What is a migraine?
Migraine headaches are horrible! They are so variable in their presentation and even though they are classed as a headache – they actually affect your entire body as any of you who suffer with them will understand.
Even when the headache has gone away, you can be left with a feeling of lethargy and malaise and vague nausea and ‘otherworldliness’ for ages afterwards.
To be best treated with medication, it is necessary to find out which type of migraine you have otherwise the wrong medication can cause other problems too. It is thought that 60% of women and 70% of men with migraine are not diagnosed correctly so it is little wonder that they give up on their medication.
According to the International Headache Society, there are seven types of migraine. They’re classified by how doctors diagnose and treat them, not when or how we feel them.
THE TWO MAJOR TYPES OF MIGRAINE ARE:
Migraine without aura – which was called common migraine in the past.
The most common migraine type.
Symptoms include moderate to severe pulsating headache pain that occurs without warning and is usually felt on one side of the head It comes along with nausea, confusion, blurred vision, mood changes, fatigue, and increased sensitivity to light, sound, or smells.
Attacks typically last 4-72 hours, and they repeat a few times a year to a few times a week. Movement generally makes the attack worse.
The problem is that if you have migraine without aura your headaches are likely to worsen the more you take medication.
Migraine with aura – also called classic migraine.
This type of migraine includes visual disturbances and other neurological symptoms that appear about 10 to 60 minutes before the actual headache and usually last no more than an hour.
You may temporarily lose part or all of your vision. The aura may occur without headache pain, which can strike at any time. Less frequent aura symptoms include an abnormal sensation, numbness, or muscle weakness on one side of the body; a tingling sensation in the hands or face; trouble speaking; and confusion. Nausea, loss of appetite, and increased sensitivity to light, sound, or noise may be felt a while before the headache
Other people have one type of migraine one time and a different type on other occasions.
Other types of migraine
There are also migraines without headache, which I have had for years. This migraine involves visual problems such as loss of part of your visual field or zig-zagging flashing lights that get larger and then disappear, leaving you feeling a bit washed out and lethargic. You can also experience nausea, vomiting and constipation but no headache.
Experts also reckon that unexplained fever, pain in part of the body and dizziness could also be types of migraine.
There is abdominal migraine and cyclical vomiting migraine – both often seen in children. Other migraine often seen in children is with girls starting the menstrual cycle, when they often experience partial or total loss of vision or double vision, dizziness, loss of balance, slurred speech and weakness followed by throbbing pain on both sides and at the back of the head.
Hemiplegic migraine is a rare type of migraine with aura and it causes temporary paralysis on one side of the body that can last for a few days before the headache starts. It is thought to run in families and the genetic changes involved make the brain more sensitive or excitable. If stress is the trigger, then less stress is needed in these people to trigger the attack, which takes the form of vertigo, stabbing sensations, difficulty speaking or seeing or swallowing before the headache. Once the headache starts those issues go away. This genetically driven migraine is called familial hemiplegic migraine.
Retinal migraine is very rare and is characterised by visual loss or disturbance in one eye only before the headache.
Chronic migraine is when headaches occur on 15 or more days per month for more than 3 months. They can be with or without aura and usually need and respond to medication. Prevention is key in these sufferers.
Can migraines be prevented or treated by chiropractic?
There not many large studies on the value of chiropractic treatment in managing migraines. However, one study examined the effect of chiropractic treatment on headaches and migraines combined the results of 22 studies, which had more than 2,600 patients total. The studies show that chiropractic treatment may serve as a good preventive treatment for migraines.
Another trial found that 22 % of people who had chiropractic treatment saw the number of attacks drop 90 %. In that same study, 49 % said they had a significant reduction in pain intensity.
Chronic migraine and chiropractic treatment
One study in Australia by Tuchin took 127 migraine sufferers in Australia found that of those that received chiropractic treatment, 22% had fewer attacks and needed to take less medication. This result is significant in that this was a group of chronic sufferers who had been suffering from migraines for an average of 18 years and in those people who improved, they reported more than 60% of their symptoms reduced during their treatment. Furthermore another 50% had noticeable improvement where the frequency of the attacks was less; the length of time they had the attack was less or they didn’t need to use as much medication as usual.
A control group was told they were receiving electrical therapy. “Both groups kept a record of their migraines for the whole six months, noting down how often they got them, how severe they were, how long they lasted, and if there was anything they could think of that contributed to them,” Tuchin explains. “For two months prior to any treatment they just diarised their migraines, followed by two months of treatment and then two months of post-treatment.”
Stress is often implicated in migraine attacks of any type, however this 1999 study found that more than 80 % of the patients thought that stress had triggered their migraine.
I agree! I get migraines when I am stressed or sitting at my lap top writing these posts for hours in one position with my neck at a bad angle. If I get stressed while I am doing so then it is even more likely to trigger a migraine!
Chiropractic treatment reduces the body’s reaction to stress; keeps the neck functioning optimally; reduces stress from muscle tension and so is very valuable in prevention and treatment of migraines.
How does chiropractic treatment help?
Migraine is reported to involve pain responses from the upper part of the neck and upper limb muscles, leading to a hyperactive state of the trigeminal pathway. The trigeminal nerve innervates the meninges – the thin skin covering the brain under the skull. It also innervates the pain-sensitive vascular structures in the base of skull, and scalp that are involved in the migraine attack.
The trigeminal pathway becomes hypersensitive due to the upper neck and upper limb muscles being overstressed and therefore the information going to the brain from the face and a lot of the head via the trigeminal nerve overloads the brain, which reacts by causing a migraine.
It was thought for many years that migraines were caused by blood vessel dilation but now migraine is not considered to be a vascular or neurovascular disorder but a central nervous system mediated disorder.
Other successful case studies on migraine have also demonstrated upper neck treatment to be beneficial in the reduction of migraine attacks, however, there is limited evidence supporting the fact that migraines respond to treatment of one specific area of the spine.
It is similar to exercises and how specific they need to be for the average person. I have said in previous posts that often, any exercise at all is better than none. Similarly if you are suffering from migraines, chiropractic treatment of any part of the mid and upper back can be beneficial. It seems to be more about relieving the stress on the brain – the central nervous system – than anything else. Stress takes many forms – external and internal and joints not functioning properly can create stress that affects the brain.
The pathogenesis of migraine is complex and still developing, however there seems to be adequate evidence to further investigate and hypothesize if the neurological pain pathway and its close links between mechanoreceptors and nociceptors might be why chiropractic treatment has shown to be effective in patients who experience migraine headaches.
Thus, we need to bear in mind that the research is still developing and is far from clear; but further research will continue to improve our understanding and meanwhile if you are suffering from migraines, based on the wealth of research on the subject, it must be worth trying treatment and seeing if after treatment you have either less migraines or less severe migraines than before.
If treatment helps your particular type of migraine then the prevention aspect of regular treatment may well be the most effective way to reduce the frequency or severity of your migraines. I know how much it helps me!