Yoga Therapy: A holistic approach for migraine reliefJun 04, 2023
"Like others, my migraine blindsides me when it strikes and takes away whatever I had planned for my day. When a migraine hits, all I want to do is lie down in a quiet, dark room, and it leaves me feeling isolated and helpless. I dread those migraine days and fear that the migraine pain is going to be bad enough to keep me from being there for my family, friends, work..." - Khloe Kardashian, reality TV star
Migraine Headache Facts
Did you know that in Canada migraine headaches:
- affects 25% women, 8% men, 10% children. About 90% of
migraine sufferers have a family history of migraine.
- 760,000 Canadians have migraine headaches more than 15 days a month. Globally more than 4 million people have chronic daily migraine, with at least 15 migraine days per month.
- cause 90% of sufferers to be unable to work or function normally during their migraine.
- are the third highest health cost related to missed days at work after back pain and mood disorders. Migraine headaches cost employers more than asthma, diabetes, cancer and arthritis.
- result in 56% of sick days, 23% of short term disability claims, and 18% of long term disability claims.
- cause 36% of sufferers to miss between 4 and 16 days per year.
Chronic Migraine Headache Facts
Chronic migraine patients suffer with significant comorbidities and diminished quality of life including:
- twice more likely to be depressed or anxious
- more likely to suffer from chronic pain
- increased likelihood of heart disease
- more likely to miss days of work and school
- more likely to become occupationally disabled
Migraine Headache Phases and Symptoms
This stage may last hours or days, and may not happen with every headache. Symptoms can include:
- trouble concentrating
- irritability, with or without depression
- difficulty speaking, reading or sleeping
- fatigue and excessive yawning.
- nausea or food cravings
- sensitivity to light and sound.
- increased urination.
- muscle stiffness
While this phase does not always happen, it can be as short as 5 minutes, or as long as an hour. Symptoms include:
- numbness, tingling, and weakness on one side of the body
- visual disturbances including blurry spots, sparkles, lines or a temporary loss of sight.
- speech changes.
This phase can last anywhere from 4 to 72 hours. During this time pain sensations (drilling/throbbing/pounding) typically start as a dull ache on one side of the head and progress to the other, to the front of the heard, or it may affect the whole head, developing in a pulsing pain that could range from mild to severe. It may also come with scalp tenderness, pain around the eyes, temples, face, sinuses, jaw or neck. Additional symptoms include:
- sensitivity of the senses: light, noise, odours and food can be disturbing and may cause appetite loss, nausea, vomiting, upset stomach, abdominal pain and occasional diarrhoea.
- nasal congestion
- temperature changes including sweating or chills or occasional fever
- fatigue, dizziness and blurred vision
- pale skin colour
- depression, giddiness and/or anxiety
This phase begins when the head pain ends, and it may feel like a hangover. Symptoms include:
- body aches
- brain fog and lack of comprehension
- inability to concentrate.
- depressed or euphoric mood
Types of Migraine Headaches
Migraine headaches come in different types, but the same type might have different names.
- Common Migraine or Migraine without aura: This type occurs without the aura . Other phases remain the same.
- Complicated Migraine or Migraine with aura: This impacts between 15 -20% of people living with migraine headaches.
- Silent Migraine, Acephalgic Migraine or Migraine without head pain: This type includes the aura, but comes without the headache phase.
- Hemiplegic migraine: This comes with hemiplegia (temporary paralysis), neurological or sensory changes on one side of your body including numbness, extreme weakness, tingling, sensation loss or dizziness. It could include head pain but might not.
- Ocular or Retinal Migraine: This comes with temporary, partial or complete vision loss in one of your eyes for anywhere from a minute to months. There may also be an ache behind the eye that could spread to the rest of your head. This can be a sign more serious issues and should always be reported to your healthcare provider.
- Chronic migraine: If your migraine headaches occur for at least 15 days of the month, you have a chronic migraine. This is true even if your symptoms and pain levels change frequently. Note that using pain medications for headaches for more than 15 days a month can result in headaches that happen even more frequently.
- Migraine with brainstem aura: If you experience vertigo, slurred speech, double vision or loss of balance before your migraine, or the pain affects the back of your head, you might have this kind of migraine, where symptoms occur suddenly and can include ringing in your ears, vomiting, and the inability to speak properly.
- Status migrainosus. This is an extreme headache that can come with nausea for longer than 72 hours. It may be triggered by medication or withdrawal from medication.
Migraine headache risk factors
Common factors that increase the risk of migraine headaches include:
- genetics where up to 80% of people who get migraine headaches have a close family member who also gets migraine headaches
- gender where female bodied people between the ages of 15 and 55 are more likely to experience them due to hormonal influences
- higher stress levels which can trigger a migraine.
- smoking (including exposure to second-hand smoke) and drinking alcohol
Migraine headache triggers
Common migraine triggers include:
- Caffeine too much or not enough of this can cause migraines because your blood vessels seem to become sensitized to caffeine and changes in levels can impact when you might get a headache. If this is you, you might use caffeine to alleviate acute migraine headaches.
- Emotional stress is one of the most common triggers since the same chemicals that help dial down your fight/flight/freeze/please response - including muscle tension and blood vessel dilation can bring on a migraine or make it more severe.
- Fatigue or overexertion or changes to your usual sleep pattern
- Hormonal changes in women, notably a drop in oestrogen that triggers menses can trigger migraines, and symptoms may be worse while a person is of an age to menstruate. Other hormonal changes including birth control pills and hormone replacement therapy
- Light and loud noises including flashing lights, fluorescent lights, light from the TV or computer and sunlight can trigger you.
- Missing a meal, dieting or being dehydrated might also trigger a migraine headache but so can consuming specific chemicals used to process and preserve foods like nitrates and sulphates. In addition, certain foods including aged cheeses, chocolate, fermented and pickled foods as well as alcohol may be responsible for triggering up to 30% of migraines.
- Pain mediation can cause rebound headaches if take too frequently or daily.
- Scents including perfumes, strong odours and smoke
- Shifting weather conditions such as storm fronts, barometric pressure changes, strong winds or changes in altitude.
Western medicine approach to managing migraine headaches
Western medicine approaches migraine headaches through pharmacological solutions in two ways:
- Prevention through blood pressure lowering medications, anti-depressants, anti-seizure medication and botox injections.
- Symptom relief through over-the-counter pain medication, triptans, ergot derivatives which act on seratonin receptors, anti-emetics which act on dopamine, seratonin and decrease nausea and vomiting, or opiods which come with a high risk of medication over use
Yoga therapy and ayurvedic approach to managing migraine headaches
Yoga therapy and ayurveda examine the root constitutional causes of migraine headaches for each individual and suggest a personalized approach that includes a mix of:
- Pitta dosha pacifying protocols to reduce heat in the body since migraines are associated with overactive pitta.
- Dietary changes including the reduction or elimination of heating foods that may be triggering including aged salted cheeses, dairy, caffeine, sugar and sweeteners, processed foods and alcohol to manage related triggers.
- Oil application in the evening to support the nervous system and muscular relaxation.
- Yoga practice focused on relaxation of all body systems, as well as relaxing the tissues of the neck, nape and upper back. This could include an active morning practice with a mix of seated and standing postures on days without symptoms. It would be paired with a deep active relaxation evening practice with breath work, sound to support good quality sleep to manage triggers including fatigue.
I approach our work to relieve your migraine headaches in the following steps:
- Assessment: In addition to assessing your range of motion, we will assess a number of quality of life markers to help determine immediate and long term changes that might be feasible
- Goal review: We will explore your short, medium and long term goals for the practice we will design together, as well as how much time you can commit to it
- Practice design to improve relaxation and reduce muscle tension in the neck, nape and upper back through accessible movement, better breathing, reduced nervous and muscle tension, improved sleep, lymphatic function, immunity, digestion and elimination which includes trying tools in a morning and evening practice including:
- Prāṇāyāma or mindful breathing
- Dharana or a focused meditation
- Asana or accessible therapeutic movement
- Sound through chanting or humming
- Once pain has been relieved we will review the practice and add strengthening components to prevent future headaches by improving posture and muscle tone.
- Practice testing, where you do your homework by trying to do the practice on a daily basis. We check in regularly to adapt it to suit your life as situations change.
Through your practice you are encouraged to start slowly and begin with a guided breath work practice to calm and centre yourself. As you move through your movement practice, you are encouraged to keep your focus on your breath by relaxing into the movement instead of pushing into it. This will help keep both your breath and movement calm, fluid and centring to balance the nervous.
While it might be tempting, please do not pushing hard because this can cause muscle tension and may trigger headaches. Instead use props and eye pillow for relaxation and stillness, and explore dimming the lights and lowering the temperature in the space where you practice to help maintain a comfortable environment.
Learn more about these five steps to relieving pain and improving your quality of life. They will help you reconnect with your body, breath and mind so you can achieve your goals and feel your best.
Feel more energized, focused and mindful.
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