Overlapping Conditions

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It's Not All In Your Head. What You Need To Know About Migraines

 

Tuesday, June 1, 2004 
By: Ed Ritchie

 

When is a headache something more than just a headache? It’s not such a frivolous question when fibromyalgia enters the picture. Is the pain another symptom of fibromyalgia? Or is it a migraine that can be relieved, and in many cases prevented, by special treatments?

 

Migraines have confounded researchers and sufferers alike throughout history, and many famous people have reported having the painful symptoms; Julius Caesar, Freud, Van Gogh, to name a few. As with fibromyalgia, women outnumber men, and the exact cause continues to elude researchers. Yet, what we do know allows for good odds in recognizing the symptoms.

 

Recognition is important in determining the treatment. Research shows that many migraine sufferers don’t quite understand the nature of their symptoms. According to the National Headache Foundation (NHF) in Chicago, 32 percent of self-reported migraine victims have not been diagnosed by a physician, and a majority admit having attributed the pain to stress or tension headaches and/or sinus pressure. A little information can easily clear up the confusion.

 

To start, a migraine is clinically defined as a vascular headache. The pain and other symptoms are associated with changes in the size of the brain’s arteries. Unfortunately, it doesn’t take much to trigger these changes. The most common causes include:

 

Emotional stress, and the "flight or fight" physical reactions that follow. We’re not talking about severe stress here. Everyday tension is enough for some unlucky people. (It’s not unusual to express that tension by clenching the jaw, or grinding teeth while awake or asleep. But scientists have some new solutions that we’ll discuss later.)

 

Food sensitivity. Too bad for those of us that enjoy our snacks. As much as 30 percent of migraines can be attributed to foods. Some of the more common culprits are aged cheese and alcoholic beverages, food additives such as nitrates typically found in pepperoni, hot dogs and meats of the cold cuts variety, and the MSG typically used in Chinese food. On the other hand, skipping meals can be a cause.

 

Caffeine. Do you really need that double espresso or monster cola big gulp? Excessive consumption of coffee or colas can trigger migraines. Withdrawal from such beverages can have the same effect.

 

Changing weather conditions. The term "severe weather phobia" first appeared in a 1996 study published in the Journal of Clinical Psychology. Researchers didn’t ask if those surveyed had migraines. Maybe they should have.

 

Hormonal changes. Nearly 75 percent of female migraine sufferers link their attacks to the menstrual cycle. Pregnancy and menopause also contribute. This may help explain why the majority of migraine sufferers are women.

 

Finally, there are two triggers that fibromyalgia sufferers know all too well; excessive fatigue and changes in normal sleep patterns.

 

Although not a symptom, another clue to migraine recognition is its links with other conditions. Statistics show that these headaches are commonly associated with asthma, chronic fatigue syndrome, hypertension, stroke and, as with fibromyalgia, sleep disorders.

 

If you have a parent with a history of migraines, researchers say there’s a 50 percent chance of following in their footsteps. If opposites didn’t attract and both parents have the problem, your odds jump to 75 percent. As unfair as it seems, even a distant relative increases your odds by 20 percent.

 

Migraine headaches are divided into two categories, and as long as we’re mentioning percentages, about 30 percent of migraine sufferers experience what’s known as the "classic" migraine. The classic is known for a 15-60 minute visual aura that signals the onset.

 

The auras sound like something from the 60’s drug culture: bright flashing dots or lights, blind spots, distorted vision, short-term vision loss, and jagged or wavy lines. Sometimes other senses are affected, such as: ringing in the ears, numbness, a pins and needles sensation, and changes in smell, taste or touch.

 

The majority of migraine sufferers don’t experience the classic and its aural prelude. Instead, they have "common" migraines. Once again, there are early warning signs similar to fibromyalgia. Common migraines often begin with anxiety, depression and fatigue. As for the actual symptoms of a migraine, it’s easy to see some more commonalities.

 

Most people report pounding and throbbing headaches. These often grow from dull to throbbing pain. In a survey by the NHF, 79 percent of the respondents reported sensitivity to light and sound as the most common symptom. Physical activity just makes matters worse. Migraines don’t play favorites inside your head. The pain can start in one location and shift to the other, or feel like it’s saturating the brain.

 

As for duration, it’s about four hours for the typical migraine. However severe migraines can last up to a week. At least the average for migraine frequency isn’t staggering. The common migraine sufferer experiences two to four per month. Obviously, even two to four migraines per month is a serious problem. Even more so in the context of fibromyalgia and pain intensity. Studies have shown that fibromyalgia sufferers appear to feel pain more acutely than others. Happily, there are a number of ways to deal with this unwelcome visitor.

 

Although it’s not foolproof, prevention works for many people. Researchers recommend starting with a "headache diary." Keeping track of events and foods that precede migraines can help you identify and eliminate those triggers. Your problem might even be one of timing. Migraines aren’t as frequent among people that eat on a regular schedule.

 

If stressful events are the cause, you have an advantage. Stress is one of the most researched and studied problems in modern history. Not that it says much for modern history, but at least you’ll have many resources to choose from. Look into stress management and relaxation training for starters. You’ve got plenty of choices; yoga, meditation, biofeedback and guided imagery to name just a few. Also, look into the subject of belief systems. It doesn’t help matters to harbor irrational beliefs such as, "I wouldn’t get migraines if I were a good person."

 

There is research to support jaw muscle activity as a trigger for migraines. If you express tension through increased neck and jaw muscle activity (clenching or grinding teeth), intraoral devices can reduce this activity. The clenching and grinding often occurs at night, and many people don’t know they do it until the headaches motivate them to seek a diagnosis.

 

Dr. James P. Boyd, DDS, offers volumes of free information about headaches, migraines, and his FDA approved tension suppression system, the NTI-tss, at his website: www.drjimboyd.com.

 

If prevention fails, the next step is treatment. As any fibromyalgia sufferer can attest, over the counter medications such as Motrin, aspirin and Tylenol are plentiful. A doctor can prescribe anti-nausea and abortive medicines that may stop the migraine--if used at the first sign of onset.

 

When the frequency exceeds more than three times per month and the pain is severe, it may be time to ask about preventative medications that reduce the problem. These medications are usually taken on a daily basis.

 

Your doctor can help if you recognize any of these symptoms. Depending on your situation, you might be referred to a headache specialist who can further determine if the pain you’re experiencing is a migraine, or just another symptom of fibromyalgia.

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