How To Get Rid of Migraines Fast (and For Good!)
Got migraines? Here’s what works.
If you’re one of the 39 million Americans that suffers from migraines, the pandemic probably hasn’t been a ton of fun. Granted, it hasn’t been the greatest time for anyone, but there has been a dramatic uptick in in both new migraine patients and people with a history of headache disorders who say they are suffering more – an increase that is largely triggered by the covid pandemic and its impact on stress, daily routines and access to care.
Add to that the increased time most of us are spending behind a screen – lots of television, lots of Zoom meetings, lots of computer time. That can be a major trigger for migraines.
If this all sounds familiar, you’re not alone.
Pandemic migraines. Please no more.
— Chase Strangio (@chasestrangio) December 10, 2020
Encouragingly, migraines don’t have to be “just part of who you are” – there’s been a ton of research in the past ten years that helps us understand what works, both short-term and long-term, for getting rid of migraines. We’re going to separate treatment strategies into those that address the symptoms (ie what works fast) and those that address the cause (what’s going to help correct the problem long-term).
But first we need to understand what a migraine actually is.
What is a migraine, anyway?
Migraines are debilitating headaches lasting anywhere from 4 to 72 hours and are characterized by severe throbbing pain. They’re often accompanied by nausea and vomiting, as well as heightened sensitivity to light and sound.
For centuries, experts believed migraines were simply caused by vasodilation (expansion) of the cerebral and meningeal arteries, putting pressure on structures inside and on the surface of your brain. And that’s not wrong – migraines are a vascular disorder. That throbbing, pulsating pain you get with a migraine headache? It’s due to enlarged blood vessels expanding and contracting with your pulse. Moreover, many of the most successful migraine drugs are vasoconstrictors – they cause your blood vessels to contract in size.
But vasodilation isn’t the whole story.
We now know that the vascular changes that happen during migraines (and their painful symptoms) are the end result of a much more complex cycle involving both nerves and arteries in the brain and spinal cord. Here’s how experts currently understand the migraine headache pathway.
1. A trigger starts an inflammation reaction
First, a trigger causes mast cells – a type of white blood cell – to release inflammatory molecules within your brainstem and the dural membrane surrounding it. This trigger can be any one of a number of chemical or mechanical stressors, such as a reaction to medications or certain foods, or changes in your hormones.
It can also be caused by instability and hypermobility in your upper cervical spine putting mechanical stress on surrounding soft tissues. Headache researchers are beginning to understand that problems in the neck are a much bigger contributor to migraines than previously thought. In fact, in a 2017 study published in The Journal of Headache and Pain, researchers found that only 1 in 9 migraines don’t have an upper neck component.
2. Inflammatory molecules directly cause blood vessel vasodilation
The molecules released by mast cells directly leads to dilation/expansion of surrounding blood vessels, increasing the amount of swelling and mechanical stress in the area.
3. The trigeminal nerves are activated
The combination of physical swelling and inflammatory molecules being released causes firing of the trigeminal nerves – a major pain pathway that starts in the brain stem and travels along your face, teeth, eyes, sinuses and forehead, as well as to blood vessels both inside and on the surface of the brain.
This is the beginning of the second stage of a migraine, where the central nervous system gets involved. If you can take action before the second stage of the migraine occurs, you are more likely to be able to prevent a full-blown migraine.
4. Release of neurochemicals causes cranial blood vessel dilation
At the other end of the activated trigeminal nerves, surrounding the blood vessels in and around the brain, chemicals called neuropeptides are released, causing vasodilation and plasma leakage from cranial blood vessels. This creates a nasty positive feedback loop, as mast cells again are triggered to release inflammatory molecules, additional neurons are activated, and blood vessels dilate even more as the cycle repeats.
5. Cortical spreading depression (CSD) occurs
As this wave of inflammation causes neurons to be excited (and then subsequently inhibited), a phenomenon called “cortical spreading depression” occurs across the surface of the brain. This spread moves like a slowly advancing thunderstorm, traveling from the back to the front of your brain.
This cortical depression is the cause of the visual auras that some people with migraine experience. These auras result in people seeing dark or colored spots, sparkles, or other visual disturbances.
If untreated, migraines can last up to 72 hours before the nervous system response finally quiets and your brain returns to its normal state.
Treating Migraine Symptoms
So the question for treating migraines becomes, where do we attack the cycle? Do we treat the effects – which gets relief fast – or the cause – which gets long-term results?
Mainstream medicine has generally targeted the later part of the pathway (the effects) by using triptans, which act on serotonin receptors to cause blood vessel constriction, in combination with pain relievers like aspirin, ibuprofen and acetaminophen.
New injectable medications called called calcitonin gene-related peptide (CGRP) antagonists have also been shown to reduce the frequency and severity of migraines by counteracting the neuropeptides released by the trigeminal nerves.
Unfortunately, despite the advances in migraine-specific drugs, studies have shown that only 50% of patients with migraine headaches ever attain more than 50% reduction of headache frequency with them. Even worse, recent research suggests that medication causes extra “rebound” headaches in 1 out of every 4 migraine sufferers.
Ginger, like triptans, causes vasoconstriction by increasing serotonin levels. A 2019 study found that taking ginger powder capsules, in addition to regular over-the-counter pain meds, eased migraine pain almost as well as prescription migraine meds. Guidelines suggest taking 500mg at the first sign of a migraine, and then every 4 hours as needed.
Caffeine is also a vasoconstrictor, and it’s been shown to reduce migraine symptoms. If you suffer from episodic migraines — that’s up to 14 headaches per month — caffeine can help, but only if you limit it to no more than 200mg a day. Anything above that actually increases your risk of developing more headaches or migraines.
Magnesium has been shown to help prevent cortical spreading depression – in particular the aura associated with the phenomonenon. The Canadian Headache Society suggests that migraine sufferers supplement with 600mg of elemental magnesium (magnesium citrate) daily.
Attacking the cause
A better approach? Correcting the root cause of the inflammation and preventing the migraine cycle before it even starts. For many, this means keeping a record of your what you eat and drink, what medications you take, and where you are in your monthly cycle (for women), and then correlating it to when migraines occur.
Though there’s no standardized anti-migraine diet, the usual suspects for triggering migraines include aged cheese, processed meats, additives such as monosodium glutamate and aspartame, and chocolate. “Dark” alcohol – especially red wine – is known to be triggering.
If you’ve ruled out diet, drugs and hormones as triggers, then it’s time to look at your cervical spine.
For many of those with new or worsened migraine conditions, the ergonomics of sitting in front of laptops for much of the day, combined with difficulty in maintaining good exercise habits, may be leading to weakening of the muscles that surround the neck and head – and therefore instability and inflammation in the cervical spine.
Because 90% of migraines have an upper cervical component, in a 2016 systematic review of available research published by European Spine Journal, they concluded that migraine treatments should include manual therapy (chiropractic) to help get the neck back into its natural position and cervical strengthening exercises (to help stabilize it).
A 2012 randomized, clinically controlled study showed that low-force specific chiropractic treatment – like what we do at Ascent Chiropractic – can reduce the average severity of symptoms in migraine sufferers by 68%. Within an hour after receiving an adjustment the average patient reported a reduction in pain scores from a 5 to 0.5.
The Ascent Chiropractic Difference
Not every chiropractor is the same. At Ascent Chiropractic in Brookfield, we specialize in gentle, hands-on, low-force chiropractic adjusting techniques, along with rehabilitative strengthening exercises to help stabilize the spine. If you’re suffering from migraine headaches, make an appointment at Ascent Chiropractic by calling 262-345-4166 or schedule an appointment with our online scheduling app.
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