Migraines are dealbreakers—everything stops when a migraine occurs, leaving the sufferer in the dark waiting for relief. This uncomfortable and often chronic condition plagues an estimated 5 million Americans every month! In addition to being painful, frequent migraines can negatively affect overall health, ability to work, and even your relationships. Surprisingly, the best defense against migraines is a good offense. Learning your triggers and taking preventative measures against this disabling condition can reduce the frequency and severity of migraines.
A migraine is a severe, debilitating headache that can last hours or even days. To arrive at a proper diagnosis, medical professionals will ask about family history, complete a physical exam, run blood tests, and perform MRI and CT scans. Some doctors will recommend keeping a journal notating the frequency of migraine attacks as well as other symptoms to identify possible trends. In the rare case that a doctor suspects infection as the cause of a migraine, they may recommend a spinal tap. Through a combination of medications and lifestyle adjustments, sufferers can reduce the frequency and/or severity of migraines.
There are four stages to a migraine: prodrome, aura, attack, and postdrome—though not everyone experiences all four every time. Sometimes a migraine occurs without an aura; sometimes the aura and the attack happen simultaneously.
Prodrome: This first stage usually occurs one or two days before the attack. Symptoms include:
• Constipation or diarrhea
• Mood swings
• Food cravings or loss of appetite
• Neck stiffness
• Increased urination and/or thirst
• Frequent yawning
• Sensitivity to light and/or sound
Learning to identify these early symptoms and start treatment right away is an important step, and can reduce the risk of the migraine progressing to subsequent stages.
Aura: This second stage can manifest before or even during an attack. Many people never experience the aura stage. Symptoms include:
• Visual phenomena (bright light, flashing light, jagged light that blocks vision)
• Vision loss
• Tingling in hands, arms, neck, and face (typically concentrated on one side of the body)
• Blurred vision
• Partial paralysis
• Difficulty speaking
• Hearing noises
• Weakness or numbness in one side of face
Attack: This third stage is the part commonly referred to as the migraine. This part can last anywhere from four to 72 hours and is the most painful and disabling stage. Symptoms include:
• Moderate to severe headache
• Throbbing, pulsating pain on one or both sides of face
• Sensitivity to light, sound, and/or smell
• Nausea and/or vomiting
• Blurred vision
• Lightheadedness and/or fainting
• Neck stiffness
Postdrome: This final stage can be thought of as the aftershock of the attack. Symptoms include:
• Weakness and sore muscles
• Sensitivity to light and sound
• Scalp tenderness
• Intolerance to food
It is important to rest and recover during this stage to accelerate healing.
The cause of migraine headaches is still pretty unclear. Some theories suggest they may be due to an overactivation of the trigeminal nerve in the hinge of the jaw. The trigeminal nerve, a complex motor nerve responsible for sensation, biting, and chewing, is sometimes described as a “major pain pathway.”
Other theories link migraines to imbalances in serotonin levels. Serotonin is a chemical that helps nerve cell and brain function. Studies show that serotonin levels drop dramatically during migraine attacks. This could lead to the release of certain biochemical substances in the brain that lead to inflammation of the blood vessels surrounding the brain. This inflammation may cause the throbbing sensation experienced with migraines.
Either way, there is some miscommunication and/or imbalance in the nervous system that triggers a series of biochemical reactions, leading to this debilitating pain.
The development of chronic migraines appears to be linked with certain factors, including:
Though migraines can affect any age group, they tend to begin in adolescence, peak in the 30s, and then taper off with age.
Headaches affect more young boys than young girls; however, this shifts in adolescence with the onset of migraines. In fact, women are about 3 times more likely than men to develop migraines.
Genetics seem to play a big role in the development of migraines. If one or both of your parents suffer from chronic migraines, your chance of developing them increases significantly.
Migraines often begin for women around the same time as the onset of menstruation. Sometimes migraines are linked with the menstrual cycle. Many women notice a decrease in the severity of migraines during menopause. Some women notice migraines worsen during pregnancy, though this is not so for everyone.
Additionally, some factors that may contribute to the onset of an isolated migraine attack include:
Particularly salty, fatty, or highly processed foods can sometimes trigger a migraine. Food additives like MSG and aspartame have also been linked to migraines in some individuals.
Fasting may put your body into a state of “emergency,” which can trigger the sympathetic nervous system. This can lead to a migraine.
Certain beverages, particularly alcoholic beverages and heavily caffeinated beverages, can trigger a migraine.
Excessive stress from work or home life can lead to a migraine. Stress triggers the sympathetic nervous system to put the body in a fight or flight mode. This mode is associated with inflammation and changes in serotonin levels.
Bright lights, strong smells, or loud noises can trigger migraines.
•Sleep pattern changes
Dramatic changes to your typical sleep-wake cycle can result in a migraine. Some examples of this include getting too much sleep, too little sleep, or jet lag.
•Intense physical activity
Overexertion in a sport, workout session, or even sexual activity can trigger a migraine.
Allergens, air pollution, or dramatic changes in weather or barometric pressure can trigger a migraine.
Oral contraceptives have been linked to the onset of migraines. This makes sense, considering hormonal changes can be a factor in the development of migraines, and oral contraceptives alter the body’s hormone levels.
See “Hormonal changes” above.
- Keep a journal. Notate each time you start to detect symptoms of an oncoming migraine. Write down things like what you ate, drank, and did that day prior to the symptom onset. Also notate where you were in your menstrual cycle. Include as much detail as possible. After a few migraines, you may start to notice trends. If you do notice trends, try to avoid the triggers when possible. For example, if you always get a migraine after drinking red wine, avoid red wine. Or if you get a migraine each time you stay up past midnight on a workday, try to implement a consistent sleep schedule.
- Notice the early signs. For unavoidable or unexpected triggers, start to become familiar with the early signs of a migraine. Often there are subtle changes in mood, behavior, or sensations leading up to the attack. Take any necessary medication or implement therapy techniques (like restorative yoga, breathing meditations, or essential oils) immediately to avoid a full-fledged attack.
- Exercise! While you should definitely avoid rigorous exercise in the midst of a migraine attack, healthy exercise habits when you’re well can actually help reduce the frequency of migraines. Jogging or biking strengthens your cardiovascular system, making your heart and lungs pump blood more efficiently to and from the brain. Implementing a yoga routine can increase muscular strength and help reduce your body’s reaction to stressors. Keep in mind that a healthy exercise routine will benefit you the most when supported by rest, water, and a nutritious diet.
1. Soften the Base of Skull. The base of the skull is at the back of the head, where the head and neck meet. This is where the spinal cord connects to the brain. If the base of the skull is overly tight or constricted, serious consequences can result, affecting the nerves in the neck and spine. This excessive tightness and potential for nerve damage can trigger headaches and migraines. To Soften the Base of Skull, place finger pads at the base of the skull, set your gaze slightly above the horizon, and pull the chin back as if making double, triple, even quadruple chins! Imagine the base of the skull opening east and west. Use your hands to notice how the neck muscles feel during this exercise. Moving the head back into alignment over the spine relaxes the neck muscles and clears the passage for the spinal cord, decreasing tightness in and around the area, alleviating pain, and ultimately preventing future pain. Set an alarm to practice this exercise 3 times each day. In everyday life, you can Soften the Base of Skull while waiting in line at the grocery store. Set your gaze high toward the cashier. Keep your gaze high, and pull the chin back in line with the neck. Take a few deep breaths.
2. Release the Jaw. An overcontracted jaw is linked with excessive stress, anxiety, and anger. Releasing tension in the jaw can trigger a release in other parts of the body and lead to feelings of calm. Keep in mind that the migraine-linked trigeminal nerve is located right at the hinge of the jaw, so the less tension that exists in that area, the better the chances for reducing and preventing migraines. To Release the Jaw, drop the tongue to rest at the bottom of the mouth between the teeth. Now, open the mouth slightly as if trying to drool (bonus points if you actually do drool—though maybe save that for when you’re home alone!). Avoid opening the mouth so wide that you have to strain. Instead, just let the jaw fall open gently as it might if you were sleeping. Hold this relaxed pose for a few breaths, paying special attention to the hinge of the jaw. Feel the muscles in the jaw, particularly the masseter (the muscle that closes the jaw in chewing), begin to release tension. In everyday life, you can Release the Jaw while checking your email. Drop your tongue to the bottom of your mouth and open the mouth slightly as if trying to drool. Take a few deep breaths focusing on maintaining this release.
3. Mobilize the Ribs. Mobilizing the ribs increases breath capacity and circulation, allowing the body to release the state of emergency it feels when stuck in the sympathetic nervous system (fight or flight). Deep, slow breathing helps the body relax and allows pain and inflammation to subside. To Mobilize the Ribs, expand the ribs in all directions on your inhale—toward the back, sides, and front. On an exhale, contract the ribs toward center. Start by noticing your natural breath and breathing tendencies. Then, actively expand and contract the ribs. You can use a mirror to see where you more easily inhale or exhale, or better yet, place your hands on your ribs and feel the movement. If you typically breathe in the front of your ribs, try to inflate the back of your ribs. It may be harder than you imagine. Since you are constantly breathing, you can Mobilize the Ribs any time of day. Practice while waiting on your morning coffee or tea, walking down the street, or warming up before you exercise. Notice the ribs expand wide as you inhale. Now, actively contract the ribs as you exhale. Challenge yourself to keep the side body—the space between the ribs and hips—long as you contract.
The best thing you can do for your body when you are experiencing a migraine is to rest. Find a quiet, dark place to lie down. Find a comfortable position, either on your back or side. Prop your head up slightly to promote blood flow back to the heart. An eye pillow can be nice to use—the gentle compression offers pain relief while blocking out light. Sometimes placing a cool compress or icepack wrapped in a towel on the back of the neck or the forehead can take the edge off the pain. Take slow, deep breaths and focus on releasing tension in the muscles of your shoulders, neck, jaw, and brow.
An anti-inflammatory medication like ibuprofen can help reduce the severity and length of a migraine. The gel capsules work faster than the regular pills. They work best if you are able to take one or two as soon as you feel an attack coming on. In some cases, they can actually prevent a full-blown attack.
Some people swear by essential oils in treating their migraines. Common essential oils for this purpose include:
•Eucalyptus to reduce inflammation
•Lavender and Roman chamomile for their soothing properties
•Rosewood or rosemary to reduce tension and increase circulation
•Peppermint to cool and inhibit muscle contractions
Keep in mind, migraines may make you more sensitive to scents, so what you like in everyday life may be overpowering during a migraine. Experiment with oils with a certified aromatherapy expert.
•Progressive muscle relaxation.
With the guidance and supervision of a therapist, progressive muscle relaxation trains you to individually release tension in each muscle of the body. This technique is widely used to treat anxiety and insomnia, but some find it helpful in the early stages of migraine headaches. Because this technique is performed in a darkened room, stimuli are decreased and you can focus on releasing any tension that may be contributing to the migraine.
Any form of meditation can help relieve early migraine headaches. Bring your attention inward to slow and deepen your breath. This balances the nervous system and reduces potential inflammation. Restorative yoga can be implemented as a meditative practice to reduce the severity of an oncoming migraine.
Acupuncture is a form of traditional Chinese medicine where practitioners stimulate “pressure points” in the body by inserting a thin needle into the skin. The practice is based in the concept that our body contains qi (pronounced chEE), a life force energy that flows throughout the entire body. By placing needles along the meridian (a grid that follows the path of the qi), you re-balance the qi in your body. Acupuncture is used for pain management and relief for a variety of maladies, including migraines.