The root of migraine may reside in brain stem malfunctioning. Debate still swirls about the precise cause of migraines, but new discoveries are already permitting the development of new treatments.
At the moment, only a few drugs can prevent migraines, all of them developed for other diseases such as hypertension, depression and epilepsy. But they work in only 50 percent of patients, and even then, only 50 percent of the time, and can also induce a range of potentially serious side effects.
New techniques are now being tested, such as drugs that work by preventing gap junctions, a form of ion channel, from opening, thereby halting the flow of calcium between brain cells.
More than 300 million people worldwide -- about 6 to 7 percent of men and 15 to 18 percent of women -- suffer from severe migraine headaches, yet to this day, it’s one of the least understood and poorly treated medical disorders.
Part of the problem has been that the experiences of those suffering from migraines vary greatly. Aside from throbbing, searing pain, which may or may not be one-sided, some experience “auras” prior to onset, while others do not. There may also be nausea, vomiting, fever, chills, sweating, and/or sensitivity to light, sound, and smells.
The pain can be extreme; some of the patients I’ve seen have actually considered suicide as a reasonable solution!
On average, “migraineurs” have one or two day-long attacks every month. But 10 percent get them weekly, 20 percent experience them for two to three days, and up to 14 percent have them more than 15 days a month. It comes as no surprise then that headaches cost the U.S. economy an estimated $17 billion a year in lost work, disability payments, and health care expenses.
New Research Offers New Insights into What Causes Migraine Pain
It has long been thought that the cause of migraines was due to vascular changes in your brain, from initial blood vessel constriction and a drop in blood flow, followed by dilation and stretching of blood vessels, which activates pain-signaling neurons.
However, new research finds flaws in this theory, as they’ve now been able to determine that migraines are not preceded by constriction and decrease in blood flow, but rather by an increase of nearly 300 percent. However, circulation then appears normal, or even slightly reduced, once the attack is in full swing.
Based on new research, a migraine is now thought to arise as a result of a disorder of your nervous system, most likely in your brain stem.
Although most regions of your brain do not register or transmit pain signals, a network of nerves called the trigeminal nerve system does. Pain is relayed through the trigeminal network to an area in your brain stem called the trigeminal nucleus. From there, it is conveyed to the sensory cortex in your brain, which is involved in your awareness of pain and other senses.
What first activates your trigeminal nerves, setting off a migraine, however, is still under debate, but is thought to be one of two things.
Some researchers believe that a wave release of neurotransmitters across your cortex can directly stimulate your trigeminal nerves, setting off the chain reaction that ends in the transmitting of pain signals.
Others place the root of migraine pain in the brain stem itself, as it is your control center for alertness, perception of light, noise and smell, cerebral blood flow, cardiovascular function and pain sensitivity -- many, if not most, of which are part of the symptoms of a migraine attack.
Positron-emission tomography has revealed that three clusters of cells in your brain stem are active during and after migraine. According to this hypothesis, abnormal activity in those cells could induce pain in two ways.
These cells normally inhibit trigeminal neurons within your trigeminal nucleus by continuously giving out orders “not to fire.” But, if they do not function or communicate normally, it can allow your trigeminal neurons to “fire at will,” even when there’s no pain signals being received from your brain membrane or blood vessels.
Occasional dysfunction in these clusters of cells could therefore explain why some migraine sufferers experience sensitivity to light, sound and odors.
If these findings are correct, they offer a clue as to why migraine medications have been so largely unsuccessful in treating migraine pain.
Triptans (tryptamine based drugs), for example, work by binding to serotonin receptors in cranial blood vessels, causing them to constrict. Well… if your pain is not due to engorged blood vessels (as previously thought) and your blood flow is normal, constricting them is likely to do little good, and potentially a lot of harm. And, lo and behold, serious cardiovascular events, including heart attack and stroke, are side effects of these types of drugs.
What Typically Triggers Migraine Headaches?
There are many potential triggers, and what triggers a migraine for one might not trigger it in another. However, here are several of the most commonly reported triggers:
- Food and Drink: Many people experience migraines when they eat certain foods, especially wheat, dairy, sugar, artificial preservatives or chemical additives. Cured or processed meats, alcohol, aspartame, caffeine, and MSG are common culprits.
- Allergies: Including food allergies and food sensitivities, and chemical sensitivities.
- Dehydration and/or Hunger
- Changes in sleeping cycle: Both missing sleep and oversleeping can trigger a migraine.
- Stress: Any kind of emotional trauma can trigger a migraine, even after the stress has passed.
- Physical exertion: Extremely intense exercise or even sex has been known to bring on migraines.
- Hormones: Some women experience migraines before, or during their periods, during pregnancy, or during menopause. Others may get migraines from hormonal medications like birth control pills, or hormone replacement therapy.
- External stimuli: Bright lights, fluorescent lights, loud noises and strong smells (even pleasant ones) can trigger a migraine.
- Weather changes, Seasonal changes, and changes in Altitude
Headache Medications: Causing More Harm Than Good
A debilitating headache may be one instance where you could justify popping a pill that would give you instant relief. But headache medications only work in 50 percent of people, half the time.
They also have intense side effects, including “medication overuse headache,” which often occurs when people take too much of a headache drug. Once you taper off the drug, you can also get rebound headaches that can be worse than the original!
Other side effects of migraines drugs include:
- Ulcers and gastrointestinal bleeding
- Stroke and heart attack
- Muscle weakness
Counter-intelligent as it may be, some migraine-fighting medications (such as Maxalt-MLT and Zomig-ZMT) also contain the artificial sweetener aspartame, which is a common migraine trigger…
Fortunately, there are better ways to treat migraines than pharmaceutical drugs.
Quick, Natural Tips to Relieve a Migraine
Preventing migraines begins by avoiding the triggers. Most often this means eating healthy whole foods (avoiding most processed ones) and managing your stress effectively.
Following my eating plan seems to reduce migraines by about 80 percent, although it does take some time to work. Avoiding wheat, grains, sugar and all fluids but water seem to be particularly effective.
Regular exercise will also help to keep migraines away by improving your response to stress along with the underlying inflammatory conditions that can trigger migraines.
Ideally, these are the things to focus on so that you can reduce your migraines altogether.
But if a migraine does strike and you need relief NOW, try:
1. Stimulating your body's natural painkilling ability. By putting pressure on a nerve just under your eyebrow, you can cause your pituitary gland to release painkilling endorphins immediately.
2. Taking 10 teaspoons of cayenne pepper in a glass of water. Endorphins are released by your brain when the cayenne hits your stomach lining.
3. Using Emotional Freedom Technique (EFT). Newcomers who use this simple process by themselves achieve relief 50 percent to 80 percent of the time and, in many cases, the relief is complete and permanent. More sophisticated uses by an EFT expert may be required for some migraine sufferers.
4. Green apple scent. One study found that the scent significantly relieved migraine pain. This may also work with other scents that you enjoy so consulting with an aromatherapist may be beneficial.
Other useful techniques include:
- Putting a cold compress on your forehead or behind your neck
- Massaging your ears and ear lobes
- Massaging the "crown" of your head -- the ring of muscles that circle your head where a crown would sit
Some people even say that having a purring cat, which sends out low frequency vibrations, next to their head relieves migraine pain.
The point is that there are many, many, non-drug options out there, and finding the one that works for you is likely just a matter of trial and error.