Do you suffer from severe headaches, sometimes with nausea and visual impairment? Can these headaches last for up to a day or longer at a time? If so, you could be experiencing migraines. In this easy-to-follow book, Wendy Green explains how dietary, psychological, and environmental factors can cause migraines, and offers practical advice and a holistic approach to help you manage them. Find out 50 things you can do today to help you cope with migraines, including Identifying your migraine triggers and learning how to manage them, choosing beneficial foods and supplements, learning how to adapt your home and work environments, discovering how to treat children and teenagers with the condition, and finding helpful organizations and products.
About the Author
Wendy Green is a health project coordinator and health promoter.
Read an Excerpt
A Self-Help Guide to Feeling Better
By Wendy Green
Summersdale Publishers LtdCopyright © 2016 Wendy Green
All rights reserved.
A migraine is a complex, episodic (intermittent), neurological condition characterised by an intensely painful, throbbing, one-sided headache. However, migraine isn't just a headache – it is a collection of symptoms and the headache isn't always the predominant feature. Other symptoms can include nausea and vomiting; visual disturbance; pins and needles down one side of the body; increased sensitivity to sound, light and smells; a stiff and aching neck; drooping eyelids; lethargy and exhaustion.
Do migraines cause permanent damage?
Migraines can be debilitating and terrifying, but there is no evidence that they cause any permanent damage to the body. Common fears are loss of sight, or that they are indicating the onset of a stroke or the presence of a brain tumour. However, these are rarely linked to migraine and most sufferers return to their normal selves in between attacks. The two main types of migraine are: Migraine with aura – otherwise known as a 'classical migraine' and, incorrectly, as a focal migraine; the term 'focal' is also used to describe the neurological symptoms of a stroke, whereas 'aura' relates only to those specific to migraines.
Migraine without aura – also known as a 'common migraine'.
Other forms of migraine include:
Menstrual migraine – migraines that occur between two days before and three days after the start of the menstrual period.
Menstrually-related migraine – these migraines develop at the time of a period and other times during the menstrual cycle and are clearly linked to hormonal fluctuations. For more in-depth information, see Chapter 5 – Migraine and Hormones.
Basilar-type migraine – this form of the condition can involve speech problems, double vision, dizziness and even fainting. It is rare, with only around one in 400 migraineurs suffering from it. It is thought to be caused when the basilar artery – a blood vessel at the base of the brain – goes into spasm, leading to a reduced blood supply to the brain.
Hemiplegic migraine – is a very rare form of the condition, often genetic, where the migraineur experiences weakness down one side of the body that may last for several days. Other symptoms include double vision or blindness, impaired hearing and mobility and numbness around the mouth, causing problems with speaking or swallowing.
Retinal migraine – is also uncommon though some studies suggest that may be partly because it is not always correctly diagnosed. Retinal migraines (as with all migraines) affect more women than men and it seems to be more common in women who have had migraines with auras. In retinal migraines, visual problems develop before the headache part of the attack and there may be total but temporary blindness, often in one eye. There may also be temporary blind spots. It is thought the visual problems are due to the muscles around the eye contracting and disrupting blood flow. A retinal migraine may differ from a migraine with aura in that the visual disturbance tends to affect just one eye rather than both. Exercise, or any other form of physical exertion, may prompt a retinal migraine.
Ocular (opthalmoplegic) migraine – is another rare type of migraine. It usually occurs in children aged from six to twelve years, but can also occur in adults. The pain is often around the eye and may be accompanied by weakness in one of the eye muscles, as well as double vision, nausea and vomiting.
The stages of a migraine
There are five distinct stages that can happen during a classical migraine attack. These are the prodromal, aura, headache, resolution and recovery phases. There is no aura in a common migraine.
1. Prodromal (premonitory) symptoms
These can start up to 24 hours before an attack. Some people find they are bursting with energy and rush around doing far more than usual. Others may find themselves sinking into a low mood and feeling tired or craving food – especially sweet things. Irritability and general aches and pains, particularly in the neck, are also common features.
Aura is the term used to describe sensory changes experienced by about one in ten migraineurs prior to the onset of the headache itself. Common aura symptoms include:
Visual disturbance – this is the most common type of aura symptom and can include blind spots, silvery flashing lights, zigzag patterns or even tunnel vision. This symptom can be quite alarming – especially when you experience it for the first time.
Pins and needles or numbness down one side – this often follows visual disturbance and usually begins in the hand, travelling up the arm and, in some cases, reaching the face, lips and tongue. Sometimes the numbness travels down the leg. This symptom can also occur with hemiplegic migraine.
Speech disturbance (dysphasia) – the sufferer has difficulty in finding the right words; this is the third most common aura symptom.
Confusion and clumsiness – this may also be experienced by some sufferers.
All of these symptoms indicate that the brain isn't functioning normally. If any of these symptoms continue for longer than an hour, see your GP, as they may indicate something more serious.
The headache is usually only experienced on one side of the head, though some people experience pain on both sides. The pain is usually intense and extends across the forehead or temples. It can last between four and 72 hours, but this can be shortened considerably by taking painkillers or using alternative treatments – such as the application of one or two drops of peppermint or lavender oil to the site of the pain – as early on as possible. See Chapter 6 – Medical and Other Treatments and Chapter 7 – DIY Complementary Therapies.
The headache is also accompanied by at least one of these other symptoms:
Stomach upset – including nausea, vomiting and diarrhoea. Nausea accompanies the headache in around 95 per cent of migraineurs. There may also be a heightened sense of smell (osmophobia) that is possibly linked to the nausea – some people find they are aware of smells that they would not normally notice. About a quarter of sufferers vomit and around one in five have diarrhoea. Some find eating a little plain food – digestive biscuits or dry toast – helps, while others are unable to face food. Chewing raw ginger root or eating ginger biscuits may also ease the nausea, see Chapter 2 – The Food Factor for more information.
The nausea is linked to the digestive system slowing down during an attack. This also makes the absorption of food or medication more difficult.
Photophobia – increased sensitivity to light – is common in about 80 per cent of migraineurs. Many sufferers find themselves instinctively wanting to escape a light environment. Looking at a computer screen or watching TV may be uncomfortable.
Phonophobia – increased sensitivity to noise – seems to be part of the heightening of senses that many people experience and that causes sufferers to seek out a quiet and dark place to rest during a migraine. Go to bed, if you can, and draw the bedroom curtains.
Droopy or puffy eyelids – the eyelids can appear swollen and droopy or just feel heavy.
The way an attack comes to an end varies from one person to another. Some people feel better after taking painkillers, others only feel better after lying down in a darkened room or being sick.
5. The recovery phase (postdrome)
Once the headache has gone, it can take a few days to return to normal. During this time you will probably feel washed out and lethargic – some people describe it as a migraine hangover, though some sufferers report feeling more energetic immediately after an attack. Other postdrome symptoms include sore muscles, scalp tenderness, mood changes and general malaise. As you return to normal, treat yourself kindly and don't overdo things.
Episodic and Chronic Migraine
Migraines are further defined by how often the sufferer experiences them.
Episodic migraine is defined as fewer than 15 headache days per month. Chronic migraine is categorised as more than 15 headache days per month over a period of three months, of which more than eight are migrainous (in the absence of medication overuse).
Although chronic migraine, also known as transformed migraine, is thought to affect less than one per cent of the population, this still equates to more than 610,000 chronic migraine sufferers in the UK. The severity and frequency of the symptoms of chronic migraines mean they can be very disabling.
Chronic migraineurs are more likely to be absent from work and school and experience disruption of their leisure and social activities than episodic migraine sufferers. The after effects of chronic migraine are also thought to halve the productivity of sufferers at work or school. For some sufferers, being unable to function normally for more than half of the month means they are unable to work at all, so they have to rely on disability living allowance. In recognition of the serious impact chronic migraine can have on sufferers' lives, the World Health Organisation (WHO) has categorised it as more disabling than blindness, paraplegia, angina or rheumatoid arthritis.
Each year, there are around 2.5 to 4.6 per cent of people with episodic migraines whose condition progresses to chronic migraines, while a similar percentage reverts back to episodic migraines. There are many individual factors that could be involved in why migraines become chronic; some large-scale studies have identified links with chronic overuse of acute medication (i.e. painkillers/triptans), chronic sleep problems, obesity, anxiety/depression, and hypothyroidism. There is also evidence that a progressive increase in migraine frequency could be linked to the fact that the brain 'learns pain'. However, it has also been shown that early therapeutic intervention – before migraine attacks have reached a critical level of frequency – may help to prevent them becoming chronic.
Migraines in children and teenagers
These differ from migraines in adults; children may experience vomiting or abdominal pain without a headache, or they may suffer from a headache that affects the whole head instead of being one sided. Attacks in children and teenagers can be considerably shorter than those in adults – some last for less than an hour.
The advice for dealing with migraines in children is the same as for adults: identify and avoid the triggers and select suitable treatments. There is advice on how to do this throughout the book.
The main triggers in children are likely to be eating insufficient food, not drinking enough fluids and, occasionally, a food sensitivity (see Chapter 2 – The Food Factor). Stress linked to worrying about exams could also be a factor (see Chapter 4 – Mind Over Migraine). In teenage girls it could be linked to menstruation (see Chapter 5 – Migraine and Hormones).
The tips outlined in this book, such as lying down in a darkened room and taking painkillers early on, also apply to child migraineurs. It is best to stick to basic medications for young children suffering from a migraine, like soluble paracetamol, perhaps 'disguised' in a fizzy drink. Ibuprofen is also safe, but aspirin should not be taken by children under 16 years of age because of the risk of developing Reye's Syndrome. Other drugs – like triptans – are generally not recommended for children under the age of 18, except for sumatriptan nasal spray.
What causes migraines?
No one knows exactly why migraines happen, but several theories have been put forward involving genetics, blood vessels in the brain, the nervous system, a brain chemical called serotonin – also known as 5-hydroxytryptamine (5HT) – and a heart defect.
It seems that many migraine sufferers inherit a predisposition to the condition as it often runs in families.
The blood vessels
There is a long-held view that migraines occur when the blood vessels in the brain first narrow (constrict) and then expand (swell). This leads to fluctuations in blood flow to the brain, which result in migraine symptoms.
The nervous system
This view actually backs up the blood vessel theory by suggesting how changes in the blood vessels come about. It is thought that the chain of events leading to an attack begins with oversensitive brain cells triggering nerves to release brain chemicals. These chemicals cause the blood vessels in the head to swell, leading to pain, throbbing and other migraine symptoms. The hypothalamus is part of the brain that is linked to much of the nervous system and it controls, among other things, appetite and emotions. This may explain prodromal symptoms, such as food cravings and mood changes.
It has been suggested that levels of a brain chemical called serotonin, or 5-hydroxytryptamine (5HT), are low at the beginning of an attack. Serotonin is important for normal brain function and affects the size of the blood vessels. It is thought that drugs called triptans – also known as 5HT agonists – constrict the blood vessels in the brain by balancing the levels of serotonin. An injection of serotonin has been shown to end an attack, but it is not used as a treatment as it has a number of adverse side effects. For more information about serotonin and how you can safely increase your intake, see Chapter 2 – The Food Factor and Chapter 3 – Supplementary Benefits.
A heart defect
Research has suggested a possible link between migraine with aura and a hole in the heart, which is known medically as a patent foramen ovale (PFO). PFO is a small hole in the wall that divides the two upper chambers of the heart (the atria). All babies have this hole whilst in the womb, so that blood is circulated more efficiently. The hole usually closes after birth, but in some people it stays open. Tests show that 60 per cent of migraine sufferers have larger than average PFOs, which is six times as many as the general population. It is thought that the problem can lead to impurities not being filtered out of the blood properly. In those without a PFO, all of the blood returning to the heart after being pumped around the body is cleaned and filtered by the lungs to remove small clots and other debris. However, in those with the condition, unfiltered blood may get through the hole. It is believed that when this unfiltered blood reaches the brain it can trigger a migraine in some people. It is possible to close a PFO using corrective surgery but, following a trial involving 147 people with severe migraines, concerns have been raised over the risks involved, especially given the small reduction in migraine frequency that was reported (see Chapter 7 – Medical and Other Treatments).
It is possible that all of these factors could be interrelated. For example, a migraine sufferer could inherit an oversensitivity to stimuli, such as bright light, loud noise or physiological disturbances, including blood sugar changes, altered sleep patterns or dehydration. Any of these could trigger the release of serotonin – causing the blood vessels first to narrow and then widen – which then leads to a migraine. In some cases a migraineur could inherit a PFO, which could lead to similar changes in the brain and trigger an attack.
1 Determine whether it is a migraine
DIY Migraine Test
This is based on a 'self-administered screener' for migraines, which was developed by scientists in 2003. If you answer 'yes' to at least two of the following three questions, it is likely your headache was a migraine.
1. Did you feel nauseous?
2. Did light bother you more than usual?
3. Did your headache limit your ability to do what you wanted for at least one day?
What else could it be?
There are other types of severe headache, including tension and cluster headaches, which could be mistaken for a migraine.
With tension headaches, the sufferer experiences a dull and heavy pain and a feeling of pressure – as if a band is being tightened around their head. The pain tends to worsen as the day goes on and can last for several days. There may also be a dislike of light and noise, but not to the same degree as with a migraine. The pain is also likely to be less severe and is not usually one sided. However, a tension headache may sometimes be misdiagnosed as a migraine without aura. The cause, as the name suggests, is usually stress and tension, and painkillers may not help. The pain tends to arise from the neck muscles going into spasm. As well as stress, poor posture and neck injuries are common causes of muscular tension in the neck. Improving posture and finding ways to relax and manage stress may help both to prevent and relieve the pain.
Excerpted from Migraines by Wendy Green. Copyright © 2016 Wendy Green. Excerpted by permission of Summersdale Publishers Ltd.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Author's Note 9
Foreword Anne MacGregor, specialist in headache and women's health, and honorary professor at the Centre for Neuroscience and Trauma 11
Chapter 1 About Migraines 15
1 Determine whether it is a migraine 28
2 Identify your triggers 30
3 Keep a migraine trigger diary 34
4 Visit your GP 36
Chapter 2 The Food Factor 39
5 Check your caffeine intake 39
6 Watch your blood sugar levels 40
7 Be aware of food intolerances 42
8 Watch out for tyramine 43
9 Be aware of food additives 45
10 Keep a food diary 47
11 Chew ginger 48
12 Eat magnesium-rich foods 49
13 Boost your serotonin levels 50
14 Drink water 50
Chapter 3 Supplementary Benefits 53
15 Benefit from supplements 54
Chapter 4 Mind Over Migraine 67
16 Identify your stress triggers 72
17 Learn to delegate 73
18 Be assertive 73
19 Accept what you can't change 75
20 Change your attitude 75
21 Manage your time 76
22 Get moving 76
23 Go back to nature 77
24 Laugh it off 78
25 Share problems 78
26 Breathe deeply 79
27 Be mindful 79
28 Meditate 79
29 Sleep soundly 80
30 Eat a de-stress diet 82
31 Try natural therapies 83
32 Seek help 84
Chapter 5 Migraine and Hormones 85
33 Learn how hormone fluctuations can affect migraines 85
34 Hormones: keep a diary 90
35 Hormones: be prepared 90
36 Choose medications for menstrual migraine 91
Chapter 6 Tackling Other Triggers 93
37 Establish a sleep routine 93
38 Cope with summer, Christmas and the working day 94
39 Sit up straight 99
40 Use the power of plants 100
41 Clean your home naturally 100
Chapter 7 Medical and Other Treatments 103
42 Learn about medications for migraine 105
43 Discover other treatments 115
44 Try self-help treatments 119
Chapter 8 DIY Complementary Therapies 123
45 Apply acupressure 123
46 Ease pain with essential oils 125
47 Try homeopathy 128
48 Use the power of touch 131
49 Relax with reflexology 132
50 Try yoga 134
Jargon Buster 137
Helpful Reading 141
Useful Products 143