Headaches and migraines are common reasons patients seek integrative care. The exact root cause or mechanism of migraines has long eluded scientists and doctors, as no explanation seems to fully explain the wide variety of symptoms migraine-sufferers experience. One theory is that migraines may be neurological in origin, which may be why chiropractic care may reduce migraine frequency and intensity. Migraines caused by tension and stress can significantly benefit from acupncture and/or physical therapy treatment.
Because migraines are so varied, and elusive to define some people don’t even know that what they are experiencing is a migraine. While many think a migraine is “just a bad headache,” the cranial pain is often also accompanied by light sensitivity and visual disturbances, sensitivity to sound, sensitivity to motion, and nausea, among other symptoms. Migraines can manifest in episodic and chronic forms, affecting 14% of the population, and up to 18% of women. Episodic migraine (EM) is defined as experiencing 0 to 14 headache days per month, while chronic migraine (CM) is defined as 15 or more headache days per month.
Chronic Migraine has been shown to impose a greater emotional and social burden on the individual. CM sufferers tend to have lower household income levels, and are nearly twice as likely to be occupationally disabled. Those with CM had a statistically significant increase in healthcare resource utilization, meaning more primary care visits, specialist visits, emergency room visits, and hospitalizations compared to those with Episodic Migraine. Chronic Migraine sufferers are also about twice as likely to be depressed.
Unfortunately, Episodic Migraine progresses to Chronic Migraine in about 2.5% annually. Risk factors include depression, anxiety, and chronic pain disorders, obesity, stressful life events, caffeine consumption, and medication overuse. A population-based study that investigated caffeine consumption among participants determined that high medicinal or dietary consumption of caffeine before chronic daily headache onset was a modest risk factor, particularly women and those under 40.
As for medication overuse being a risk factor, this can get some patients into a “catch-22.” Suffering from migraines causes the patient to frequently rely on medication, which then leads to migraine. Fortunately, new research shows that mindfulness meditation may be as effective as pharmacological treatment for medication-overuse headache. Other herbs or supplements that may help migraine symptoms include magnesium, riboflavin, feverfew, butterbur, melatonin, vitamin D, and higher dosages of vitamin B6/folic acid combinations. Physical therapy continues to have strong evidence of support, as well as acupuncture.