Physiology of a Migraine

A Migraine means pain on one side of the head in the Greek language.  It is characterized by recurrent pulsating headaches that may vary from moderate to severe and affect only one half of the head. A migraine episode may last for 2 to 72 hours.  An aura ‘warning’ can occur prior to the onset of a headache or with a headache. Warning symptom or aura varies from person to person.

Classification

  • A Migraine without aura: This is a more common
  • A Migraine with aura: This is less common
  • Childhood periodic syndrome: It is a  precursor to a migraine and includes vomiting, abdominal pain, and vertigo
  • A Retinal migraine: This migraine associated with visual disturbances or temporary blindness in one eye
  • A Chronic migraine: In chronic migraine headaches occurs for more than 15 days in a month over a three months period.

Causes

  • Hormonal changes in women can trigger migraines: In such cases attacks are observed more commonly just before or after the menstrual cycle, during pregnancy or menopause. Fluctuating estrogen levels are a trigger factor for a migraine in women.
  • A migraine is familial: You are more likely to be affected by a migraine if your blood relatives suffer the same
  • Foods: Cheese, processed food, alcohol, wine and salty food are triggering factors
  • Stress: It is one of the common triggers for a migraine
  • Sensory stimulation such as bright light, loud noise, pungent smell do cause a migraine
  • Jet lag, change in sleep pattern, change in weather, physical exertion including sexual activities can cause a migraine
  • Medications such as oral contraceptives and nitroglycerin can aggravate a migraine

Symptoms

The Symptom of a migraine is categorized as prodrome, aura,  pain, and postdrome

Prodrome Symptoms: These symptoms occur hours or days before the headache/ migraine occurs. Altered mood, irritability, depression, fatigue, neck stiffness, nausea, diarrhea, craving for certain food and sensitivity to light and sound.

Aura Symptoms:  These symptoms precede or occur during a headache. Symptoms vary for each individual eg: sensitivity to light, noise, and touch. Aura can be associated with nausea and vomiting.

Pain: Pain is usually unilateral, throbbing pain varying in intensity, aggravated by physical activities, may be associated with nausea, vomiting, sensitivity to light, sound, smell and irritability.

Postdrome Symptoms: Once a headache subsides a person experiences a feeling of soreness or a “hangover” along with mood swings, fatigue and an increase in appetite.

Treatment in Allopathy

Treatment is aimed at preventing further attacks and reducing the symptoms during an attack.

Lifestyle changes

Regularizing the sleep pattern, avoiding trigger factors, increase in fluid intake, indulging in relaxation therapy

Medications

Preventive medications like topiramate, propranolol, gabapentin, pregabalin are used to prevent further attacks.

Painkillers such as diclofenac sodium are used to reduce a headache, antiemetics such as metoclopramide is used to control nausea and vomiting, antidepressants such as sumatriptan are used to control mood swings and irritability.

Surgery

Injecting irritants to an extracranial branch of the trigeminal nerve and cervical spinal nerves may reduce the intensity of pain in a migraine headache. This procedure is done in severe cases of chronic migraine headaches.

Ayurveda and Migraine

A migraine is referred to as Surya Varta, soorya means sun and avarta means affliction or blockage. A migraine is predominantly a caused due to Pitta dosha, which obstructs the flow of vata dosha in the brain causing a throbbing headache. Every case of a migraine would involve a unique combination of doshas. It is for your Ayurvedic physician to carry out a detailed root cause analysis to get to the bottom of the problem.

Treatment of a Migraine in Ayurveda

The aim of the treatment in Ayurveda is to cleanse toxins, balance Pitta and Vata doshas, give nervine tonics to strengthen the nervous system and rejuvenate body and mind through Rasayana.

Detox

A panchakarma is done to remove Ama or accumulated toxins from the body. The gastrointestinal system is thoroughly cleansed to remove excess Vata and Pitta dosha from the body. Vamana (emesis), Virechana(purgation), and Basti (enema)  are used for the cleanse.

Special panchakarma techniques like Shirolepa, Shirodhara, Kavla Graham, Shirobasti, and Sneha nasya are carried out to relieve the symptoms of a migraine.

Shiro Lepa consists of the application of herbal pastes like sandalwood, camphor, jatamansi to pacify Pitta dosha.

Shirodhara is used to treat disorders affecting the nervous system. A thin stream of liquid, mostly oil is poured over the forehead. When the oil is poured continuously, it causes vibration in the forehead, which allows our mind and nervous system to experience a deep state of mental rest. The feeling is almost similar to that of meditation.

Taila dhara with oils like ksheerabala taila, chandanadi taila is used when vata is predominant. Kaseera dhara (cow milk) is used when pitta is predominant

Kavala graham is an oil pulling technique. It is very effective in treating various ailments and also has a detoxifying effect on the body. In case of a migraine chandanadi tailam or mahanarayana taila is used for this treatment

Shirovasti is the application of medicated oils in the leather cap container fitted over the scalp. The gap between the cap and scalp makes the place to accommodate oil.  In case of migraine ksheerabala taila is used

Sneha nasya involves administration of medicated oils through nostrils, oils such as shadbindu taila or anu taila.

Ayurvedic Herbs

  • Yastimadhu (Indian licorice) is used to cure pitta predominant diseases
  • Sariva (hemidesmus indicus) used to create a balance in the three doshas
  • Amalaki (Amla) is the first herb of choice for a person suffering from a migraine headache. Increases the elasticity of the blood vessels and prevents high blood pressure.
  • Kumara (aloe vera) is used to treat symptoms of aura such as nausea and vomiting.
  • The ayurvedic herbs Ashwagandha and Brahmi is used to balance the nervous system. They are known to reduce reactivity to stressful events and raise the threshold at which the headaches are triggered.

Ayurvedic Diet

A Pitta and Vata pacifying diet is recommended to the patient. It is better to keep a predictable time schedule in eating. A diet rich in fruits, vegetables, and whole grains is useful for relieving migraine headache. Avoid hot spicy food, refined carbohydrate, and sugar as they aggravate the symptoms. Also, avoid having any stimulants like tea, coffee, and alcohol. Drink lots of water during the day.

Lifestyle modifications

Going to bed early and waking up before sunrise is advised for persons suffering from migraines. Excess sleeping should be avoided. Sun exposure from noon till sunset is best avoided by people suffering from migraines.  Increased consumption of water is beneficial

Yoga and Pranayama

Yoga and Pranayama

Yoga and pranayama help in calming the mind and relaxing the blood vessels. Yoga along with lifestyle modifications can go a long way in keeping migraine in check.  Kriyas like Jal Neti and Kunjal are useful.

Pranayama

Bhramari Pranayama or the Honey Bee Pose is one of the most recommended to treat migraine headaches. Bhastrika, Anulom-Vilom, and Kapalbhati are also beneficial.

Yoga Poses

  • Hastapadasana (standing forward bending): It benefits the nervous system by increasing the blood supply and also calms the mind
  • Setu bandhasana (bridge pose): calms the brain and reduces stress and anxiety
  • Shishuasana (child pose): calms the nervous system and effectively reduces pain
  • Marjariasana (cat stretch): improves blood circulation and relaxes the brain
  • Paschimottanasana(two-legged forward bending): known to relieve a headache
  • Padmasana (lotus pose): relaxes the mind and alleviates a headache
  • Shavasana (corpse pose): rejuvenates the body and brings it to a deep state of meditative rest

Naturopathy and Migraine

Naturopath takes a holistic approach to treating migraines. Its main aim is to find the root cause of migraines. Prescription drugs only target the symptoms and not the root cause. Weak digestion leading to a build-up of toxins, stress, exposure to environmental toxins, nutrient deficiency, allergies, and over stimulation of the nervous system. The naturopathic doctor first takes the complete medical history of the patient and then design the treatment protocol.

Treatment of a Migraine in Naturopathy

The treatment in naturopathy focuses on detoxing the body of toxins, modification of diet & lifestyle, and administration of extracts from botanical herbs beneficial for a migraine.

Detox

A naturopathic detox consists of fasting, enema, colon hydrotherapy, kidney and liver packs. Massages, head massages, mud therapy and hydrotherapy are also carried out to detox and rejuvenate the body.

Diet

Foods such as cow’s milk, cheese, wheat, chocolates, egg, orange, tomato, food dyes are to be avoided. High fiber diet consisting of fresh fruits, vegetables, beans, and whole grains are recommended. Green leafy vegetables and other vegetables like pumpkin, ridge gourd, squash, carrots and sweet potatoes are recommended.

Natural nutritional supplements such as wobenzym, magnesium citrate, Vitamin B6 and 5-hydroxytryptophan are beneficial in reducing the frequency of migraine attacks.

Lifestyle modification

Having a regular sleep with fixed time to sleep and wake up is very important to avoid a migraine. Avoid unnecessary stress in life is advised, increase in fluid intake is recommended and maintaining a clean surrounding with fresh air is very important.

Certain Home remedies

Submerging one’s feet in a bucket of cold water and applying an ice compression to the back of the neck is helpful in reducing pain during a migraine.

Acupressure is also helpful in preventing further attacks.

Massaging of lavender oil just behind the earlobe (temple) is proven to cure a migraine.

Botanical herbs

  • Ginger in any form is an excellent medicine for a migraine, having anti-inflammatory property.
  • Basil has an analgesic effect, this works well during a migraine.
  • Bay leaf has anti-inflammatory property hence used as a painkiller.
  • Catnip and chamomile, when taken in tea form have a mild sedative effect.
  • Feverfew is known as medieval aspirin has both anti-inflammatory and analgesic property.

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