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Migraines

Signs & Symptoms:
A migraine is a primary headache disorder manifesting as recurring attacks, usually lasting for 4 to 72 hours and involving pain of moderate to severe intensity (1). Typical characteristics of the headache are unilateral location, pulsating quality, moderate or severe intensity, and aggravation by routine physical activity. Sufferers may also experience auras, photophobia, phonophobia, nausea and vomiting.

Are Migraines Common?
Migraines are a common disorder (2); a UK follow-up study found the migraine incidence rate to be 3.69 cases per 1,000 person-years, and to be around 2.5 times higher in women than men (3).

What Causes Migraines?
Although the exact cause is unknown, we do know it starts deep in the brain with misfiring of neurotransmitters, which set in place a chain reaction. This results in many symptoms, which affect hearing, eyesight and ability to smell, and usually ends with a throbbing one-sided headache. Exactly what triggers a migraine is very individual to each person. For most people it is rarely just one trigger but a combination of factors which individually can be tolerated but when several occur together or accumulate, a threshold is passed and an attack is triggered.

Migraines are thought to be the result of temporary changes in the chemicals and blood vessels in the brain. The misfiring of neurotransmitters set in place a chain reaction although the exact cause is unknown. Exactly what triggers a migraine is very individual to each person. For most people it is rarely just one trigger but a combination of factors which individually can be tolerated but when several occur together or accumulate, a threshold is passed and an attack is triggered. Migraines can be exacerbated or caused by a variety of factors for example:

Emotional Stress and Anxiety

  • Anger, tension, worry, shock, depression, excitement

Physical Stress

  • Poor posture. This places greater strain on muscles of the neck and shoulders.
  • Muscle imbalances or faulty movement patterns. These result in certain muscles becoming overworked and tight.
  • Increased sitting / lack of physical activity. This increases stiffness of the muscles and joints.
  • Tiredness - Lack of sleep can lower pain thresholds predisposing to pain.
  • Squinting can increase tension in the muscles around the eyes, the back of the head, neck and shoulders.

Diet/Food

  • Long gaps between meals.
  • Insufficient food, fasting or dieting
  • Dhydration
  • Caffeine (coffee, tea)
  • Food sensitivities e.g. monosodium glutamate (used in preservatives in many prepared foods), aspartame (sweetener), cheese and other dairy products.
  • Nutrient deficiency. Certain micronutrients (such as magnesium) can cause or exacerbate symptoms.

Environmental

  • Lighting – bright, flickering, flashing.
  • Loud noise
  • Chance of climate/weather
  • Intense of penetrating smells
  • Smoking
  • Stuffy atmosphere

Hormones

  • Menstruation and the premenstrual period
  • Puberty
  • Pregnancy
  • Contraceptive pill
  • Menopause/Hormone replacement therapy

Other triggers

  • Use of sleeping tablets
  • Congested nose/sinus problems
  • Toothache or other dental problems (4)

Standard Care:
Many people with migraine can be adequately treated when the attacks occur, but some need prophylactic interventions, as their attacks are either too frequent or are insufficiently controlled in this way. Several drugs, such as beta-blockers, amitriptyline or sodium valproate, are used in the prophylaxis of migraine in an attempt to reduce attack frequency, but all these drugs are associated with adverse effects (5).

Your treatment plan

After a thorough medical history and examination procedure treatment needs to address the underlying causes and any exacerbating factors. 

Acupuncture
Acupuncture is commonly recognised as an aid to pain relief. N.I.C.E (the National Institute of Health and Clinical Excellence) concludes that acupuncture is a proven method to prevent tension-type headaches and migraine and doctors should prescribe it. Certain acupuncture points have been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety (6)

Acupuncture can help in the treatment of migraines by:

  • Providing pain relief by stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurochumoral factors and changes the processing of pain in the brain and spinal cord.
    Reducing inflammation by promoting release of vascular and immunomodulatory factors.
  • Reducing the degree of cortical spreading depression (an electrical wave in the brain associated with migraine) and plasma levels of calcitonin gene-related peptide and substance P (both implicated in the pathophysiology of migraine).
  • Modulating extracranial and intracranial blood flow.
  • Affecting serotonin (5-hydroxytriptamine) levels in the brain. (Serotonin may be linked to the initiation of migraines; 5-HT agonists (triptans) are used against acute attacks.(7)

Massage
A combination of bodywork such as tui na, acupressure, massage, reflexology, relaxation, breathing and mindful awareness exercises are also a core strategy that has proven helpful for many people.

Other Lifestyle factors - Creating restful sleep patterns, making sure you have the right diet, nutrients and nourishing eating habits are also key, as well as addressing any emotional issues that may be involved.

British Acupuncture Research Fact Sheets - For further information please take a look at the related issues section on the right hand-side of the screen.

References:
  1. IHS 2004. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004;24:1 160.
  2. Olesen J et al. Funding of headache research in Europe. Cephalalgia 2007;27:995 9
  3. Becker C et al. Migraine incidence, comorbidity and health resource utilization in the UK. Cephalalgia 2008;28:57- 64.
  4. http://www.migraine.org.uk/information/triggers
  5. Managing migraine. Drug and Therapeutics Bulletin 1998;36:41-44
  6. Wu MT et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain-- preliminary experience. Radiology 1999; 212: 133-41.
  7. British Acupuncture Council research fact sheet - Migraines 
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  • I was referred to Lorna by my local GP after the re-occurance of problems in my shoulder and neck. The injury was from being hit by a car while out cycling over 18 months ago. Lorna quickly assessed the problem of the damaged muscle area but also correctly predicted the secondary effects on other muscles. Lorna is very professional and dedicated to her work that it makes your treatment less stressful. I would recommend Lorna to anyone, especially sports people looking to clear up injuries in a positive way with long term benefits.

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  • Lorna's amazing, such a lovely way about her that I overcame my fear of needles and gave it a go. Turns out they're nothing like normal needles, they're tiny! Now I get regular accupuncture and it gives such a deep relief to my muscle tension and back pain. I come out feeling super relaxed with a softened back and muscles like jelly, all the tension completely gone, ready for a long deep sleep.

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  • From the start I’ve found Lorna to be very professional. The setting created in the office was very relaxing and comfortable in one of our meeting rooms. Lorna explained the process of acupuncture and the steps in the treatment to follow. As the treatment started, Lorna determined the main spots in the back and neck area where the tension was. She was spot on and as she inserted the needles I could immediately feel the muscles in my neck, shoulders and lower back relax. She put on some relaxing music while she attended to another patient next door. The 15-20 minutes or so relaxing with the music and acupuncture felt like heaven. I was definitely more relaxed in my shoulders and neck in the days that followed.

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    Hentie (29) Acupuncture at work - EY Channel Islands
  • Massively grateful to Health Point Clinic's Lorna Jackson for the incredible difference she's made to my chronic back pain... Oh my god, why didn't I get on to acupuncture years ago?! Lorna didn't just address the issues that were highlighted by all of the 'regular' doctors, consultants and experts - she nailed it (pardon the pun) with astute recognition of a number of my body's quirks, such as hyper mobility as being a contributing factor to everything else; three prolapsed discs, facet joint problems and pain and sciatica and numbness - to name a few of the delightful symptoms. For the first time in a very long time, I feel like someone listened to me, took notice of my chronic pain symptoms and the other attributed issues and addressed the root causes of what has been one of the most hindering factors in my life. I cant recommend Lorna Jackson and Health Point enough. I'm more mobile, my pain is barely measuring on the 1-10 for the most part, and I'm starting to feel like I can get my life back on track. Only three/four weeks ago, I honestly thought I was going to end up in a wheel chair within the next few years. The pain metrics between 1-10 meant nothing - constant mind shattering pain and immobility don't 'fit' within a 1-10 scale... Now I feel like I'm almost ready to start those essential core exercises and address the strength, fitness and maintenance that my body so desperately needs.

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