Migraine is a neurological condition and not just a headache. It is a condition which effects the sensitivity of the part of the nervous system that deals with regulating pain, and results in heightened pain perception due to a lack of ability for the brain to ‘dampen’ pain signals. Migraineurs have a genetic predisposition for their brain to be easily excitable, and lack strong inhibitory control over key areas of their brain. Importantly, this tendency for head pain is just one feature of a broader migraine ‘disease’.
Symptoms and Course
Prodrome - vague symptoms hours to days before attack. Person feels ‘off’ and can often tell a migraine is coming. This stage can present as neck stiffness, mood changes, food cravings, frequent yawning, constipation, increased thirst and urination.
Aura – classic migraine symptom not found in all forms of migraine- focal neurological symptoms reversible within an hour before attack. Visual disturbances such as halos around lights, wavy lines, flashes of light, or distortions in the way sizes of objects appear can occur. Other symptoms can include vision loss, pins and needles sensation in an arm or leg, weakness or numbness in the face or one side of the body, difficulty speaking, hearing noises or music, and uncontrollable jerking or other movements.
Migraine Attack – headache on one side or both sides of head that is usually worsened by physical activity (some exceptions), lasts 4-72 hours and often accompanied by neurological symptoms such as nausea, sensitivity to light (photophobia) and vomiting.
Postdrome – ‘wash out’ phase for a day or so when patient feels exhausted or ‘foggy’
- Physical factors- musculoskeletal
- Dietary factors
- Weather change
- Hormonal change
- Alterations to sleep habit
Chiropractic and Migraines
Because migraine is an alteration in the ability to dampen pain, resulting in pain hyper sensitivity, then neutralizing pain sources in the musculoskeletal tissues can be an effective way to prevent pain over-sensitization and over stimulation that leads to a migraine. If a musculoskeletal trigger exists in the most common place for migraine, the neck and spine, then chiropractic can help prevent migraine by treating any pain, stiffness, or loss of motion in the neck,. This gives the brain a rest from constant bombardment by pain signals which heightens pain sensitivity. Removing a significant trigger in this way will lessen the frequency of the episodes.
Another technique that has been very helpful for our patients is called ear insufflation, and involves a gentle pumping of air into the ear. The insufflation creates a suction on the ear drum, which moves the ear drum in and out. Within minutes, a person in the midst of a migraine can be completely free of pain by creating this movement on the ear drum. The theory of why this works to decrease pain during a migraine is still being studied, but it is thought that by moving the ear drum in this way, a specific nerve that is linked to a key area of the brain involved in migraine called the trigeminal nucleus is stimulated. This stimulation over-rides the pain of the migraine, similar to how rubbing a body part, say after bumping your knee, will help it feel better and in the people who it works for, the effect is immediate and long lasting.
Yours in health,
Dr. Ryan Khalsa