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15/09/10 Migraine help

Positive steps for Migraine sufferers.

The beginning of September brought us the ‘Migraine Awareness Week’. Surely not many of us can claim to have never experienced a headache, be it ‘the morning after’ type, the ‘way too much pressure’ type or the ‘too much sun’ type, and it is likely that many of us suffer, or are in contact with a colleague/friend/acquaintance who suffers from a disabling condition, ranked as being one of the 20 most disabling conditions by the World Health Organisation, the Migraine.

Not forgetting the intense stress and anxiet it can cause an individual, the economic burden of migraine is huge.  It is estimated to cost the NHS £150 million per year while the cost of absenteeism due to migraine costs £2.25 billion.  In a recent study by the CBI on workplace absenteeism migraine and chronic headache were ranked by employers as being the second highest cause of short term absenteeism.  Only colds and flu ranked higher.

So as an employer what can you do?

An understanding of this affliction can be useful, empathy can be helpful, providing a dimly lit room for sufferers and allowing employees half an hour to retreat, take their medication may be just what the doctor ordered.

Cruikshank-TheHeadAche

In this article:

  • What is a migraine?
  • Tell Tale Signs
  • Migraine Facts
  • Migraine causes & triggers
  • Migraine treatment – alternative solutions

What is a migraine?

Migraine is a neurological syndrome characterized by altered bodily perceptions, severe headaches, and nausea. The migraine headache is more common to women than to men.  Migraine’s can last from four hours up to three days. The headache can be all over or may only affect one side of the head. It can stay in one place or shift. The pain is often made worse by movement and people are likely to become sensitive to light or certain smells.
Once a migraine has gone, some people can feel washed-out and lethargic.

Tell-tale signs

Classic migraines have three distinct phases: a prodromal phase, a headache phase, and a resolution phase.   Many suffers can learn to identify the warning signs and control their reaction by taking their medication, herbal tea or self massage at this point.  During the prodromal phase, it is possible to experience an altered mood, irritability, depression or euphoria, fatigue, yawning, excessive sleepiness, craving for certain food types  (chocolate/coffee), stiff muscles, commonly in the neck and shoulders, hot ears, constipation or diarrhea, increased urination, and other visceral symptoms.  Emotional response may be feelings of anxiety, euphoria, irritability, rage and occasionally panic.

Visual Signs:  There are a variety of visual symptoms (Aura) that exhibit themselves variably during the prodromal phase of the classic migraine. The most common visual aura  - the scintillating scotoma usually begins as a shimmering arc of white or coloured light in the left or right visual field. The arc of light gradually enlarges, becomes more obvious, and may take the form of a definite zig-zag pattern.  These symptoms in themselves can be debilitating, combined with the knowledge of the struggle for up to 3 days with chronic headache pain, the Migraine can cause increased stress and anxiety to individuals lives both at home and at work.

Migraine facts

  • Almost six million people in the UK have migraine
  • Migraine is the most common neurological condition in the developed world. It is more prevalent than diabetes, epilepsy and asthma combined
  • Over half (54%) of migraineurs experience one or more attacks per month, and 13% claim one or more attacks per week
  • Women are three times as likely to have a migraine than men
  • The first attack usually happens when you are a child or teenager
  • Around 10% of school children suffer from migraine

What causes a migraine?

No one knows what causes migraines, there is no diagnostic test or cure.  Exactly what triggers a migraine is very individual to each person. For most people it is rarely just one trigger but a combination of factors which individually can be tolerated but when several occur together or accumulate a threshold is passed and an attack is triggered.

Some possible triggers you may notice in yourself could be:

  • Food
  • Missing meals can result in a drop of blood pressure which can lead to an attack
  • Specific foods can trigger a migraine in some people it can help to keep a food diary to help you identify the foods/or food groups
  • Changing sleep patterns
  • Too much or too little sleep can cause a migraine
  • Hormonal changes in  women
  • 50% of women notice a link between migraine and their period
  • Most women also suffer attacks at other times of the month
  • A migraine is most likely to occur 2 days before a period and three days into it
  • Keep a diary for at least three menstrual cycles to help you realize if you suffer menstrual migraine
  • The oral contraceptive pill can make migraines worse
  • Head and neck pain
  • Muscle tension can trigger an attack
  • Be careful not to hunch over a desk all day
  • Try simple neck exercises to alleviate tension
  • Travel
  • A long journey or flight can often trigger a migraine
  • Stress
  • Stress is one of the biggest causes of migraine

Treatment for Migraine

We recommend that all migraine sufferers visit their GP to obtain a formal diagnosis.  It is believed that up to 50 – 60% of sufferers don’t seek help as they feel that nothing can be done for them.  It may be likely that you will have to try different medications and dosages before finding the most effective medical treatment. Migraine is a complex health condition which means that patients may need to review their management strategy from time to time.

Complimentary treatments for migraine suffers. Many migraineurs find themselves turning to complementary treatments out of frustration when they are having limited success with prescription drugs and other approved medical treatments.   These treatments offer many of people additional relief, but are not an excuse to abandon approved medical care.  They will work better if integrated into your overall care programme, and you should always advise your GP of every non-drug treatment you are trying, no matter how irrelevant you feel it may be, I have an acquaintance who decided to seek Chinese herbal remedies for a condition whilst being under medication from his GP, he was uncomfortable telling his GP about this new avenue of exploration and as a result suffered liver damage and was at risk of failure.  So to avoid any uncomfortable situations, please be sure to seek approval from your doctor before commencing any alternative treatment, if your GP is not open to your idea’s, perhaps you could try taking in some research on the effectiveness of the treatment you choose, and if you continue to feel uncomfortable, remember, you can ask to see a different doctor.  This list is not exhaustive and is based on knowledge gained from my clients, together with some useful research statistics.

Acupuncture This has been endorsed by the British Medical Association as an effective treatment for headache and migraine.  Its treatment consists of small fine sterile needles being inserted into your skin at certain points; they may be left in for just a few seconds or for several minutes.

Traditional Chinese acupuncturists will position the needles at various points along the body’s energy meridians, according to their assessment of each individual (i.e. different migraineurs could have differently positioned needles).

Practitioners of western acupuncture will usually be health professionals (e.g. GPs, physiotherapists, doctors and specialist nurses working in pain clinics) who have received additional training in this method of treatment. They will position the needles in certain areas determined by the condition they are treating (i.e. all migraineurs are likely to have the needles placed in similar positions). If western acupuncture has not helped you, it may still be worth considering traditional acupuncture.

On site Massage If you are needle phobic or have access to an on-site masseuse at your work place, then you could give this treatment a try.  Acupressure works by treating the same pressure points used in acupuncture and has the added benefit of working the key muscle groups and encouraging a sense of calm during the treatment.  There is research to show that massage can help with migraine frequency and sleep quality during the intervention weeks, and this effect can last up to 3 weeks after treatment, with reduced anxiety, heart rate and cortisol levels.  The treatment is performed on a fully supported massage chair and pressure points and muscle groups are worked through the clothes.

Reflexology There has been some interesting research into reflexology recently, in terms of the efficacy of the treatment and the way in which the therapy works.  A functional MRI study, which took place at the University of Tohoku, investigated three reflex areas relating to the eye, shoulder and small intestine. A statistical analysis showed that reflexological stimulation of the foot reflex areas corresponding to the eye, shoulder, and small intestine activated not only the somatosensory areas corresponding to the foot, but also the somatosensory areas corresponding to the eye, shoulder, and small intestine or neighboring body parts.

According to a large nationwide research study undertaken in Denmark, reflexology treatment has a beneficial effect on patients suffering from migraine and tension headaches. The study was conducted at the Department of Social Pharmacy, The Royal Danish School of Pharmacy in co-operation with five reflexology associations. 220 patients participated with treatment being given by 78 fully trained reflexologists across the country.

Three months after a completed series of reflexology treatments, 81 percent of patients confirmed that reflexology had either cured (16%) or helped (65%) their symptoms. 19 percent of the patients re-ported that they had been able to completely dispense with the medications they had been taking before the study.

Chiropractic Chiropractic methods employ a holistic approach to pain relief through massage, spinal manipulation and periodic adjustment of joints and soft tissue.  I would recommend trying McTimoney Chiropractic as it is gentle and effective from my experience.  There are several studies that show promise:

One hundred and twenty-seven Migraine patients (at least one Migraine per month) were divided into two groups for comparison. Group 1 received chiropractic adjustments at specific vertebral subluxations determined by the treating practitioner; group 2 served as controls and received inactive treatment (electrical stimulation with no current delivered). Subjects receiving chiropractic adjustments reported substantial improvement in Migraine frequency, duration, disability, and medication use following two months of treatment. One in five participants reported a 90% reduction in Migraines, and half reported significant improvement in Migraine severity.

Feverfew Leaf Researchers at the London City Migraine Clinic made a study, which, reported in the British Medical Journal, investigated seventeen patients who had been using the herb to treat their symptoms for a minimum of three months. Of these patients, all of them were told to stop using the herb with eight of them being given a feverfew capsule and nine of them being given a placebo.

The patients who received a placebo reported an increase in the intensity and frequency of their migraine headaches while those who took the feverfew noticed no rise worsening of these symptoms.

A great deal of other studies have since taken place to prove that feverfew works in treating the symptoms of migraine headaches. People who took the herb also reported no significant side effects.

The herb also has other properties such as anti-inflammatory like ibuprofen or aspirin. One of the contents of the herb, parthenolide, is also an inhibitor for the forming of compounds, which cause inflammation. Parthenolide also reduces the secretory activity in blood platelets and the white blood cells.

If you would like to try this remedy, please consult your GP, it is also advisable to seek advice from a qualified medical herbalist.

If you have any personal experience with natural controls for migraine, please do get in touch.