Migraines, Headaches, and Nonpharmacologic Treatment Options

June is Migraine and Headache Awareness Month, providing an opportunity to increase awareness around the invisible disease that plagues so much of our population. This month we explore this topic and delve into the symptoms, causes, and treatment methods for individuals who suffer from these disorders.

Headaches are defined as pain or “aching” in any region of the head. The pain may be dull or sharp, localized to one spot or traveling from place to place on the head, and may be subtle in pressure or feel extremely vice-like. While many of us may be familiar with the irritating presence of a headache, migraines are less common but still quite prevalent. There are more than 3 million cases of migraines each year in the United States alone. Migraines are a recurring type of headache that can cause moderate to severe pain that is typically experienced as “pulsing” or “throbbing.” They may be accompanied by extreme sensitivity to light and sounds, and may render the victim of the migraine unable to function normally in their day-to-day routine.

While a dull headache may be something that is able to be ignored and “worked around” in order to continue doing one’s job, studying in school, or enjoying dinner with the family, some types of headaches, as well as most types of migraines, can be utterly debilitating, leaving the individual feeling weak or dizzy, perhaps curled in a ball on the couch or in bed, and feeling helpless. With symptoms this severe, it is easy to understand the tendency to completely detach from the world, avoiding light, noise, and excessive external stimulation.

So what is causing these terrible symptoms of pain, and what can we do to decrease them, or better yet, avoid them entirely?

There are several factors that may cause headaches or migraines. Here is a brief list of some of the more common causes:

• Weather changes – extreme changes in barometric pressure, such as going from a bright and sunny day to suddenly having heavy cloud cover with strong rains or hail approaching, does a number on our bodies.
• Changes in light – exposure to bright or fluorescent lighting
• Stress – high stress situations raise our blood pressure, which can lead to excessive pressure in the brain, which can cause pain.
• Hormonal changes, such as those accompanying menstruation (common), pregnancy, and ovulation
• Oral contraceptives – just as hormone changes can cause headaches, so too can ingesting oral contraceptives, which contain hormones and must travel through the entire digestive systems of the bodies, which can have adverse effects.
• Pharmaceuticals – some forms of medications, such as vasodilators, may cause changes in our blood pressure that can result in aching in the head.
• Strong odors (eg, perfumes, colognes, petroleum distillates)
• Smoking – smoking, as well as the inhalation of second-hand smoke, can cause headaches and migraines, as nicotine is a vastactive substance, which means it can change the size of blood vessels, which can trigger headaches just like changes in blood pressure.
• Head trauma – perhaps obviously, trauma to our brains or skulls can have lingering effects on our health, including causing chronic headaches or migraines.
• Too little, or too much sleep – new findings have shown that lack of sleep triggers ‘migraine proteins’ — key proteins that arouse the nervous system and can either trigger or suppress pain; likewise, too much sleep may throw off the body’s natural circadian rhythms, which create similar results.
• Motion sickness – migraine sufferers are likely to have heightened sensitivity to motion sickness, as motion sickness involves reflexes that relay in the brainstem, and may share the same neural circuitry as migraine triggers.
• Cold temperature exposure – cold stimulus, such as is experienced in a “brain freeze,” or ice cream-induced headache, is a classic example of a cold-caused headache.
• Lack of exercise – while there is little evidence to show that no exercise directly results in headaches or migraines, the reverse affect of exercise reducing headaches and migraines, especially in frequency, is ample
• Fasting or skipping meals
• Red wine

Now that we have a clearer perspective on some of the most common triggers for headaches and migraines, we can consider some ways to treat the symptoms if and when they do arise.

There are certainly precedents for using pharmaceuticals to treat severe and debilitating migraines. However, whenever that form of treatment can be avoided in lieu of a nonpharmacologic option, that choice tends to be better for the both the subtle nature of the body’s defenses, as well as for its overall long-term health.

Studies have shown that nonpharmacological options for managing headaches and migraines have generally produced comparable average reductions in migraines compared with pharmacologic prevention.

From Dr. J. Chawla’s 2019 article published on Medscape on the treatment of migraines without pharmaceuticals:

Trials of nonpharmacologic management have produced average reduction in migraines of 40%-50%, closely paralleling results obtained in trials of preventive drugs; however, the evidence base for nonpharmacologic and pharmacologic prevention remains limited. Biofeedback, cognitive-behavioral therapy, and relaxation therapy are frequently effective against migraine headaches and may be used adjunctively with pharmacologic treatments. Occipital nerve stimulators may be helpful in patients whose headaches are refractory to other forms of treatment. For more on nonpharmacologic treatment of migraine, read here.

Another study L. Nie et al. published 2019 showed that acupuncture, in combination with Chinese Medical Massage (or Tui Na), was effective at significantly reducing the attack frequency, severity of pain, duration of pain, and associated symptoms of migraine as compared to a control group. More info on that study here

Other studies, such as this one show that repeated acupuncture treatments may decrease the severity of headaches and migraines for months for chronic migraine sufferers.

Lots of opportunities exist for pharmaceutical-free treatment options. Talk to your healthcare provider, of feel free to give us a call to schedule a consultation if migraines are something that has plagued your life for far too long. It’s time to find some relief.