MIGRAINES: PART 2
Who Suffers: Understanding the Genesis of Migraines
In this, the second of three articles on migraines, since some migraine sufferers have experienced migraines for many years, even from early childhood, without a clear diagnostic correlation to their problem, I will attempt to stimulate the reader’s memory regarding the onset of their migraines and will show a possible association between ADD and ADHD and whiplash and concussion. I will also attempt to reveal some differences in how men and women suffer with migraines and how migraines can be misunderstood and mismanaged as a neurological disorder and not a condition.
WHO SUFFERS FROM MIGRAINES?
According to the Migraine Research Foundation, migraine is the third most prevalent illness in the world. Nearly one in four U.S. households include someone who suffers from migraines. Amazingly, 12% of the overall population—including children—suffers from migraine. In the U.S., 18% of women, 6% of men, and 10% of children experience migraines. Migraines are most common in those between the ages of 25 and 55 and tend to run in families, with about 90% of migraine sufferers having a family history of migraines.
Yet, only 4% of known migraine sufferers seek help from migraine specialists, according to the CDC. Self-treatment, via widely available over-the-counter medications, may be one reason so few migraine sufferers consult specialists. Or they might be discouraged from seeking help, once they have been introduced to the notion that there is no cure for the condition.
WHAT IS THE FINANCIAL IMPACT OF MIGRAINE ON THE ECONOMY?
The NIH and the Migraine Research Foundation report this: “Healthcare lost in productivity associated with migraine is estimated to be as high as $36 billion dollars annually in the U.S. In 2015, the medical cost of treating chronic migraine was more than $5.4 billion dollars.” It is safe to say, that the actual figures are probably considerably higher, since, as mentioned, many migraine sufferers self-medicate with over-the-counter drugs and other methods.
There are few statistics available on the considerable social and personal economic devastation of migraines on the income loss, job loss, and home loss that create situations in which those who suffer are unable to physically, materially, or emotionally support their family and dependents. However, we do know that hundreds of millions of dollars are spent in emergency rooms visits to treat people suffering from migraines.
Simply stated, both the direct and indirect economic impact of migraines is untenable.
CHILDREN AND MIGRAINES
According to the NIH and the Migraine Research Foundation, migraines affect about 10% of school-age children. Half of all migraine sufferers have their first attack before the age of 12. Migraines have even been reported in children as young as 18 months. Recently, infant colic condition was found to be associated with childhood migraine and may even be an early form of migraines.
Children who suffer from migraine are absent from school twice as often as children without migraine. In childhood, boys suffer from migraines more often than girls; as adolescence approaches, the incidence increases more rapidly in girls than in boys. A child who has one parent with migraine has a 50% chance of being diagnosed with migraines and if both parents have migraine, the chances rise to 75%.
However, there is no evidence that migraine is necessarily bound to heredity. In fact, regardless of their parents’ susceptibility to migraine, many migraine-suffering children have experienced trauma at a very early age: for instance, a simple fall from a couch or bed—or from a bicycle, tricycle, or swing, etc. Or perhaps a first-time parent may drop their young child accidently, causing whiplash and concussion.
The parents may be so traumatized by such an experience that they emotionally shut down and fail to connect the incident to later symptoms. Or parents may take for granted that such a fall will not cause a concussive condition. Especially if they are able to comfort their child, once he or she ceases to cry, the assumption is made that, since nothing is broken or bleeding, it was just a small bump.
This is not to say that the parent is negligent or guilty. These accidents happen all the time—and some result in headaches and migraine conditions, while others do not, depending on the distance of the fall and the impact on the neck and cranium. But every concussion is not obvious. Therefore, when such an accident is the cause of the onset of migraines, many parents fail to correlate the changes in their child’s behavior and well-being—including ADD, ADHD, or other mental, emotional, and learning challenges, in addition to the onset of migraines—that occur in the days, weeks, months, or even years after that fall. Also, when there is a family history of headaches, there is too often a tendency to “geneticize” the condition, rather than relate it to the earlier trauma.
For all of these reasons, it is important that a medical provider ask questions related to possible concussions during consultation with the parents of children suffering from migraines.
WOMEN AND MIGRAINES
In women, physiological changes during the menses create a cascade of events that leads to a system more susceptible to negative influences on the body than at other points in their cycle. These influences may include reduced immune functioning, emotional lability, and increased physical discomfort and sensitivity—all of which are well-documented in the literature.
I postulate, therefore, that the migraines a woman may suffer during menses are due to a history of physical trauma, concussion, and/or whiplash conditions. It is my experience that women with such a history are more vulnerable to headaches during their menses than those who have no such history—that the hypertonicity related to the posterior triangular region of the neck and head is preexisting to the menses period and is thus stimulating an elevated physical and emotional response to an already hypersensitive regional condition of the body.
Additionally, many of the women I have treated for migraines have had a history of “pillow propping syndrome” (PPS), in which two or more pillows were propped behind their head and neck while sleeping, reading, or watching television in bed to provide comfort and relieve tension. They also rested their head or neck on the arm of a chair of the couch for the same effect.
However, since it is my belief that migraine headache conditions are caused by a vascular disorder and constriction in the neuromuscular spindle fibers, which stresses the triad region of the posterior triangular region (PTR) of the upper back neck and head and restricts oxygen and blood flow, I contend that pillow propping exacerbates, rather than relieves, the condition—and that the habitual pillow propping was actually creating a self-inflicted, slow but progressive whiplash-type condition causing increased neck, head, and upper thoracic back pain and discomfort.
MIGRAINES: WOMEN VS. MEN
According to the NIH and the Migraine Research Foundation, migraines affect 18% of women, but only 6% of men in the U.S. However, these numbers may not reflect the truth of the situation, as women and men may respond to migraines differently and report their experiences differently, as well.Here are some reasons I believe women report more migraines and headaches than men:
- Women are more likely to report headaches and migraines to their doctor than men because of a stronger innate responsibility to support their own health, and thus the well-being and survival of the family.
- Women are more inclined to report all healthcare concerns to their doctor than men because, rather than fearing the unknown as regards their health, they want to know.
- Due to an innate and cultural conditioning of male behavior (and a possible fear of the unknown), men are less likely to report pain of any kind to their doctor.
- And while men may complain later in life to family about headaches and pain, they may still refuse to seek a physician’s care.
- Women are more likely to exacerbate migraine conditions with slow-inducing whiplash, via “pillow propping syndrome” (PPS), while reading or watching television in bed.
Migraine headaches may have a lot to do with the strength and weakness of the posterior triangular region of the neck, head, and upper back regions of an individual. Statistically, men participate in contact sports more than women. Because such sports can cause whiplash and concussion, which induce a coup-contrecoup response by causing the brain to strike the intercranial skull—and because migraine attacks are degrees of hypertonicity that can be further exacerbated by movement or stress—I believe men by and large have just as many migraines as women, but either handle them silently or choose unreported forms of treatment and care.
CONVENTIONAL TREATMENT OF MIGRAINE
Approximately 3.5 million Americans are currently taking medication to reduce the number of migraine days they experience each month. However, the current available preventive therapies present challenges—including adherence, side effects, and overall treatment experience—which result in the majority of individuals discontinuing use of their preventative therapy after one year.
CURRENT MEDICATIONS FOR MIGRAINE
Some of the most helpful and commonly used medications for migraines include a family of drugs known as “triptans.” Triptan drugs act as serotonin receptor agonists. They help quiet overactive pain nerves. The literature suggests that triptans are designed to reverse the changes in the brain that cause migraines. Triptans are available as dissolvable pills, regular pills, nasal sprays, and injections. They include rizatriptan (Maxalt), sumatriptan (Imitrex), zolmitriptan (Zomig), and others. Some of these drugs may work better for one individual than another. It may take time before a doctor can find the right one. You should always consult with your physician about the various side effects of any drug that you are taking so that you are aware of the symptoms if you are experiencing trouble.
Ergot alkaloids are another type of drug that can stop a migraine. The most popular of this family of drugs is dihydroergotamine (DHE), which can be taken as a nasal spray or as a shot. NSAIDs (nonsteroidal anti-inflammatory drugs), such as ketoprofen or ibuprofen, may also stop a migraine attack. Often, doctors recommend taking anti-nausea drugs, too.
Another approach is using the eNeura Transcranial Magnetic Stimulator (TMS), a prescription device you place on the back of the head at the start of a migraine with aura. The TMS releases a pulse of magnetic energy to a part of the brain that may stop or lessen pain.
However, it is important to understand that all of these approaches have only a temporary benefit and are designed to manage patients’ discomfort for short-term periods. Taken for the long term, they may potentially create additional physical and emotional challenges and diseases. The human body is a system built on rules. These rules are organic in nature, and some can be bent, others can be modified, but none can be broken without a price. Therefore, synthetic medications will always manage but never cure the migraine condition or any other condition. This means that none of the above treatments are effective approaches to either understanding the cause of migraine or to effectively resolving the condition.
In the next segment “MIGRAINES: PART lll: Real Resolution: To a New Understanding of Migraine Headache Treatment,” I will discuss current treatments that exist and the HMD resolution.