•94% of people who
consult their Doctor for head pain have MHA.
•90% of people who
consult their Doctor for sinus HA’s actually have MHA
•28-33 million people
have MHA in the U.S., compared to 32 million who have asthma, Diabetes, and
Congestive Heart Disease combined
Migraine is considered a "primary" headache, meaning it is not attributable to any other condition or illness. There are many types and subtypes of MHA. The most common type of MHA is Migraine without aura (aura is a set of sensory precursors, such as a smell or flashing lights in the eyes that the sufferer experiences prior to the onset of the MHA).
The causal mechanism of MHA is poorly understood. Originally, it was believed that the cause was vascular, probably because of the pulsing quality of the pain. Research has shown that although there is some change in bloodflow at the brainstem (base of the brain, just above the spinal cord in the neck), there is no change in bloodflow within the cortex of the brain or surrounding tissues. Current thinking is that MHA is a neurobiologic issue. It is now believed that hyper sensitization of nerve endings within the brain itself are responsible for the initiation of MHA. Thus, attacks originate within the brain. The brain is not in itself a pain sensitive structure, but it is where the perception of all sensation (including pain) takes place. The nerves respond first, thereafter affecting blood flow. Here are a few things that are known:
•Migraine
sufferers are over-stimulated by what they see and hear.
•Pain
starts within the brainstem, which is considered the migraine generator.
•Visual
changes (aura) result from an electrically charged wave sweeping across the
brain surface, followed by decreased charge.
•The
throbbing/pulsing sensation is due to swelling (inflammation) of the brain’s
surface blood vessels and it’s covering (dura mater, meninges)
•Hypersensitive
nerve endings in the brain result in allodynia, or pain resulting from stimulation that is normally
non-painful.
This hypersensitivity is why sufferers do not want to be touched or talked to while having a migraine. Most prefer a quiet, dark place to rest until the pain passes.
TREATMENT OPTIONS
There are two main types of treatment, prophylactic/preventative, or abortive.
Prophylactic treatment seeks to prevent the onset of MHA. Some common prophylactic choices include:
- Beta blockers (propanolol) affect the blood vessels around the brain
- Anti-seizure meds like topiramate are used to prevent migraines in adults
- Acupuncture
- Chiropractic
- Feverfew herb
The most common abortive measure includes:
•Triptans affect the blood
vessels and nerve endings that become irritated during a MHA.
•They
are not a preventative and cannot be taken within 24 hours of other migraine
meds.
WHY ACUPUNCTURE?
Acupuncture is an effective MHA preventative measure. At Integrated Chiropractic
Rehab, www.integratedchiro.net we have had patients who report decreased frequency and intensity of
MHA. Furthermore, research supports the use of acupuncture as a reliable preventative measure for MHA:
•Vickers,
et al. at Sloan Kettering Cancer Center in New York performed a study on 401 chronic HA sufferers, primarily MHA.
–12
visits over 3 months
–HA
pain in the acupuncture group was almost 50% lower at 12 month follow up.
–Acupuncture
group experienced 22 fewer HA days, used 15% less meds, had 25% fewer GP
visits, and 15% fewer days off.
•2009
Cochrane Database Review reported that there is consistent evidence that
acupuncture is at least as effective, and possibly more effective than drug
prophylaxis, with far fewer side effects, and continued benefit long after
treatment ended.
Acupuncture works by increasing circulating levels of endorphins, the body’s natural pain killing chemicals. This reduces pain and prevents the onset of migraine by maintaining a circulating level of painkiller. Acupuncture also provides stress relief! The overwhelming majority of our patients report profound relaxation during and after treatment. This decreases the sensitivity of migraine sufferers to triggers and promotes an overall sense of balance.
Acupuncture involves the insertion of very fine needles at specific points on the body. The majority of the time, this process is painless. The most you might feel is a momentary pinch at the site of needle insertion. This typically passes as quickly as it comes. Once all the needles are inserted, you relax for 20 minutes. For MHA, we use points on the head, arms, neck, back, and legs. Because there are points on both sides of the body, we must do two 20 minute sessions per visit to provide comprehensive treatment.
Each person responds differently, so it is difficult to predict how many visits it will take to effect change. Because we are attempting to prevent a MHA, we will be looking for a reduction in the frequency and intensity of migraines. These factors will influence how frequent your treatment will be and how long the initial trial will last.
To learn more about acupuncture and our other services, please call us or visit our website, www.integratedchiro.net .
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