June is migraine awareness month. About migraine from my website by Celeste Cooper, RN

https://www.thesethree.com/Headache___Migraine.html#.UatjAECOAtg

SEVERE HEADACHE and MIGRAINE
by Celeste Cooper

What is a headache?

Headache means, simply, “pain in the head.” Headaches, AKA cephalgia, generally are a symptom, not a disease, and may be caused by various factors. If it is a new symptom for you, have it checked out immediately as sudden onset, unusual headache can be an indication of an impending stroke.

Migraines have been thought to be vascular in nature, however, there is new evidence they are caused by a nerve disruption in the brain that affects the vessels. Not only is the cause under debate, some believe  that migraine should be considered a disease.

Types of headaches

Migraines, often described as classic migraine (with aura), common migraine (without aura), cluster headache, hemiplegic migraine or ocular, but not always depending upon the resource. Terms and the way the experts look at migraine change as research and studies evolve.  If you have them, you will know the symptoms that apply to you. There is evidence that a tendency toward migraine is inherited.

Sinus and tension headaches are often misdiagnosed as migraine and confusingly enough the opposite can be true.  This is why you need to be under the care of a specialist if your severe headaches are chronic. 

Classic migraine is a recurrent, throbbing headache accompanied by other symptoms such as loss of appetite, nausea and/or vomiting, fatigue, and sensitivity to lights, noise, and smells. They are usually on one side of the head, sometimes preceded by an aura, which is a transient visual, sensory, auditory, motor, speech, or cognitive symptom. They can last for hours and can occur frequently. 

Common migraine is accompanied by the symptoms of classic migraine but without aura. It is usually described as throbbing or a constant ache when lying still. It, too, is usually one-sided, and can shift from one side to the other either in the same attack or subsequent attacks.  Occasionally it can affect both sides of the head. Common migraines can vary widely lasting for several hours to several days. Frequently they involve the temple area or may start at the back of the head just below the skull. Myofascial trigger points in the neck can also refer pain to the temple and be a huge component to migraine that can be easily overlooked.

A cluster headache is an intensely painful headache with sudden onset and can last from minutes to an hour. It too is usually on one side and is frequently associated with flushing, sweating, runny nose, and increased tears.  Because they seem to repeat in groups of occurrence, they are called cluster headache. 

A hemiplegic migraine is a vascular headache that causes one-sided weakness or sometimes paralysis that lasts beyond the event. Hemiplegic migraine is a sub-type of migraine with aura (classical migraine). Three genetic markers have been identified.

Ocular migraine is sometimes non-painful or can be accompanied by other symptoms of migraine. It causes temporary loss of vision or blind spots in the visual fiend in one eye. This can be very scary unless and until a diagnosis is made. They can last for hours or several days. They are also described as retinal, ophthalmic, or monocular.

Tension headache is often associated with tight muscles indicating the involvement of myofascial trigger points.  They can also be perpetuated by cervical (neck) disease. Sometimes these are called cervicogenic migraine and can be episodic or chronic. I recommend Trigger Point Therapy for Headaches & Migraines, by Valerie DeLaune.  

Sinus headaches are often confused with migraine or be misdiagnosed as a sinus headache when it is a migraine.  Generally, they occur when there is inflammation of the sinuses, which are air cavities located in the face. Because rhinorrhea, nasal discharge, is also associated in some migraine, the two can be confused. The distinguishing feature is pain usually accompanied by other sinus symptoms, such as nasal discharge, feeling of fullness in the ears, pressure, fever (indicating infection), and facial swelling. 

Miscellaneous Headaches

According to the International Headache Society, miscellaneous headaches are classified as, idiopathic stabbing headache, external compression headache, benign cough headache, benign exertional headache, and headache associated with sexual activity.  

Triggers

A variety of factors can play a role in headache. Identifying your triggers can help you eliminate some perpetuating factors such as allergies, particular foods, bruxism (teeth grinding) and alcohol.  Some people with headache note they are increased during periods of hormonal fluctuations, and weather changes. Those of us with migraines, called migraineurs can often predict the weather better than the forecaster. 

Identifying the cause of your headache is important so that you can minimize the perpetuating factors.  You are certainly not alone, however, it is important to recognize that even if you do everything right, the migraine can still persist.  All we can do is the best we can do.

Treatments

There are medications. Medications for acute migraine attacks, medications to prevent migraine, some natural remedies and over-the-counter medications may be in order. Adjunctive therapies such as myofascial trigger point treatment, electrotherapy such as a TENs unit for cervicogenic migraine may help, and the use of a night guard if you are a teeth grinder. Antibiotics and/or anti-inflammatories are indicated if the headache is due to a sinus infection or chronic sinusitis. 

Some patients find ice packs helpful, others heat.  Some find acupuncture or biofeedback helpful. Trigger point injections can be helpful when done by someone who understands the myofascial component.  Botox therapy has fallen out of favor. 

For severe refractory migraine that occurs several times a week, neurostimulation may be indicated. It uses light electrical currents to activate or modulate neurons, and according to a study on implantable neurostimulators by Reed et al, in 2010, they found “combined occipital nerve-supraorbital nerve neurostimulation systems may provide effective treatment for patients with chronic migraine and refractory chronic migraine headaches. For patients with chronic migraine headaches the response to combined systems appears to be substantially better than occipital nerve stimulation alone.”  There could be a gut connection.  Research continues into the exact cause of migraine, components, and various treatments, and this is why some are hesitant to call migraine a disease.

I know personally that migraines and severe headache can be disabling and life limiting when they are chronic.  Seek help from someone who is specialized in the management of chronic migraine or severe headache as new advances are being made every day.

For more information see Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-body Connection.  Cooper and Miller. Vermont: Healing Arts Press, 2010.

Or 

MAGNUM, the National Migraine Association.

BODY-WORK: The Anatomy’s ’ Labor of Love Manual therapies you might find helpful for chronic pain.

by Celeste Cooper, RN

Chronic pain wears us down regardless of the source. There are many painful disorders recognized in May, and I have discussed ways to advocate and raise awareness, now it is time to say something about what we can do to help our body not only function better, but feel better too.

Self-Responsibility, “…One thing that seems to have been forgotten to a surprising degree is the lifelong plasticity of most of our bodies’ tissues, and the manner in which our whole style of living molds this plasticity in innumerable ways that could never be anticipated by the coding of our DNA.
~ Deane Juhan, author of Job’s Body: A Handbook for Bodywork

  

The myofascia covers all muscles, and it is part of the largest organ structure of the body, connective tissue. Is it any wonder so many chronic pain conditions share myofascial dysfunction?

The continuum of connective tissue for the most part is not made up from living cells, instead it is made up of fluids and fiber. Because of this, we need to help it along either manually or by stretching, keeping the life fluids going in and the waste fluids going out.

Massage therapy

Somewhere along the line, we forgot about the value of touch. As one of our major senses, touch has more than one job. It provides information to the brain regarding impending danger, and it provides feelings of comfort and caring. Massage therapy provides helpful feedback to the body and the brain, promotes relaxation, and relieves stress and physical pain and mobilizes stagnant fluid in the lymph system which is dependent on physical movement and manual stimulation.

The type of massage therapy depends upon your personal tolerance. Until your brain learns to like it, it is prudent to start with soft touch. As you progress, you should eventually be able tolerate bodywork that helps with deep muscle and joint function.

Massage therapy versus bodywork

Massage is a manipulation of the body using hands on touch therapy by stroking, kneading, and rubbing soft tissue. Massage is sometimes accompanied by aroma therapy, hot rocks, and other modalities to help you

achieve a full body experience.

Bodywork on the other hand, is a distinct therapy and requires advanced training. Bodywork targets specific areas of the anatomy that are holding back the body as a whole. It is a systematic therapy with specific goals for improving function and feelings of well-being. For instance, a good bodyworker knows how to break down restrictive tissue, such as adhesions and scars, and treat knotted up and tense muscles, thereby restoring the normal flow of blood and lymph. When you see a bodyworker, it is prudent to start with the problem that bothers you the most, pain, swelling, muscle weakness, etc.

The goal of both massages therapy and bodywork is to restore balance to the mind-body connection.

Myofascial trigger point massage/bodywork

Myofascial pain syndrome (MPS) has been associated with spinal disease, arthritis, sport injury, post surgical restrictions, migraine, chronic pelvic pain (including vulvodynia and bladder disorders), teeth grinding, TMJ, fibromyalgia, chronic fatigue syndrome, restless leg syndrome, TMJ, bowel dysfunction, sexual dysfunction and impotence, and the list goes on from there.

If you know you have co-existing myofascial pain syndrome which is identified as myofascial trigger points lasting more than three months,  specific bodywork is indicated. Read more here. 

Myofascial trigger points (MTrPs) are called “neurological imitators.” This explains why physicians who do not understand MPS are perplexed by what they think are unexplained tingling, numbness, or sensations of needles and pins, or other associated sensation abnormalities their patients often experience.

Myofascial trigger point pressure therapy by someone trained in the work of Travell and Simons, here,  is helpful in this instance.  You can also learn to do self treatment using tools such as tennis balls, Theracane, or Knobbers, Yoga ball, swim noodles, and a good book on self treatment, such as Clair Davies, The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, forward by Dr. David Simons. (May you both RIP gentle souls).

Basically, any organ or body system can be affected by myofascial trigger points (MTrPs), they can also obstruct blood circulation, nerve transmission, and lymphatic flow. Learn more about MTrPs here. 

Conclusion

Bodywork and massage therapy comes in many shapes and sizes. The good news is that the current level of thinking among medical practitioners is that it works!

The next hurdle to overcome is getting insurance to cover it as a helpful medical tool. I want you to know that people are fighting for the integration of these types of therapies and more.  Raising awareness, such as what we do at the Pain Action Alliance to Implement a National Strategy, here, will help in these endeavors.

The goal of and bodywork is to keep all body parts in motion with the least amount of stress. Learn more about different types of bodywork, such as, Alexander technique, craniosacral therapy, shiatsu, myofascial release, reflexology, Rolfing, Rosen method, myofascial trigger point therapy, self treatment for myofascial trigger points, spray and stretch, acupressure, Trager work, Vodder manual lymphatic massage/drainage, and how to find the right, qualified therapist here.

You can also find helpful tips on massage and finding the right therapist in the Fall Devotions of the Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain, here.

*As with everything medical, there are some risks for certain people. These include, fear of touch, bleeding disorders or take blood-thinning medication, burns, open or healing wounds, blood clots in the veins, fractures, severe osteoporosis (brittle bone disease), or other severe bleeding disorders. If you are in doubt, be sure to check with your physician.  

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  For more information about the author see http://TheseThree.com

Check pub med for citations

As with any new therapy, discuss any risks for your particular condition with your physician first.

Answers are based on the writings/books of the author and are not meant to replace medical advice.

Celeste Cooper interviewed by Cinda Crawford on the Health Matter’s Show. Fibromyalgia, Chronic Fatigue Syndrome and other May awareness disorders:

Improving Perceptions, Using Anger to Your Advantage, and Managing Strategies for a Complete Life despite Pain and Other Life Altering Symptoms

Two Interviews PART ONE and PART TWO

Each interview is approximately 30 minutes.

 

Part One:

Part one of the interviews with Cinda Crawford, regards awareness and the importance of advocacy, including tips for how you can contribute your time, talent and treasures.

We cover important topics such as:

• What conditions are considered for MAY awareness?
• What is a neuro-endocrine-immune disorder/disease (NEI/NEID)?
• What overlapping conditions are also honored in May? You could be surprised.
• How you can participate
• Support for organizations and individuals

Learn about your kissing cousins, what others do for you and how to use your own time, talent and treasures to make a difference for everyone.

You will need to copy and paste the following link in its entirety into your web browser:

https://www.audioacrobat.com/playweb?audioid=Pb5dd383b9d44c671a7af979de4ae06cbZVl7RnxuY2dwUA&buffer=5&shape=6&fc=33CCCC&pc=CCFFFF&kc=20&bc=FFFFCC&brand=1&player=ap21

Part Two:

Chronic pain and illness can create feelings of frustration, fear, anger and helplessness. In part two of the interview we discuss ways to address these feelings and start a journey to make a difference in your own life.

There are four key elements to being whole and finding balance in our life. We talk about everything from sleep and diet to learning the value of emotional and spiritual awareness. The four elements for fullness and balance are:

• Physical
• Emotional
• Mental
• Spiritual

You will need to copy and paste the following link in its entirety into your web browser:

https://www.audioacrobat.com/playweb?audioid=P59f02ac9621a152c3b1ef08e3dbd36aeZVl7RnxuY2dwVw&buffer=5&shape=6&fc=33CCCC&pc=CCFFFF&kc=20&bc=FFFFCC&brand=1&player=ap21

 

Cinda Crawford is a health counselor and host of the Health Matters show, a mind-body healing author, ordained minister and creator of Sacred Celluar Healing.

Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD), and contributing author to Deirdre Rawlings, Fibromyalgia Insider Secrets: 10 Top Experts.  

Celeste is also a fibromyalgia expert for Dr. Oz, et al., at Sharecare.com,  and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy (PainsProject.org). Her website is www.TheseThree.com