Migraine [Great Guide]
Migraines are characterized by unilateral intense headaches and varying symptoms. Symptoms of migraine and migraine attacks can vary greatly with or without aura. There are a number of different forms of migraine presentations - they can include:
Aura and visual disturbances
sensitivity to light
Intense pain behind the eye
Nausea and vomiting
Neurological symptoms - such as tingling in the face
We will go through almost all possible symptoms later in this large and comprehensive article. This migraine guide is designed to give you the most useful information possible - so you can have better control over your migraine attacks. Remember that you can contact Vondtklinikkene for help with both assessment and treatment.
Article: Migraine [Great Guide]
Last updated: 23.03.2022
Of: The pain clinics - Interdisciplinary Health
In this article you will be able to learn more about:
1 Good Tips to Reduce Migraine Attacks
2. Who is affected by Migraines?
3. Symptoms and Clinical Signs of Migraine
Causes of Migraines
5. Treatment of Migraines
6. Self-measures against Migraines and Headaches
7. Exercises and Training against Migraines
8. Contact Us: Our Clinics
1 Good Tips to Reduce Migraine Attacks
Here we want to start the article with five evidence-based tips on how to prevent and reduce migraines. These are based on research and we also link on to the individual studies.
4. Physical activity
Research on magnesium has shown that this is a well-tolerated, inexpensive and safe way to prevent migraine attacks. What many do not know is that studies have also shown that magnesium supplements can have an effect even after a seizure has started. In addition to counteracting stress headaches and cluster headaches (1). Precisely for this reason, magnesium is one of the first pieces of advice we are happy to give to our patients who suffer from migraines, but also other types of headaches.
Here we could make a real deep dive into the neurophysiological effect magnesium has against migraines, but we choose to keep it simple. Magnesium is a vital electrolyte in the human body. One of the main roles of magnesium is to safeguard and maintain the nerve cells' electrical potential. In the absence of magnesium, neurological complications can occur. Studies have shown that migraines are usually associated with low levels of magnesium in the blood plasma and cerebrospinal fluid (2). There have also been indications that people with a migraine history use more magnesium than others. First advice, if you are not already doing so, start with magnesium supplements.
- At our interdisciplinary departments at Vondtklinikkene in Oslo (Lambertseter) and Viken (Eidsvoll Sound og Råholt) Our clinicians have a uniquely high professional competence in assessment, treatment and rehabilitation training for headaches and migraine problems. Click on the links or here (in Danish) to read more about our departments.
Stress and high pace are often closely linked to higher consumption of electrolytes - including magnesium. In addition to this, many people have a tired tendency, when they are stressed, to forget about consuming food and water. In other words, stress and hypomagnesia (magnesium deficiency) can reinforce each other's negative effects. Physical and mental stress also often lead to elevated muscle tension and muscle pain. The second piece of advice for you with migraines and headaches is to take time to relax. For some, this is physical therapy for improved muscle and joint function. For others, this is self-time with relaxation techniques.
An own measure we often recommend is daily work towards muscle knots with the use of trigger point balls or acupressure mat (see example here - the links open in a new window). The latter benefits from the fact that you can also calm down the body in a hectic everyday life - which can help you calm the 'overactivity' in body and mind.
We recommend: Try yourself on a daily session of 20-40 minutes with relaxation on acupressure mat. Many of our patients report that they experience a positive effect both physically and mentally. This variant also comes with a separate neck pillow that makes it easy to work tense neck muscles. A simple self-measure that can give you a number of positive effects. Click on the links or the image above to read more about this relaxation mat - and to see shopping opportunities.
Relaxation: How to relieve migraines?
Migrant attacks are terrible, so here's the thing to be a leader. There are medications that can stop an onset seizure and there are soothing medications along the way (preferably in the form of nasal spray, as there is otherwise a high chance of the person vomiting).
Other measures for faster relief of symptoms, we recommend that you go down a bit with a so-called "migraine mask»Over the eyes (mask that you have in the freezer and which is specially adapted to relieve migraines and neck headaches) - this will reduce some of the pain signals and calm down some of your tension. Click on the image or link below to read more about it.
Read more: Pain Relieving Headache and Migraine Mask (Opens in new window)
3. Physical Treatment For Migraines And Headaches
Processing tight muscles and stiff joints can help reduce headaches. When there is a clear malfunction in the muscles and joints of the neck, this can lead to what is known as cervicogenic headache (neck-related headache). Many people experience clear improvement with the help of physical therapy in the form of modern chiropractic and physiotherapy. Modern chiropractors treat both joint restrictions and work actively against tense muscles.
4. Physical activity
Make sure you get enough of regular physical activity. A safe and good way to get enough activity can be by going on two daily walks - one in the morning and one in the afternoon. Maybe you have the opportunity to change parts of the transport stage to work with a little extra walking? Cardiovascular training in particular, such as jogging, swimming, cycling and the elliptical machine, have shown documented preventive effects against migraines (3).
Those who are affected by migraines often get a gloomy feeling when someone mentions the word "triggers". Triggers, or triggers in Norwegian, are often foods or beverages that can be linked to migraine attacks. Too much caffeine and alcohol are, among other things, two known triggers. In our clinical experience, we see that especially red wine and chocolate are repeatedly mentioned as triggers. The key points here are therefore to reduce the intake of sugar and alcohol - at the same time as eating a lot of green vegetables for a good supply of electrolytes and minerals.
2. Who is affected by migraines?
Everyone can be affected by migraines, but migraines mainly affect younger to middle-aged women. Studies have shown that as many as 12% of the population are affected - to varying degrees. But it is estimated that the number may be even higher (4). Some migraine attacks can be very powerful and many experience a so-called aura before the attack. It is about twice as common among women (19%) versus men (11%). Furthermore, it is estimated that as many as 6% of men and 18% of women have at least one migraine attack a year. During their lifetime, 18% of men and 43% of women will experience a migraine attack (5).
- Affects Almost a Billion People
If we put this in a global perspective, almost a billion people will be affected by migraines. This is a very high number and really shows what socio-economic costs this diagnosis entails. In addition to sick leave, we must also keep in mind how this can affect quality of life, social relationships, physical activity and mental health.
Affected? Join the Facebook group «The Headache Network - Norway: Research, New Findings and Cohesion»For the latest updates on research and media writing about this disorder. Here, members can also get help and support - at all times of the day - through the exchange of their own experiences and advice.
3. Symptoms and Clinical Signs of Migraine
Symptoms of migraine can vary greatly from person to person - and also before, during or after the attack. We therefore choose to divide them into these four categories:
Symptoms - Before the headache
Symptoms - With aura
Symptoms - Migraine attacks
Symptoms - After the attack
Less common symptoms
Symptoms of migraine - before the headache
Many people who struggle with migraines learn to recognize the symptoms they often experience before a migraine attack strikes. It is often the case that these can be seen as early as a day or two before the attack. Many report that they can feel:
- Depressed and sad
- Very happy and full of energy
- Very sleepy
- Thirsty and hungry all the time
- A craving for special food or drink
Symptoms of migraine - with aura
About 20% of people who experience migraine attacks experience what is called hate - a warning that a migraine attack is on its way. Normally, an aura will present about 30 minutes before a seizure. Symptoms of aura can be:
- Visual disturbances with flashing or constant dots, lines or shapes in vision
- Numbness and "tingling" in the face, arms and / or hands
Symptoms of migraine - during the attack itself
- Intense, throbbing pain in one side of the head (but one can also atypically have pain in both sides)
- Pain behind the eye
- Moderate and significant pain - the pain can be so bad that you can not do everyday chores
- Pain aggravated by normal physical activity
- Nausea and / or vomiting
- Light sensitivity - The pain is aggravated by normal light
- Sound sensitivity - The pain gets worse with sounds
- May also be sensitive to odors
The attack itself is like a big "electric storm" in the head. To relieve it, it is important that the room you are in is darkened and that it is quiet for sounds. Many people experience symptom relief by adding one reusable ice pack on the head - the cold can in fact help to calm down the electrical signals. Research from headache institutes in the USA has for a long time shown that these have a documented effect. In fact, as many as 52% experienced an almost immediate improvement - and 71% reported an effect (6). We advise everyone with migraines and regular headaches to have a reusable ice pack like this in the freezer - the advantage is that it is also made so that it does not cause frostbite on the skin.
- Buy here: Reusable ice pack (Opens in a new window)
The advantage of this package is that it is a so-called reusable multi-gel package. This means that it can be used both as an ice pack and a heat pack. But for those of you with a headache, we recommend that you have it lying around in the freezer.
Symptoms of migraine - after the attack
After the migraine attack itself you can feel very tired in the body and be very sleepy. Many people report an exhaustion and something that can be compared to a "hangover" feeling. Here it is important that you are careful with hydration and nutrition.
Rarer symptoms include:
- Problems talking
- Stabbing on the face, arms and shoulders
- Temporary weakness in one side of the body
If you experience any of these rarer symptoms, without having experienced them before, you should contact the emergency room immediately so that you can rule out a brain drop or stroke.
How long can a migraine attack last?
Without treatment, migraines and symptoms can persist for a total of 4 to 72 hours. The most common is that it is better within 24 hours.
Causes of Migraines
It has long been understood that migraines can vary and that there are probably a number of causes that can trigger a seizure. But there have been clear indications that several contributing causes may play a role. Among others:
About half of those with migraines have a close relative with migraines. But if you look at the large extent of migraines (almost 1 in 5 women), it is not particularly surprising that someone close to you is affected. What may be the case, however, is that some people seem to use more electrolytes, including magnesium, than others.
Recent research indicates that magnesium deficiency appears to play a key role in a number of migraine cases. This makes sense as magnesium is an essential electrolyte that, among other things, regulates electrical signals.
Stress and muscle tension
Many people may find that both stressful situations and tense muscles feel like a cause of their migraine attacks. In such situations, there is also higher electrical activity and thus higher consumption of magnesium - so a link between these can also not be ruled out. However, many people experience a significant reduction in migraine attacks with physical treatment, so it can probably not be said exclusively that magnesium deficiency is the only cause.
- Triggers (Triggers)
It is known that certain things can lead to or provoke migraine attacks - these are called "triggers". One person may have different triggers from another - so there is no universal code on what can be done to avoid such provocation. For example, a person may experience a significant decrease in their migraine attacks by drinking less red wine. Another may experience improvement by eating more natural, less cooked foods without additives (such as monosodium glutamate).
Some have more triggers - and thus have a higher chance of provoking a migraine attack.
Some of the most common triggers are:
Poor sleep hygiene
Red wine and alcohol
Change of daily routine
Additives (eg monosodium glutamate / MSG)
Other causes may include:
Malfunction of the neck muscles (myalgia) and joints
Head injuries and neck injuries, including whiplash / whiplash
Menstruation and other hormonal changes
Inherited hypersensitivity to the nervous system
5. Treatment of Migraines
When we talk about the treatment of migraines, it is very important to have a holistic approach. In addition to addressing physical dysfunction, often in the neck, it is important to map out what lifestyle changes and factors are provoking your migraine attacks. Therefore, the treatment often falls into three main categories:
1. Lifestyle Changes and Diet
3. Drug treatment
Lifestyle Changes and Diet
There are several different categories that fall under the changed lifestyle. Here we look in particular at physical activity, ergonomic adjustments, diet and the exclusion of triggering factors. We also emphasize the importance of mapping the use of drugs. Examine with your doctor or look The common catalog if any of your regular medications, if any, have listed headaches as a side effect. In that case, you may want to check with your GP if there are alternatives to the ones you are taking now.
- Prevention: The best treatment for migraines is prevention. Many people experience significant improvement by changing their diet and changing their activity level.
- Relaxation: Stress and tension are linked for many to be the triggering cause of migraine attacks. Yoga, mindfulness, acupressure mat, breathing techniques and meditation can be helpful in lowering the level of both physical and mental stress in the body. A good daily measure for you who stress too much in everyday life.
Prevention of migraines
As mentioned, it is important to map the triggers and the factors that provoke migraine attacks. There are also other tips and measures that can help prevent migraine attacks:
- If you use painkillers regularly, you should consider stopping this for a period of a few weeks. If you have drug-induced headaches, you will find that you get better over time when you stop using them.
- Drink enough water and stay hydrated
- Try magnesium supplements
- Stay in good physical shape
- Lie down and get up at regular times of the day
- Live healthy and exercise regularly
- Seek well-being and avoid stress in everyday life
Physical Treatment For Migraines
Physical therapy is often used as an umbrella term for the treatment of dysfunction in the body's muscles, nerves and joints. Treatment methods can include joint mobilization, muscular techniques, intramuscular acupuncture, pressure wave therapy and a variety of other treatment methods. We know that dysfunction in the muscles and joints of the neck in particular is strongly linked to an increased incidence of headaches.
- Muscle Knut Treatment: Muscular treatment can reduce muscle tension and muscle pain. Trigger points are tense and sensitive muscles that have increased content of damage tissue and reduced function.
- needle treatment: Dry needling and intramuscular acupuncture can reduce muscle pain and relieve muscle problems, which may be a contributing factor to migraine problems.
- Joint Treatment: An expert in muscles and joints (eg chiropractor or manual therapist) will work with both muscles and joints to give you functional improvement and symptom relief. This treatment will be adapted to each individual patient based on a thorough examination, which also takes into account the patient's overall health situation. The treatment will most likely consist of joint corrections, muscle work, ergonomic / posture counseling and other forms of treatment that are appropriate for the individual patient.
Chiropractic and manual treatment, consisting of adapted neck mobilization and muscle working techniques, has a clinically proven effect on relieving headaches. A systematic review of studies, a meta-study (the strongest form of research), conducted by Bryans et al (2011), published as «Evidence-based guidelines for the chiropractic treatment of adults with headache » concluded that neck mobilization has a soothing, positive effect on both migraine and cervicogenic headache - and should therefore be included in the standard guidelines for the relief of this type of headache.
Many people do not have to resort to medication, but for many it can still be beneficial to have it available for relief of severe migraine attacks. We divide drug treatment into two categories:
Medications that stop an ongoing migraine attack. For example Imigran or Sumatriptan.
2. Medications that prevent a migraine attack from erupting.
For milder migraines, it may be beneficial to, in combination with your GP, try more common painkillers, as these have fewer side effects. Also remember to try magnesium supplements if this has not been tried. If this does not work then prescription medications may be needed.
- At our interdisciplinary departments at Vondtklinikkene in Oslo (Lambertseter) and Viken (Eidsvoll Sound og Råholt) our clinicians have a uniquely high professional competence in assessment, treatment and rehabilitation training for migraines and headache ailments. Click on the links or here (in Danish) to read more about our departments.
6. Self-measures against Migraines
Several of our patients ask us questions about what they can do themselves to relieve headaches and migraines. We previously referred to research that has shown that cold treatment (with the use of reusable cold pack og cold migraine mask) can provide immediate relief from migraines and headaches. In addition to this, relaxation techniques with the use of trigger point ball og acupressure mat be beneficial. Thus, we land on these four main tips.
Tip 1: Have one reusable cold pack in the freezer.
In a study at a headache institute, 71% of the patients reported that they experienced symptom relief when using a cold pack. For those who have an ongoing migraine attack, even the mildest relief can be very welcome. Our first stable tip is therefore to always have a cold pack in the freezer ready for use. Click on the link here (in Danish) or the image to see purchase options.
Tip 2: Cold migraine mask
We stay in the cold element with another tip for cold treatment. The advantage of one migraine mask is that it consists of both a cooling element and a mask. The mask is fastened with elastic band around the head. Click on the link or image above to read more and see purchase options.
Tips 3 and 4: acupressure mat og Trigger point ball
Our last two tips focus on relaxation. Both physically and mentally. Roll the trigger point ball towards tense muscles in between the shoulder blades and in the upper back - about 30 seconds per area. Then lie down acupressure mat and its massage points. We suggest that you start with sessions of about 15 minutes and then work your way up to longer sessions over time. Links to the products can be found above. Stress down and take time to relax.
7. Exercises and Measures for Migraines and Headaches
We know that regular physical activity reduces the risk of migraines and headaches. It is also known that malfunction in the neck can contribute to more frequent occurrence. In the video below, we show an exercise program that can help you with neck stiffness and tense muscles.
VIDEO: 5 Clothes Exercises Against Stiff Neck
Feel free to subscribe for free our Youtube channel (link opens in new window). Here you will also find several good exercise programs and health knowledge videos.
8. Contact Us: We are here if you want help with your pain
We offer modern assessment, treatment and rehabilitation for migraines and headaches.
Feel free to contact us via one of our specialized clinics (the clinic overview opens in a new window) or on vår Facebook-side (Vondtklinikkene - Health and Exercise) if you have any questions. For appointments, we have XNUMX-hour online booking at the various clinics so that you can find the consultation time that suits you best. You can also call us within the clinic's opening hours. We have interdisciplinary departments in Oslo (included Lambertseter) and Viken (Råholt og Eidsvoll). Our skilled therapists look forward to hearing from you.
- Do not let the headache take away the joy of everyday life. Remember that the second best time to plant a tree is today. We are happy to help you.
Research and Sources:
1. Yablon et al, 2011. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. Discipline of Anatomy and Pathology & Adelaide Center for Neuroscience Research, School of Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
2. Dolati et al, 2020. The Role of Magnesium in Pathophysiology and Migraine Treatment. Biol Trace Elem Res. 2020 Aug; 196 (2): 375-383. [Systematic Overview Study]
3. Lockett et al, 1992. The effects of aerobic exercise on migraine. Headache. 1992 Jan; 32 (1): 50-4.
4. Burch et al, 2019. Migraine: Epidemiology, Burden, and Comorbidity. Neurol Clin. 2019 Nov; 37 (4): 631-649.
5. Vos et al, 2019. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet.
6. Diamond et al, 1986. Cold as an adjunctive therapy for headache. Postgraduate Med. 1986 Jan; 79 (1): 305-9.
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