In fact, migraine headaches have been ranked by the World Health Organization as the 19^th disease world-wide causing disability.¹ Anyone experiencing migraines on a regular occasion would attest to their disabling nature.² Most often, the typical migraine sufferer can be found in a dark, quiet room, all alone waiting for the pain to subside.

What is a migraine, and what causes it?

Migraines differ from most other bouts of head pain because they occur in different phases or stages. And, the painful stage of the migraine is almost always associated with other bodily symptoms.

Although the specific cause of migraines remains elusive, vascular changes in the brain have often been blamed for the pain. A sequence of blood vessel contractions and dilations has been observed in the brains of certain subjects when experiencing the onset of a migraine. Given that vasospasm and dilation can be influenced by neurological or hormonal factors, experts are looking in these areas for potential solutions to cure this disorder.

Common triggers for migraines may include any of the following:

• Stress: migraines sometimes occur after the resolution of a conflict or stressful situation

• Lack of sleep

• Changes in weather

• Rapid change in hormone levels (example: during menstrual cycles)

• Environmental chemicals

• Liver problems

• Dental pain

• Certain foods, including: cured meats, red wine, onion, freshly baked yeast products, eggs, alcohol, nuts, and aged cheese

• Medical conditions: depression, severe hypertension, etc.

• Medications: estrogen has been linked to increasing the symptoms of a migraine in many women who take it.

There are four characteristic phases involved with migraines: prodrome or premonitory phase, aura, headache, and postdrome or resolution phase.2 (Teri Robert for About.com ) Although not all migraines will involve all four phases, most patients will experience a combination of these symptoms. In the IHS classification system, the two main types of migraine headaches differ mainly with the presence of, or absence of the aura – the most recognizable characteristic of the migraine.

The Four Phases of the Migraine

Prodrome & Aura

Most patients with migraines will experience a phase hours or days preceding the actual headache. During this phase, symptoms may include hyperactivity or fatigue, depression, food cravings, neck stiffness, nausea or other less common attributes. Many people also experience auras during this phase. An aura is a collection of neurological symptoms that usually involve the person’s visual experience (ie. flashing or wavy lights). Other symptoms of an aura may include things like: scotomas, strange smells, tingling sensations and cognitive difficulties. According to one medical expert, only approximately 20% of patients with migraines will experience an aura, and if they do, it is likely to occur shortly before or at the onset of the headache.

Although it is typically an uncomfortable experience, the prodromal phase gives the person a warning signal that, if heeded, may allow them to avoid the more painful stages of the migraine.

Headache

The main characteristics of the headache pain include: a pulsating quality, moderate or severe intensity lasting 4-72 hours, unilateral location on the head, and pain that is aggravated by bright light or loud noises. During the headache phase, other symptoms usually accompany the head pain. Typical symptoms include:

• phonophobia - sensitivity to sound

• photophobia - sensitivity to light

• nausea and vomiting

• depression, severe anxiety

• hot flashes and chills

• dizziness

• confusion

• dehydration or fluid retention

Postdrome

Although the headache pain has subsided, most migraine sufferers will tell you that the migraine episode is definitely not over. The postdrome phase may take hours or days to complete. Typical symptoms associated with the postdrome may include:

• lowered mood levels, especially depression

• or feelings of well-being and euphoria

• fatigue

• poor concentration and comprehension

How do you treat a migraine?

For most people who experience recurring migraines, the best reaction is no reaction. Finding a dark, quiet place, and just focusing on relaxing is the best medicine. Migraines respond well to peace and quiet.

For others who do not have the luxury of waiting out the more painful stages of the migraine, there are a number of other options that may speed up the recovery. Pain medications that are migraine-specific may include families of drugs such as NSAIDs, Triptans or Ergot. If you experience migraines, consult with your medical physician to see if any of these medicines would be right for you.

Many studies show chiropractic as a very effective tool used to treat migraine headaches.^3-5 Sometimes chiropractic treatments result in very immediate and dramatic relief, but most cases will require ongoing care to manage the painful episodes.

References:

1. International Headache Society –

http://ihs-classification.org/en/02_klassifikation/02_teil1/01.00.00_migraine.html

1. Edmeads J, Findlay H, Tugwell P, Pryse-Phillips W, Nelson RF & Murray TJ. Impact of migraine and tension-type headache on life-style, consulting behaviour, and medication use: a Canadian population survey. Can J Neurol Sci. 1993; 20(2): 131-137.

2. Bronfort G, Assendelft WJ, Evans R, Haas M & Bouter L. Efficacy of spinal manipulation for chronic headache: a systematic review. J Manipulative Physiol Ther. 2001; 24(7): 457-466.

3. Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. J Manipulative Physiol Ther 2000;23(2):91-95.

1. Tuchin PJ. A case of chronic migraine remission after chiropractic care. J Chiropractic Medicine. 2008; 7(2): 66-70.

Christian Guenette BSc DC