
Understanding Migraine (Part I) – Root Cause and Triggers
It has been many months since my last post – I have been busy with my work and some other priorities. I hope you are all keeping safe and healthy!
In this post, I am covering “Migraine” – one of the problems affecting a large population across the world – particularly women. And, this is an area where Yoga as a therapy has been largely successful not only in alleviating symptoms, but also recovering completely – if practiced diligently under the guidance of a Yoga teacher experienced in therapy.
Symptoms
Migraine is associated with periodic, throbbing headache often accompanied by nausea and vomiting. The pain can be at the front, back, or sides of the skull. The migraine attack may also be preceded by sensitivity to light and sound, visual blurring, or numbness in the lips. The intense pain is mostly related to the dilation of blood vessels in the head. A migraine, as distinct from a stress headache, is usually one-sided and lasts for many hours to a few days. Most often migraine hits between 6:00 am to noon when the sympathetic nervous system is in ascendance.
The Root Cause
The exact cause of migraine is not fully understood by medical science. Migraine is similar to many other “psychosomatic diseases” without demonstrable pathology but characterized by disorders of homeostasis (imbalance in the nervous system). Most researchers think that migraine is due to abnormal changes in levels of chemicals (hormones and neurotransmitters) that are naturally produced in the brain. Emotional disturbance/stress results in an imbalance of the autonomic nervous system (we covered this in detail earlier) and causes the brain to change the levels of these chemicals abnormally. These disturbances cause inflammation, which results in blood vessels in the brain to swell and press on nearby nerves, causing intense pain. It is important to note that such vascular reaction is secondary to the primary cause, which is the cerebral mechanism (functioning of the brain) – that involves the Hypothalamus. The hypothalamus plays a crucial role in many important functions like controlling the actions of the autonomic nervous system, releasing hormones. regulating body temperature and so on. Hence the holistic therapy for migraine should involve bringing the balance in the autonomic nervous system, and not just managing the headache alone or the triggers (mentioned below).
Triggers
Though the root cause of migraines is an imbalance in the autonomic nervous system, people react to a variety of factors and events, called “triggers”. These triggers can vary from person to person and don’t always lead to migraines. A combination of triggers – not a single thing or event – is more likely to set off an attack. A person’s response to triggers also can vary. The main triggers include:
- Stress – Though emotional disturbance/stress over a longer period is the primary cause, sudden stress like physical exertion and/or emotional trauma, can trigger instances of migraine.
- Hormonal changes – Many women are more prone to migraines before or during their menstrual periods. Many times, migraine starts and/or worsens at puberty and menopause – when hormonal shifts are significant. In general, women report suffering from migraine headache twice as often as men.
- Overstimulation of sensory organs – Bright lights, loud noises, or strong odors may trigger migraines.
- Muscle tension – Many times, stress and overworking, because of a sedentary lifestyle (very typical with people in IT) trigger migraine-like symptoms. These people stay in a posture for a long time where the head and shoulders are carried well forward, with the chest collapsed and the thoracic curve exaggerated. This results in muscle tension in the neck, shoulder, and cranial areas – causing muscle-contraction headache, which over a period of time gets converted to migraine.
- Food – For many people, certain foods, alcohol, or caffeine can also trigger migraines. Sudden changes in dietary patterns can also be a trigger point. Though alcohol is a vasodilator at low concentrations, it becomes vasoconstrictive at higher levels, worsening migraine headaches and symptoms including increased blood pressure. Also, even skipping a meal can trigger a migraine attack.
- Sleep – As discussed in a series of blog posts earlier, unhygienic sleep habits can cause multiple disorders. Lack of sleep or too much sleep can trigger a migraine. People with Insomnia are prone to migraines.
- Environmental Extremes – extreme weather conditions may also trigger a migraine.
From a medical science perspective, the pain associated with migraine involves the trigeminal nerve (Cranial Nerve V). The migraine headache begins with hypersensitivity of the visual area of the occipital lobe. Scientific study suggests that when this area is stimulated, it leads to the production of the prostaglandins in trigeminal pain pathways, which in turn causes vasodilation – resulting in pain. Experiments also show that there are intimate connections between different sensory channels. In the case of migraine, a crossed-wires effect between these signals may occur which may cause the absorption of light by the eyes to vasodilate of the blood vessels in the brain – leading to migraine headaches. Readers further interested can also find the relation between Photo Sneeze Reflex and Migraine useful – in both cases crisscrossing within the trigeminal nerve is involved. Evidence also suggests that low levels of the norepinephrine and can contribute to migraines and other psychological and physiological conditions like insomnia, Attention Deficit Hyperactivity Disorder (ADHD), depression, fibromyalgia, and low blood pressure. At the same time, high levels of these can cause anxiety, hypertension, palpitation, and headaches.
Lifestyle Changes
Modern science has no permanent cure for migraines. Your migraine can be managed by the Doctors by finding out the ways to treat migraine symptoms (the secondary cause) as and when they happen. You can reduce migraine instances by making changes in lifestyle:
- Understand your triggers and avoid/limit them.
- Follow sleep hygiene. We covered this in one of our previous posts.
- Eat healthy foods and do not skip meals. The magnesium-calcium imbalance may trigger or exacerbate migraines. Himalayan pink salt (called “Sendhav Namak” in India) is rich in minerals and known to bring the electrolytic balance. Banana is also a good source of minerals.
- Vitamin-D supplements can help as a deficiency of it may trigger migraines.
- Engage in regular physical activity – Yoga (restorative in particular), jogging, walking.
- Limit alcohol and caffeine intake.
- Learn ways to reduce and cope with stress.
- Stop any unguided Yogasana or Pranayama practice. Alkalosis (higher levels of blood and extracellular pH levels – as a result of over-breathing) is also known to trigger a migraine attack. This can happen with the wrong Pranayama practice, which we will cover in a future post.
In our next post, we will see how a practice of Yogasana and Pranayama under proper supervision can help alleviate the migraine condition – and even eventually recover completely from it. The benefit of this approach is that it directly manages the root cause – an imbalance in the autonomic nervous system. We will also cover Yoga poses that will help alleviate the symptoms of migraine when it gets triggered.