American Fitness Professionals & Associates

By: Ruth Dalsky, MEd and Diane Wakat, Ph.D.

Migraine headaches have been tormenting people since the time of Hippocrates. And torment is the correct descriptor, because migraines can be debilitating. They can range along a continuum from mild headache and no disability to excruciating pain and complete dysfunction. They can last for hours or days; they can make you nauseous, photophobic (sensitive to light), and phonophobic (sensitive to sound). And they have serious economic consequences as well, leading to the loss of millions of work days per year.

Headaches are not a minor malady; they are the seventh leading reason for why people seek medical assistance in the US. More than 18 millions out-patient visits per year are due to headache. Of the different types of headache, women are more likely to develop tension headaches or migraine headaches - while men are more likely to experience cluster headaches.

Migraines are unfortunately too common, affecting about one in 10 adults internationally - predominantly women. The prevalence of migraine headaches in adults is about 6% in men and 15-19% in women. These figures vary with age, but the occurrence increases from puberty until age 40, and then declines more significantly in older men.

At least we’ve come far enough along the path of understanding migraines to have dismissed the ancient belief that headache was the result of demonic possession. But we still know more about what the precipitating factors are and about how to treat migraine pragmatically than we know about its underlying biological cause.

There is a long standing debate as to the cause and nature of migraine headaches. This debate focuses on whether the origin of migraines stems from a vascular disturbance or a neurobiological imbalance. However, there may be an underlying mechanism involved in the development of migraine headaches that is characteristic of both theories. The role that serotonin plays in the brain may be a link between the neural and vascular systems. Therefore, regulating the role of serotonin receptors may help prevent migraines and lead to significant therapeutic outcomes.

Experience has shown that certain foods can act as triggers in the onset of a migraine attack. Food culprits such as chocolate, caffeine, cheese, fish, wheat, nuts, tomatoes and alcohol (red wines and champagne) are the most well-known triggers of migraines. Certain food additives such as sodium nitrite (found in processed meats and hot dogs), MSG (Chinese foods), and food colorings may also cause migraines. Tyramine, a natural substance which is found in foods thathave been fermented or aged - such as wine, cheddar and blue cheese - may trigger migraines.

Certain levels of female hormones may also trigger the onset of or contribute to the intensity of a migraine. The all-too-predictable headaches that develop across the 3-5 days before a woman’s period are even referred to as ‘menstrual migraines.’ Women may experience a greater number and more severe migraines with pregnancy, lactation, and in particular with menopause. Estrogen replacement therapy does not seen to alleviate these migraines, and in some instances may even exacerbate the condition.

The use of computers has also contributed to an increased incidence of migraine. One type, ‘cervicogenic migraine,’ is precipitated by muscle tension and spinal rigidity in the neck. Staring at a computer screen, holding your head in one position for long stretches, really tightens up the neck and shoulder muscles - constricting the nerves and blood supply to the neck and head. That’s a prime trigger for a migraine.

There are natural remedies that can benefit a person susceptible to migraines. Nutritional therapies that have been shown to be helpful include Vitamin D and calcium (for menstrual migraines, in particular); magnesium (600 mg/day); and high-dose riboflavin (400 mg). Good hydration (drinking enough fluids) is also important.

One of the most effective natural remedies for preventing migraines is parthenolide, a compound found in the herb feverfew. It is used best as a preventive, but can also help blunt a migraine when it occurs. The key is in getting the effective dose of parthenolide, which is 250 micrograms. Just using a feverfew supplement may not work, since it doesn’t contain a standard amount of parthenolide. Another herbal aid for migraine is ginger. Ginger can settle the stomach, and may reduce some migraine symptoms after the fact.

Standard medical treatment for migraines includes one or more of the following, depending upon whether the strategy is to prevent a migraine attack or if symptomatic relief is being sought. Options include aspirin (low dose for prevention), non-steroidal anti-inflammatories (NSAIDS), Sumatriptan, Beta blockers, calcium channel blockers, and even hyperbaric oxygen.

Although there has been no steadfast cure or prevention of migraines, exercise and other natural remedies can be used effectively to prevent or abort a migraine attack. Chiropractic and massage may be especially helpful for cervicogenic migraine. Acupuncture, biofeedback, and stress reduction have been proven effective in many cases. By the way, if you use exercise to reduce the frequency or intensity of a migraine, don’t exercise during an attack (as if you felt like it!).

It’s important to appreciate that ‘migraineurs’ may need to practice one or a combination of these strategies to prevent migraines, or to limit the intensity of a migraine headache. Knowing and avoiding migraine triggers, especially in foods, can make a big difference in the quality of life - by preventing the pain and debility that these nasty headaches cause.