Migraine: Despot In The Head

Words: Dr Rajgopal NIDAMBOOR

Headaches are as old as civilisation. Our ancients, perhaps, believed that certain spirits were to blame for headaches, including insanity and epilepsy [fits]. It is contended that William Harvey — the first physician to discover the function of the heart and circulation of blood — recommended trepanation, or the process of making a hole through the skull to the surface of the brain, to a patient with obdurate migraine in 1660.

The ancient Egyptian doctors wrote about migraine [1550 BC]. They would prescribe certain bizarre practices to rid one of migraine. However, it was Hippocrates, the father of medicine, who first described visual symptoms of migraine. He defined a dazzling light, typically in the right eye, tailed by violent pain beginning in the temples and sooner, or later, reaching the entire head and neck area. He also distilled, no less, the implication between headache and other activities, viz., exercise and sex.

Headaches are as common as the common cold. They are most often caused by stress, food and environmental allergies, nutritional deficiencies and emotional tension. They can, at times, be a symptom of serious illnesses too. It is, therefore, important to rule out other major triggers — meningitis, brain tumour, haemorrhage, and dangerously high blood pressure.

There are three primary types of headache. Cluster headache, which occurs at the same time of day; it affects one side of the head and face, causing severe pain. It may last from half to three hours.

Tension headache presents with a vice-like twinge felt on either side of the head. It is more frequent, but milder than other types of headaches. It develops over several hours and is often worse at dusk.

Migraine headache presents with pulsating pain, usually on one side of the head. It typically lasts from four to 72 hours. A dark, quiet room is what most migraine sufferers seek to manage pain. Nausea, light-sensitivity and visual aura [déjà vu] are common with migraines.

Migraine is a complex syndrome. It affects millions of people worldwide. What distinguishes the disorder, from other types of headaches, is its periodic, or episodic, ache, or pain.

Migraine usually affects people in their mid-twenties, or 30s — especially, ‘perfectionists.’ Interestingly, it is also common in children. Have you not heard parents complain that their child has had ‘migraine-type’ of headaches for as long as they know?

Symptoms  

  • Pain may be intense, usually on one side of head; ‘as if in a vice-like grip’
  • Intense attacks of periodic headaches, preceded by visual disturbances, blind spots, tingling in the arms and legs, followed by sleepiness
  • Giddiness and sensory loss of hands
  • Sudden change from happiness to depression, or vice versa
  • Aversion to light; profuse watery eyes
  • Loss of appetite, nausea and vomiting at the ‘peak’ of the attack
  • Gas, bloating, loose stools and/or profuse urination.

What actually causes migraine is not yet known, notwithstanding scientific advance. It is suggested that it may result from a blend of factors — blood vessel constriction and release of certain chemicals from nerve fibres. Once this happens, the nerve fibres ‘curl’ around blood vessels. This may lead to puffiness of the blood vessels just under the skin of the temple. There may be a genetic element too, although migraine is more common in women, right from the teenage years, motherhood to menopause. It also tends to affect people who strive for perfection in everything they do, as already cited.

The following sequel is, thereafter, a lurking prospect: headache, feelings of nausea, diarrhoea and/or vomiting.

During a migraine episode, there may also be delayed emptying of the stomach into the small intestine. This may affect absorption of food and blood circulation. It also increases one’s sensitivity to light and noise [sound]. 

Migraine rules the head like a despot. Migraine pains may, of course, differ in their nature, frequency and duration, but they all make the affected individual literally pray for relief.

A migraine headache may start suddenly. It may also be plodding; this usually affects the unwary individual in the wee hours of the morning. It may also have a propensity to spoil one’s weekends. This is quite upsetting, although it may not interfere with one’s work/occupation, unless one is working during weekends. Any which way you look at it, migraine often robs its ‘victims’ of the pleasures of relaxation, a holiday, or vacation.

Self-Help

At the first sign of a migraine —

  • Find a peaceful setting
  • Turn off the lights. Migraines often ‘ups’ one’s sensitivity to light and sound. Unwind in a dark, quiet room. Sleep, if you can
  • Apply hot, or cold, compresses to your head, or neck. Ice-packs have a numbing significance; they may ease the feeling of pain. Hot packs and heating pads can relax tense muscles. Warm showers may have a similar effect
  • Drink coffee: coffee alone can ‘boot out’ migraine pain. However, drinking too much coffee can lead to withdrawal headaches. Drinking coffee too late too in the day may hamper your sleep; it can also prompt migraines.

Sleep  

  • Have regular sleep hours.Wake up and go to bed at the same time every day — even during weekends. If you have a siesta during the day, keep it short. Snoozes longer than 15-20 minutes may affect with night-time sleep
  • Relax at the end of the day.Anything that helps you relax can encourage better sleep; listen to calming music, soak in a warm bath, or read a favourite book, or watch a light comedy. Intense exercise, hefty meals, caffeine, nicotine and alcohol can inhibit sleep
  • Curtail diversions.Save your bedroom for sleep and intimacy. Don’t watch television, or take work to bed. Keep your bedroom door closed. Use a fan to stifle off-putting sounds
  • Don’t try the rigid mode to sleep.The harder you try to sleep, the more wakeful you’ll feel. If you can’t fall asleep, read, or do a quiet activity until you become somnolent
  • Check your conventional medications.Medications that contain caffeine, or other stimulants — including some prescription drugs for migraines — may hinder sleep.

Diet

  • Be constant.Eat at about the same time every day
  • Don’t ‘hop’ meals.Fasting escalates the risk of migraines
  • Keep a food dairy.Keeping a watch on the foods you eat and/or experiencing migraines thereto can help recognise the most likely food triggers
  • Avoid foods that activate migraines.If you suspect that a certain food — such as old cheese, chocolate, caffeine, or alcohol — is engendering your migraines, exclude them from your diet.

Exercise  

  • Physical activity eases anxiety and depression — the two conditions can make migraines worse
  • Obesity increases the threat of chronic headaches. Keeping a healthy weight through exercise and diet can provide supplementary benefits in dealing with migraines
  • Walking, swimming and cycling are good choices. Avoid strenuous exercise; it may trigger migraines.

Manage stress

  • Reduce ‘to bare bones.’Don’t look for ways to pack more activities, or everyday jobs into the day. Find a way to dump some things out
  • Manage your time prudently.Bring up-to-date your ‘to-do’ list every day. Delegate what you can, and split large projects into wieldy lots
  • Take a break.If you feel overawed, a few measured stretches, or quick stroll may refurbish your energy for the task at hand
  • Adjust your attitude.Be positive
  • Enjoy yourself.Find time to do something you love for at least 20 minutes every day
  • Do meditation, or yoga.

Migraine Diary

A diary may help you regulate what triggers your migraines. Note when your migraines start, what you were doing at the time, how long they last and what, if anything, provides respite. Report them to your doctor.

Homeopathy

Homeopathy aims to treat the individual that carries the migraine ‘burden’ on their head, rather than the problem per se. Remember, no two individuals with migraine present with the same set of symptoms, idiosyncrasies, sensitivities, or disposition. Homeopathy elicits and treats these special characteristics, from the back-to-front, looking at the possible causes, or triggers.

Homeopathy evidences that a certain remedy that can cause migraine-like symptoms can also treat individuals having migraine, and exhibiting the same, unique set of symptoms. However, what differentiates homeopathy from other systems is no two individuals with migraine may be prescribed the same remedy. Rather, the most appropriate remedy takes its ‘prompt’ from the nature of each individual’s distinctive symptoms. One individual with migraine, for example, may feel well with a bandanna tied around the head; while another may feel worse. This calls for the use of two different homeopathic remedies.

A Study In Point

Objectives and background. The objective of this study was to evaluate treatment details and possible effects of individualised homeopathic treatment in patients with migraine in usual care.

Design. This was a prospective multicentre observational study. Consecutive patients beginning homeopathic treatment in primary care practices were evaluated over two years using standardised questionnaires. The data recorded included diagnoses [International Classification of Diseases, Ninth Revision] and current complaints, including their severity [numeric rating scale = 0–10], health-related quality of life [QoL; 36-item Short-Form Health Survey], medical history, consultations, homeopathic and conventional treatments, as well as other health service use.

Results. Two-hundred-and-twelve [212] adults [89.2 per cent women], mean age 39.4 ± 10.7 years were treated by 67 physicians. Patients had suffered from migraine for a period of 15.2 ± 10.9 years. Most patients [90.0 per cent] were conventionally pre-treated. The physician workload included taking the initial patient history [120 ± 45 minutes], case analysis [40 ± 47 minutes], and follow-ups [7.3 ± 7.0, totaling 165.6 ± 118.8 minutes]. Patients received 6.2 ± 4.6 homeopathic prescriptions. Migraine severity showed marked improvement with a large effect size [Cohen’s d = 1.48 after three months and 2.28 after 24 months]. QoL improved accordingly [Mental Component Score and Physical Component Score after 24 months: 0.42 and 0.45]. The use of conventional treatment and health services decreased markedly.

Conclusion. In this observational study, patients seeking homeopathic treatment for migraine showed relevant improvements that persisted for the observed 24-month period [Note: Due to the design of this study, however, it does not answer the question as to whether the effects are treatment specific, or not].

  • Witt C M, et al, “Homeopathic Treatment of Patients with Migraine: A Prospective Observational Study with a 2-Year Follow-Up Period,” The Journal of Alternative and Complementary Medicine, Vol 16, # 4, April 27, 2010.
Dr RAJGOPAL NIDAMBOOR, PhD, is a wellness physician-writer-editor, independent researcher, critic, columnist, author and publisher. His published work includes hundreds of newspaper, magazine, web articles, essays, meditations, columns, and critiques on a host of subjects, eight books on natural health, two coffee table tomes and an encyclopaedic treatise on Indian philosophy. He is Chief Wellness Officer, Docco360 — a mobile health application/platform connecting patients with Ayurveda, homeopathic and Unani physicians, and nutrition therapists, among others, from the comfort of their home — and, Editor-in-Chief, ThinkWellness360. 

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