A patient, of mine ☝🏼. We have been working together on their migraines.
Today's blog is going to examine migraines, acupuncture and other migraine treatments. It will look at a variety of migraines including menstrual migraine, vestibular migraine and migraine aura and how acupuncture will diagnose and treat them.
As always my messages are open to your questions.
I hope you find this useful and a potential alternative technique, to consider, for your migraine treatment.
Love
Andrea
Migraine symptoms
The Migraine Trust (which has a wonderful feature of dimming the screen), describes migraines as
a severe and painful long-term health condition [........] which can be a whole-body experience.
They estimate that 1 in 7 people will experience migraines (which can have a huge impact on quality of life) and symptoms can include:
head pain,
problems with your sight such as seeing flashing lights,
being very sensitive to light, sounds and smells,
fatigue,
feeling sick and being sick.
It is estimated that about 43 million days, a year, are lost in the UK to migraines. It can affect your job, education, your social life or even your relationships.
Before working with migraine patients I had underestimated the varieties of migraines and below is a brief introduction to each.
Types of migraine
Migraine with aura
The specific symptom will be related to sight, such as blind spots or flashing lights. This will usually typically occur before other signs of a migraine. Other symptoms might include:
numbness or tingling sensation like pins and needles in parts of your body
muscle weakness
feeling dizzy or off-balance
Ocular migraine
Unlike a migraine with aura, an ocular migraine will affect one eye only. Symptoms can include blindness or flashing lights and a headache.
Migraine without aura
Unlike migraines with auras, these migraines will start with no notice. Symptoms can include:
A pain that is usually one-sided on the head. This pain is throbbing and worse for movement. It is so severe that it means you can’t do your normal daily activities.
Nausea or vomiting
Being sensitive to light, sound and/or smells.
Vestibular migraine
Similar symptoms to the migraine without aura, a vestibular migraine will also be accompanied by vertigo (dizziness, swaying)
Migraine with brainstem aura
Similar symptoms to a migraine with aura these migraines will also have neurological symptoms. These symptoms would be:
slurring of speech
a sensation of movement
ringing in the ears
double vision
Unsteadiness when walking
Temporarily decreased consciousness
Pins and needles and /or numbness affecting both arms and/or legs
Changes in eyesight in both eyes such as patterns or flashing lights
Menstrual migraines
These migraines will occur around a menstrual cycle
Other migraine types might be stomach migraine (or abdominal migraine) and hemiplegic migraine. There are of course a multitude of headaches, including cluster headaches, that are also intense and affect the quality of life. I have looked at headaches here.
How long do migraines last?
Unfortunately, there is little uniformity about how long migraines last. They might last for a few hours, or a few days. They may happen on a regular basis, like menstrual migraines, or you may experience one or two a week, or one or two a year.
In acupuncture, we are always seeking the root cause of a condition. Because if we can work with the root, we can decrease or even stop the signs and symptoms.
Cause of migraine
People at any age can experience migraines. Before puberty, boys tend to experience them more frequently however this then reverses after puberty with 3x as many women experiencing migraines.
Unfortunately, there is no consistent cause of migraines. This is why I created a pain tracker that you can download and complete. This will enable you to see what YOUR triggers are.
Migraines and acupuncture
Did you know that the NHS recommends acupuncture for migraines? These podcast episodes below look at the mechanisms behind migraine and acupuncture and are definitely worth a listen.
As I talked about the causes, one person's migraine may be diagnosed differently from another person's migraine and so treatments may vary depending on your diagnosis.
I know that migraines are not headaches (see my blog post here for headaches), however, in Chinese medicine headaches and migraines are diagnosed similarly i.e.
Where is the pain felt? Is it at the sides, neck, behind the eyes, forehead?
What is the pain like? Is it tight, bursting, sharp, splitting?
What causes the migraine? Food? Menstruation? Weather?
Below are some common Chinese medicine diagnoses for migraines:
Liver Yang Rising:
intense, severe, throbbing or distending migraine
"pulsating", "pounding" or "bursting" migraine
usually, the migraine affects either or both sides of the head along the Gall-Bladder channel, or the temple or eyebrow.
Frequently the migraine is felt behind one or both eyes.
nausea or vomiting.
can also be accompanied by diarrhoea
usually better for sitting up
visual disturbances e.g. flashing lights / auras
dizziness
tinnitus
insomnia
irritability
Liver Fire:
similar in nature to Liver-yang ~ however, migraine is even more intense, tends to be more fixed in one place, and is more frequently accompanied by nausea or vomiting
dizziness
tinnitus
deafness
insomnia
irritability
Liver Wind:
The migraine from Liver-Wind is pulling in character and affects the whole head rather than the sides.
severe giddiness
slight shaking of the head,
numbness,
tremor of a limb
Liver Qi stagnation:
usually occurs on the forehead or temples
moves from one side to the other
typically caused by anxiety and stress
poor digestion
small-bitty stools
sighing
Which diagnosis does your migraine feel most like?
Migraine treatment
Acupuncture for migraine
You could be looking at a minimum of 10 treatments, for your migraines, depending on their frequency and chronicity. I talk here about what affects an acupuncture treatment.
I have never claimed acupuncture is a miracle cure. It will definitely take time and it may not always be 100% effective. As the National Migraine Centre says
Unfortunately no migraine treatments currently available work for everyone. They work in about 50- 60% of people who try them. In some cases, the improvement is dramatic but in others, it is not as effective but can reduce the severity and frequency of the migraines enough to make a difference on their impact on daily life. There are some people who do not respond to these at all.
However, acupuncture is safe and has good evidence of efficacy hence why the NHS recommends it. Acupuncture for migraines can also be used during pregnancy and whilst breastfeeding.
In a Cochrane review (considered the gold standard of research) they found:
Available studies suggest that acupuncture is at least as effective as, or possibly more effective than, prophylactic drug treatment, and has fewer adverse effects. Acupuncture should be considered a treatment option for patients willing to undergo this treatment.
Other treatments for migraine
Depending on red flags and any biomedical tests you may have undergone other forms of migraine treatment might be:
Migraleve: a form of opioid that should be used with caution due to the addictiveness of opioids.
Zolmitriptan: is used for acute migraine but it is not advised to take during pregnancy or breastfeeding.
Amitriptyline: is used for migraine prophylaxis and chronic tension-type headache. The British National Formulary says that the amount secreted into breast milk is too small to be harmful
Sumatriptylin: is used for acute migraine. Should withhold breastfeeding for 12 hours after taking
Topiramate: is used for migraine prophylaxis and should not be used in pregnancy or breastfeeding
Botox: studies have shown that Botox injections may reduce the number of migraine days by two days each month. However, with any medications (or even medicine, acupuncture is not infallible), they found that
Of the participants treated with botulinum toxin, 60 in 100 reported side effects (most common was drooping eyelid or muscle weakness), which was a little higher than the number receiving placebo (47 in 100). No difference was seen in the risk of side effects between botulinum toxin and oral treatments. Participants from two small trials were nearly four times less likely to stop their treatment if they were given botulinum toxin than if they had oral treatments. Information about side effects was reported for 8 in 10 trial participants
Emgality: is used for migraine prophylaxis and is given as an injection. The National Institute for Care and Excellence (NICE) which provides guidelines to the NHS suggests that Emgality can be used for people who experience migraines more than 4 times a month (and who have tried 3 other methods which have not been helpful) and it can be prescribed by your GP.
Migraine relief
Ideally, for fast migraine relief, I would suggest seeing your acupuncturist during a migraine attack. With my patient (whose quote is above), we have been able to time some of their migraine treatments around their menstrual cycle (which is a cause of their migraines). For the stress-related migraines that is not always possible and then her treatments are working with her underlying root problem.
We are on treatment 6 and there is light at the end of the tunnel. Fewer days of migraine pain. Less need for medication.
The migraine still happens, but it is improving. For them. And their family.
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