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Brian Carter, acupuncturist, herbalist, and author  

Migraine Headaches:

Medicines for Relief, Natural Treatments, Causes and Cures

by Brian Carter, MS, LAc

Brian is the founder of the Pulse of Oriental Medicine. He teaches at the Pacific College of Oriental Medicine and maintains a private acupuncture and herbal practice in San Diego, California, and is the author of Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure.

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Migraine headaches and the symptoms of migraine are a common problem with both biomedical and chinese medicine treatments. The cause of migraines is unclear. There is speculation about allergy (primarily food but also airborn), specific foods, scents, and environmental toxic load. Despite the lack of clarity in cause, there are still drug treatments and natural "cures" that provide relief for migraine sufferers. Prevention forms a large part of the treatment for frequent "migraineurs" whose symptoms are severe.

Migraines affect one tenth of Americans and cost us an estimated $5 to $15 billion per year. Migraines are three times more common in women, and they peak at mid-life in both sexes. Everyone is beginning to understand that migraines are a serious disorder that steal our ability to work, study, play, and enjoy our families and friends. It's not anonymous either; Elvis got migraines, Chicago Bull Scottie Pippen does and Thomas Jefferson did too. Nor are migraines simply an American problem; nearly one third of Peruvians suffer from these terrible headaches.

The Symptoms of Migraine Headache

The pain is usually throbbing (because it is vascular). Migraines may be one-sided (the word migraine is a 15th century adaptation of the latin hemicranium, which means one side of the head) but not necessarily; migraines can affect your entire head. They can last from an hour to a few days, and often are accompanied by nausea or vomiting. You may also suffer from light, sound, or smell-sensitivity. Indeed, these last three may trigger your attacks. Migraines may or may not be preceded by an aura. The migraine aura may be a visual disturbance such as flashing lights or loss of peripheral vision, or one-sided tingling or numbness, heaviness of limbs, or even difficulty speaking. These are symptoms of the increased vascular pressure in your brain.

Warning Signs of More Serious Problems

You should have a migraine diagnosed by a physician, because there are more serious problems they need to rule out first. You don't want to just be taking amerge or maxalt if you actually have a brain tumor, and your Chinese Medicine doctor can't order you a CT scan or MRI. If you're over 50, have more pain with chewing, and you have a fever, you need to get checked out for Temporal Arteritis, because that can lead to blindness if it's not treated! Here are some more warning signs:
  • Sudden violent pain
  • More serious changes in speech, vision, and personality
  • A headache that wakes you out of sleep
  • Fever and a stiff neck

OK, so what causes migraines?

The short answer is that we don't know. Drug treatments for migraine attacks (triptans like Imitrex, Zomig, Amerge, and Maxalt) work pretty well. The theory is that they make up for the problems cause by a lack of serotonin. However, they do not really understand the initial cause - what sets in motion the cascade of events that culminates in a migraine headache. There has been a good deal of research on food allergies and diet, but it appears that they are not the only factor. Each person may have different triggers and sensitivities, so prevention is an individual solution that must be worked out between you and your and doctor. From a Chinese Medicine perspective (link to flaws amazon), we believe that emotional excesses (stress, long-term emotional disturbance, even just long-term frustration!), dietary imbalance (too much of the wrong foods and too little of the right ones), and the deficiencies inherent in the aging process (I like to call it 'maturing') can lead to the symptoms of migraine.

Chinese Medicine Refines the Migraine Diagnosis

In Chinese Medicine, we diagnose each patient according to what is called a pattern, or group of symptoms. There are 5 basic patterns involved in migraines (although real people are complex and may have several patterns going on at the same time). If there is enough interest, I can write a follow-up article on the patterns and herbal formulas. But for now, you can get in touch with a good Chinese Medicine herbalist and get a diagnosis and herbal formula there. In fact, you may be recommended two formulas- one for your attacks, and another one to take preventively.

Acupuncture for Migraines - The Pain "Reset Button"

At the Pacific College of Oriental Medicine, a prominent neurologist told us in a guest lecture how acupuncture treats pain. His message was that chronic pain signals can get 'grooved in' to the brain. That means that even after the real problem has been totally eliminated, the brain may still be "echoing" pain signals to us. Acupuncture can act as a 'reset button' to end these echoes of pain. The sooner you get acupuncture, the better, because the longer the pain is there, the more difficult it is to change.

Migraine Prevention

Since migraines are the culmination of many stressors and triggers, you can view your condition as a nearly full glass of water. If you pour more stressors and triggers in, it will overflow into a migraine headache. However, if you keep the stressors and triggers down, and lower the baseline level by clearing out the tensions (qi stagnation), toxicities, inflammation (heat), plus strengthening your systemic weaknesses, it will be harder for you to end up with a migraine. You'll be stronger and less sensitive.

Migraine Prevention Step 1: Be regular in sleep, exercise, and eating!

I have trouble with the sleep part of it at times when I feel like staying up late to work. I have to consciously begin to wind down hours beforehand by getting organized for the next day, putting on some pajamas, making some relaxing tea, and reading a book. I find it's best to read more dull or philosophical non-work-related books. If I read anything exciting, I may get great ideas I don't want to wait on. I save my inspirational material for the mornings to get going on the right foot. More sleep tips.

And don't forget about naps. Many of us migraneurs have to lay down with a pillow over our head when its really bad. I've found that laying down for a bit works just as well to stave off an attack if I am starting to get some initial warning signs.

The type of exercise that suits you depends on your constitution. Some people are more naturally bound up and frustrated and need aerobic exercise. Others are more tired and should walk moderately. If you do the appropriate exercise for you, you improve your body's ability to function healthily. Don't overdo it, and don't underdo it.

My two biggest obstacles to regular eating are appetite and work. I'm not as hungry in the morning. I drink a protein/carbo shake so that I'm not running on empty, and it's not hard to digest. Then, if I get too involved in work, I may forget to eat. I have to take regular breaks to reconnect with myself and God so that I can be connected with my body and know the best way to take care of it.

Migraine Prevention Step 2: Discover your Stressors and Triggers and Eliminate Them!

Migraines can be caused by many factors. The key is to discover yours and eliminate them.

Some people have many food allergies, while other people have none. Food allergies are hard to track because today's symptoms may be from any food in the last 3 days. Your physician or Chinese Medicine doctor can order you a pretty complete blood test for food allergies through Great Smokies Diagnostic Laboratories. This is much easier and more reliable than a several-month-long elimination diet. Even if you are allergic to foods, you don't have to totally give up them up. You just rotate them (eat them less often).

I had to (very relunctantly!) quit drinking coffee and espresso. I wasn't 100% sure they were a problem, but I knew that, for my Chinese constitutional type, they could be. I have had less migraines and less frustration since I quit, so I see that as one step in my journey toward health and away from migraines! I didn't totally give up caffeine; I still drink green tea moderately in the morning or if I feel tired.

If your migraines are stress or emotion-related, you have two options: cut out the source of the stress (a person, a job, a task, a situation), or work on your reaction to the stressor. I realize not all of us can just change jobs, and we may not feel right expelling a person from our lives, so the better way is to work on our buttons (the ones they push). I am working on an article on this topic for the June 2002 issue. If you need help sooner, just email me (bbcarter@pulsemed.org).

Migraine Prevention Step 3: See Your Chinese Medicine Herbalist and Take Chinese Herbal Formulas

Your acupuncturist may or may not be capable of this. Herbal education standards vary across the United States; some acupuncturists have no training in Chinese Herbal Medicine, while some are as advanced as or more than those in China. Chinese Herbal Medicine is very complex (uses multiple herbs in specific combinations), and can be very effective. Everyone gets a slightly different formula because we're all unique. There are pre-formulated versions, but even then your formula may be different from your significant other, cousin, or dog's herbal formula.

As I mentioned above, you will probably be recommended one (acute) formula to take during attacks, and another to take preventively between attacks. This is a good thing, because while you are still working on steps 1 and 2, you will still be experiencing migraines more frequently, and you will rely on the acute formula more. As you improve, you will use the preventive formula more. If you get this far and have changed your lifestyle in steps 1 and 2, you may eventually be completely cured.

Is This a Natural Cure for Migraine Headaches?
No one is 100% sure what causes migraines, so it's not 100% certain that all migraneurs can be cured. Our goal is treatment, management, and prevention. For my migraines, I use a combination of western and eastern medicine. I take several herbal formulas both preventively and acutely, and sometimes I even take Excedrin Migraine. I find I cannot take the excedrin at night, though, because it contains caffeine, and I believe staying up late would lead to a continuing of the imbalances that cause my migraines. That is why prevention and herbal remedies are so integral to the management of migraine headaches.

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