti-inflammatory drugs” like Aspirin, Tylenol, Advil, and anti-nausea medications may be enough to provide relief.
- Mild Migraine Symptoms- Many migraine sufferers know that if they feel the symptoms begin they have a regiment of techniques, food, positions and postures they can attempt to stop the symptoms from progressing into a full blown migraine. “Non proven methods” Many people have reported relief by using CBD “Canabidiol Oil derived from Cannabis, Acupuncture, Biofeedback Therapy or coping skill workshops, Peppermint Oil along the scalp line, eating almonds, Daith Piercing, yoga, sleep, green tea, cranberry juice and more”. Please consult your physician before attempting these to confirm that you are eligible or in physical condition to attempt them.
Simple measures may help you deal with a migraine at home: lie in a quiet, cool, dark room. Place a cold cloth on your forehead or neck. Do not drink coffee, tea, or orange juice. Avoid moving around too much, try to relax through meditation or listening to soft music. Do not read or watch television. Do not drive. Some people find relief by “sleeping off” an attack. Take painkillers as directed by your doctor.
- Moderate Migraine Symptoms– A moderate level migraine is normally managed with NSAID “non-steroidal anti-inflammatory drugs” like Aspirin, Tylenol, Advil, and anti-nausea medications. “Please consult your physician or pharmacists to confirm the dosage that is right for your age, size and NSAID type.” Combine Home care methods with NSAID use to achieve the best results.
- Severe Migraine Symptoms– If the pain is severe, stronger medications “usually intravenous into the vein through a drip” and hospital treatment may be necessary. Consult your physician and attend a medical facility, have a friend or family member bring you to a hospital to receive care. If your headache is severe, is not like the usual pattern, does not respond to the usual pain relief medication, or is associated with arm or leg weakness, speech difficulty, fever, drowsiness or confusion, you should seek URGENT medical care.
Post Migraine “Postdrome”
For most people the pain stops and they feel well again, or you may be left with a “hangover” like state that lasts several hours or days. This can leave you weak, tired or with mild headache. Commons symptoms of “Post Migraine” are nausea, blurred vision, feeling spaced out or hard to concentrate, headache that can worsen with movement. Many sufferers of “Post Migraine” symptoms have reported that “Home Care” techniques like Electrolytes, NSAIDs, Rest, Yoga, avoiding screen time from TV or phone and more help to alleviate the symptoms. “Refer to Home Care section”
Prevention of Migraines:
Non-pharmacological options include strategies we can employ for ourselves as well as treatments used by trained practitioners. Your physician may be able to provide referrals to local resources and other health care professions that have been shown to reduce migraine frequency, severity and symptoms.
Understanding how Lifestyle impacts the severity and frequency of migraine attacks can be a large part of successful migraine prevention. The key is to develop consistent patters for all days of the week. Lifestyle changes should be undertaken gradually and over time.
- Sleep: Maintain consistent sleep patterns, including on weekends and holidays. Learn how much sleep you need and try not to get too much or too little. Not getting enough sleep during the week and trying to et extra sleep on the weekend may trigger and attack.
- Exercise: a routine of 20-40 minutes of aerobic exercise 3 or more times per week can relieve stress and balance internal physiology.
- Eating: Eat regular meals, and do not skip meals. Eat a good, healthy breakfast.
- Reduce stress
- Improve posture: pay special attention to how you hold your neck and shoulders. For example, when working on a computer, adjust your seat and table so that you don’t have to bend your neck for long periods. This will apply as well while using cellular devices, you’ll want to adjust your posture to an upright position and raise your arm to look at your phone rather than tilting your neck downwards.
Examples of behavioural treatments include:
- Biofeedback therapy: A technique where people elarn to sense changes in the body’s activity and to use relaxation and other methods to control the body’s responses.
- Coping skills: Headache sufferers generally find cognitive restructuring “identifying negative self-talk and changing the disparaging remarks to positive ones”, assertiveness training, and goal identification helpful.
- The likelihood of behavioural techniques working as preventative treatment for migraines depends upon appropriate training and discipline for the person using the technique. This is more to reduce stress and help maintain a calm to help prevent an attack.
- Acupuncture/Acupressure: Using fine metal needles or mechanical pressure, the acupuncturist manipulates energy called chi by way of nerve point stimulation to help balance the flow of energy and nerve conduction. This will help return your body to a balanced state. Individuals can also practice Tai Chi or Qi Gong to balance Chi in a more traditional way.
- Manipulative procedures / chiropractors: A skilled practitioner manipulates joints or muscles in an effort to reduce abnormal peripheral input to the Central Nervous System and restore kinaesthetic balance. Examples include: chiropractic treatment, Physiotherapy and craniofacial therapy.
- Massage Therapy: A registered Massage Therapist massages and relaxes the body, releasing stress build-up in soft / deep muscles tissue to restore movement and flexation in a nominal impact method.
- Intramuscular Stimulation: IMS is a similar technique to acupuncture and uses fine needle to treat tight muscle bands that are implicated in many chronic and painful conditions such as neck and back pain as well as many other soft tissue injures. However IMS differs from acupuncture in its application because needle insertion is indicated by the physical signs, as apposed to the non-scientific meridians of Chinese Acupuncture. This invasive and Moderate too High intensity painful procedure is designed to temporarily disable nerve conduction in specific nerve sites that are attributed to causing the painful stimulus. Please consult a physician to see if this medical procedure is right for you.
- Botox Injections: Botox is a drug prepared from the bacterial toxin Botulin, used to treat certain muscular conditions and cosmetically to remove wrinkles by temporarily paralyzing muscles. For use against Migraines you would receive several shots of Botox around your head and neck once every 12 weeks to dull or prevent migraine headaches. This procedure “must” be administered by a registered physician, to see if this is right for your please consult your personal doctor.
- Vitamins, Minerals and Herbs: The Primary Care Network reports the following may help with migraines: “Please consult your Doctor before attempting any of these”
- Riboflavin: 400 Mg per day
- Feverfew: 1 capsule 3-4 times per day for one month. If effective, the dosage may slowly be decreased if desired. Avoid during pregnancy and when taking NSAIDs such as ibuprofen and Aleve “naproxen”
- Magnesium: 400-600 mg per day
- Vitamin B complex: 1 Tablet per day
“These are not medically proven techniques and should be consulted with your personal Doctor before attempting”
For more information please consult your local Health Care Professional facility and talk to your Physician about what’s right for you. Combining many treatments and approaches may help you achieve relief from your Migraine symptoms. A Migraine Disability Assessment Test may be performed to assess the severity of your migraine and what options best fit you. A Migraine Diary or “Headache Diary” should be used to help track potential triggers, this may be valuable information in finding ways to avoid a debilitating migraine.
We never know what can happen, its always good to be prepared and have the knowledge we need to help those who need it.
“This material is for information purposes only and is taken from The Canadian Red Cross / Alberta Heart & Stroke Foundation & Alberta Health Services. This information should not be used in place of medical, Technical advice, instructor, and/or treatment. If you have questions, speak to your local Physician or Safety Training Facility.”
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Info Taken From:
University of California “Berkeley”, National Headache Foundation Chicago IL, Practical Neurology April 2014 Baylor College of Medicine Houston TX, Education Fact Sheets Victoria Melbourne, J Neurol Neurosurg Psychiatry 2002, Migraine Action Center United Kingdom.