chronic migraine relief

My Biggest Frustration with Migraines

June 5, 2016 by James Bogash

chronic migraines as a progressive brain disorder — Chronic migraines as a progressive brain disorder

I have dedicated a significant amount of time to migraines. From treatment in my office to hundreds of review articles of medical studies to publishing a book on Migraines And Epilepsy, I consider myself quite educated on the topic.

While there have been a few exceptions in my office (literally less than a handful over the past 18+ years), if patients are willing to make the changes I recommend, they get better. My recommendations range from a course of treatment in the office to exercise to managing stress to major lifestyle overhauls. If patients are willing to make these changes, I can almost guarantee that migraines will be history.

Why? How can patients get better with my recommendations versus the neurologist that they’ve been seeing for years and practice out of a very well-known hospital system?

Because the “why” is far more important to me than suppressing the symptoms of a migraine. It is VERY rare that I have a chronic migraine patients come into my office that has been educated on the underlying cause of his or her migraine headaches.

But before I get into the secret of migraine headaches I need to make a very important distinction.

By the time patients make it into my office they have accumulated multiple types of headaches. The two biggest classifications are structural and migrainous. And I can say, with a high degree of confidence, that every migraine patient has aspects of both.

The structural headaches are related to the soft tissues (ligaments, tendons, muscles and fascia) and joints. While my opinion is strongly biased, these types of headaches HAVE to be addressed by a chiropractor that understands and treats the soft tissues. Adjusting alone, exercises alone, Botox alone (and yes-if someone responds to Botox it is because they have been improperly diagnosed with migraines instead of a structural headache) or soft tissue work alone is not going to completely fix the problem.

But, as I mentioned, it’s my bias based on almost 20 years of treatment migraine patients who have not responded elsewhere.

The true migraine headaches, however, do not respond well to good structural care. This is because the true cause is not one that can be addressed from outside the body.

If you experience chronic migraine headaches and you really, really want to get rid of your headaches, you’re going to have to address the health of your blood vessels.

Period.

Anything less will not guarantee a fix for your headaches. And medications? Not a damn one of them will fix your blood vessels. Some will actually make it worse. And even if medications control your headaches, they have not fixed the problem.

Poor blood vessel health, endothelial dysfunction, vascular dysfunction. It goes by different names depending upon who you are speaking to, but they all mean the same thing.

The blood vessels of a true migraine patient have lost the ability to respond appropriate to changes in demand for blood supply. This system—where the blood vessels open and constrict based on how much oxygen the tissues need—is an incredibly dynamic process, with changes occurring by the second. If your blood vessel is no longer able to respond to needs of your brain cells your brain cells are not going to be happy with you and can trigger a migraine.

THIS is the key to understanding your migraines. THIS is the key to lifestyle changes that will help your chronic migraine headaches.

I have certainly spent time on migraine message boards and there are a lot of headache patients who get pissed off at my suggestion that headaches can be fixed. These patients, however, have not achieved ideal body weight. They are stressing too much. They are not eating the right foods (even if he or she thinks his or her diet is ideal). They are not exercising. They are smokers.

I would suggest that, as much as it may be offensive to some, patients with true migraine headaches have not made the correct choices for his or her blood vessels and brain.

The details of these changes are beyond the scope of this article, but are outlined very readily in my book Migraines and Epilepsy that can be purchased by clicking here.

While many migraine sufferers care about getting rid of or controlling headaches, there is a bigger problem looming. Poor blood vessel health has everything to do with risk of heart attack or stroke in the future. This is absolutely, unquestionable solidly demonstrated in medical research study after research study.

Most of these research studies, however, have focused on migraine with aura. Most of the studies that have linked future risk of heart disease or stroke have been on migraine with aura. This particular study is yet another one in the long list of studies linking heart disease risk and migraines, except this one covered ALL migraines, not just those with aura. Here’s the details on this large study of 17,531 women with migraines who were followed up for 20 years:

Migraine was associated with a 50% higher risk for major cardiovascular disease.
They had a 39% higher risk of a heart attack.
There was a 62% higher risk of having suffered a stroke.’
Sufferers had a 74% higher risk of having chest pain or having had a coronary angiogram.
Furthermore, migraines were linked to a 37% higher risk of dying from heart disease.

The relationship is so strong that, in a linked editorial, the suggestion is that migraine should be viewed as a risk factor for heart disease just like high blood pressure and cholesterol. This is a strong statement and one that is not entertained by the average treating neurologist or primary care doctor.

It also reinforces my concern that the vast majority of true migraine patients are not getting the education needed to understand and improve the condition. Chronic migraine sufferers HAVE to address the underlying dysfunction of the blood vessels through lifestyle changes geared towards protecting the heart. This include diet, stress management, exercise and focus on reducing exposure to environmental chemicals that damage the heart and blood vessels.

Anything less is only a band-aid.

Chronic Migraine Relief; Fats and Your Brain

October 24, 2015 by James Bogash

Natural remedies for seizures — fats and your seizures

Every migraine sufferer wants that miracle drug, treatment or cure that will provide chronic migraine relief. Personally, I don’t think this will ever happen.

Headaches are too diverse and too complex to be treated with a single approach. The only exception to this is those people who have been incorrectly diagnosed with migraine when what they really have is an isolated “structural headache.” This is my term for a headache that comes from the structures of the head and neck. These headaches will respond incredibly well to treatment from a chiropractor who also fully understands how to treat the soft tissues involved in addition to adjusting the cervical spine.

But even patients with structural headaches are likely to have migraine-headaches overlaid upon the structural headaches. This means that structural treatment alone is not going to be enough in the long run. It may provide some relief in the short term, but ultimately the headaches will come back until you address the other factors.

Among other things, fats play a big role in how your brain works. If you remember way back to high school biology class, all of our cells are made up of a fatty cell membrane. And this cell membrane is a critical factor in determining what comes into the cell and what leaves the cell. This includes building blocks to make proteins in the cell as well as messages.

A healthy cell membrane makes sure that messages that are supposed to make it in get in and also make sure that messages that are NOT supposed to get into the cell stay out. This is why dietary choices that emphasize intake of healthy fats (raw nuts, seeds, wild caught fish, wild game and olive oil) and avoid the intake of unhealthy fats (corn oil, soybean oils and hydrogenated oils) are good the for brain. This applies whether we are talking about chronic migraine headaches, seizures, Alzheimer’s dementia, Parkinson’s disease or cognitive decline.

Fats play a critical role. Which fits into the results from this particular study. In it, researchers looked at the levels of a particular class of cell-membrane fat called sphingolipids in a group of 88 women with episodic migraine. For those of you a little rusty in Jeopardy’s “I’ll take brain fats for $500, please, Alex” sphingolipids are a specific type of waxy fat found in high concentrations in the cell membranes of your brian cells. In general, higher levels means that your brain cells are going to be more stable. In addition, certain sphingolipids play a critical role in sending messages within the brain cells themselves.

With this in mind, here’s what they found:

Total ceramide and dihydroceramide levels were lower in those with episodic migraine.
Each standard deviation increase in total ceramide and dihydroceramide led to a 92% lower risk of experiencing migraines when compared to a control group.
In addition, every standard deviation increase in the sphingomyelin species C18:0 led to a massive 428% higher risk of experiencing migraines.
The same was true with the sphingomyelin species C18:1, leading to a 293% higher risk.

So what does all of this mean? Other than the fact that I apparently didn’t pay enough attention in biochemistry?

First of all, higher sphingomyelin levels have been consistently shown in prior studies to be linked to prediabetes. This fits in incredibly well with the concept that prediabetes is very bad for the health of your blood vessels and the unhealthy blood vessels are the key player in the development of migraine headaches.

In addition, ceramides can be converted into sphingomyelin. That would lead to lower levels of ceramides (increasing risk of migraines) and higher levels of sphingomyelin (again leading to increasing risk of migraines). It all seems to fit.

While scientists are still trying to figure out what this all means, I would venture to say that this study again links the poor blood vessel health of prediabetes to chronic migraine headaches. And an anti-diabetic diet will have huge payoffs when it comes to chronic migraine relief.

Should I See a Mesa Chiropractor for My Chronic Migraine Headaches?

October 22, 2015 by James Bogash

Why am I even asking this (it was rhetorical, by the way)? The answer is unquestionably yes.

It never ceases to amaze me how many new patients come into my office that have been having headaches for years and have never been to a chiropractor in Mesa. Many of these patients begin to feel better in as little as a week. The caveat here is that you need to find a Mesa chiropractor who addresses the soft tissue (muscle, ligaments, tendons, fascia) aspect of your problem and not just adjusting. Many times the soft tissue aspect has been present for so long that just adjusting, just exercising, just ultrasounding, just interferentialling (is that a word??), just strengthening or just adjusting is not going to be enough.

This particular study just supports this link, finding close associations between tenderness in the trapezius muscles and chronic tension headaches as well as migraine headaches that were present only on one side of the head.

Migraines "Under Control" with Meds? Better Think Twice

October 24, 2014 by James Bogash

chronic migraines and Parkinsons — Chronic migraines linked to Parkinson’s disease

Last Update December 18, 2014

I don’t mean to beat a dead horse, but merely managing your chronic migraine headaches with meds is not the answer.

I am not saying that it’s not the short-term goal. If you’ve ever spent time on some of the social networking sites that relate to migraine headaches, you’ll realize just how devastating and life-shattering migraine headaches can be. Jobs, relationships and lives in general can be restricted to living like a hermit in constant pain.

I understand that controlling the pain of the headaches is the first priority for a migraine sufferer. But not everyone gets relief from medications. This group spends their lives in a constant search for relief. Medication after medication after medication. When they’re lucky enough to find a medication to help, sometimes the side effects are just as debilitating.

The other group includes the ones who do find relief from medications. But then they stop there, blissfully unaware that this is just the first step.

I have written over and over that the headaches are the symptom of a much bigger problem. The headache is NOT a problem in the head. Rather, it is the brain that is the most sensitive organ to the unbalanced state of health, with the critical dysfunction coming from blood vessel health (also referred to as “vascular health”).

Poor vascular health is at the root of migraines. It is not always the only answer, but in most it is the principle problem. If you can address vascular health and improve the health of your blood vessels, it is highly likely that you’ll find that your migraines improve as your blood vessels do.

Just in case you think I’m crazy for suggesting this merely because your neurologist has never suggested it, I would like to present as evidence this particular study.

In it, researchers looked at the relationship between the development of Parkinson’s disease in migraine sufferers in the AGES-Reykjavik study. And the news isn’t good.

The Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-Reykjavik) is a study that began in 2002 and is designed to look at the relationship between risk factors, including genetic susceptibility and gene/environment interaction, in relation to disease and disability in old age.

Between 2002 and 2006, 5,764 participants from this study were reexamined to look for symptoms of parkinsonism, Parkinson disease, a family history of Parkinsons and Restless Leg Syndrome. Here’s what they found:

People who experienced midlife migraine (especially migraine with aura) were 360% more likely to report parkinsonian symptoms.
They were also 250% more likely to be diagnosed with Parkinsons.
Women who had migraines with aura were 226% more likely to have a parent or 178% more likely to have a sibling who were diagnosed with Parkinsons.
All of those who experienced headaches were more likely to experience Restless Leg Syndrome.

Parkinson’s disease has been strongly linked to prediabetes and diabetes. The damage to the blood vessels that occurs in the diabetic process is pretty bad, leading to actual brain damage and dying brain cells. I don’t know about you, but I’m hoping to keep all my brain cells intact as long as possible.

While no single study or research finding is enough to set anything in stone, the links between poor vascular health and migraines is quite extensive. Extensive enough to warrant finding a new neurologist if this has never been discussed with you.

It is equally clear that vascular problems LEAD to migraine headaches, NOT the reverse. This means that all the bang for your buck is in improving the health of your blood vessels to help your migraine headaches, not improving blood vessel health by controlling your migraines. There is not a single medication used to control headaches that does anything to improve blood vessel health.

There are quite a few ways to improve the health of your blood vessels. While it is beyond the scope of this article (you can read all about it in my Migraines and Epilepsy eBook by clicking here) here are a few short tips:

Short-burst exercise is a must
Cocao products like dark chocolate and cocoa, are very good for the blood vessels
Berries
Wild caught fish
Not smoking (smoking DESTROYS the blood vessels)

While this is the short list, it should be enough to get you started.

2 Things Every Chronic Migraine Sufferer Should be Checked for

February 18, 2014 by James Bogash

This is one of those “I’m a chiropractor so this will be biased” articles. This bias is further accentuated by the fact that I’ve written a Migraines and Epilepsy book. This article describes that ONE thing that EVERY single headache sufferer needs to do, and yet rarely do.

I understand headaches very well. Migraines. Tension type headaches. Cervicogenic headaches. Sinus headaches. Unfortunately, many chronic headache sufferers actually experience many different types of headaches. Since most physicians have a single tool to use, they can only address a single type of headache at a time. This is why it seems like no treatment works—it’s rare that a single treatment that is going to help for more than one type of headache.

But there is a great place to start. It should absolutely begin in a chiropractor’s office. Why? (Other than my bias, of course…) Because the tension-type / cervicogenic headache is so extremely common and a chiropractor who also understands the soft tissues involved in these types of headaches is the ONLY type of provider who can address them.

In case you think I’m being a little biased, think for a second, what tools the typical primary care doctor, orthopedic doc or neurologist has to treat muscle problems. Note that I said “muscle problems” and not muscle spasms. True muscle spasms are pretty rare in these types of headaches. Injections do nothing to fix the problems and the medications may mask what’s really going on, but there just are not any medications that are designed to actually heal the soft tissue problems involved in these types of headaches.

One could argue that a well-qualified massage therapist can also address these soft tissue problems, and it is a strong argument. However, the other aspect that contributes to these headaches, improper movement of the joints at the very top of the neck, can only be addressed by a chiropractor.

So you can see that my bias does, in reality, have quite a bit of factual information to support it.

What does all of this have to do with this particular study? In this small study, researchers looked at 4 things in chronic migraine sufferers:

Myofascial trigger points (MTrPs) in the SCM and upper trap muscles
Forward head posture (FHP)
Neck range of motion (ROM)
Cervical facet joint stiffness

As I’ve mentioned, these aspects are all well within the range of conditions that soft-tissue oriented chriopractors can treat very effectively.

So what did they find when they compared this group of chronic migraine sufferers to a similar group that did not experience headaches?? They did not find any difference in the neck range of motion nor in forward head posture. They did, however, note:

There was increased stiffness of the cervical facet joints stiffness at Occiput-C1 (top of the spine and the skull joint) as well as at C1-C2.
There were more active and latent MTrPs in the right trapezius and SCM muscles.

So, with this study and others that have come before it, I would ask the perpetually unanswered question—why do we not see referrals from neurologists and PCPs to chiropractors at least for the evaluation of whether or not these 2 findings are present?

Natural Remedies for Headaches: It’s Not in Your Head

September 23, 2013 by James Bogash

By now, if your neurologist has not discussed a link between your chronic migraine headaches and your heart, it might be time to find a new one.

This is not a new link, but it seems like the headache treatment community has been attempting to keep it secret. Or worse, they are so disconnected from the medical literature that they are still telling their migraine patients that we don’t know what causes migraines. Before we get to the meat of this article, we do need to bring up the blood vessel theory of migraine headaches. Long ago headache specialists believed that chronic migraine headaches were caused by an event that led to constriction of the blood vessels (the cutting off of blood to certain regions of the brain from this constriction was believed to cause the aura associated with the headache). The body then counteracted the constriction by forcing the blood vessels open again, leading to rebound dilation of the blood vessels. This overexpansion of the blood vessels pressing on nerves in the brain was believed to cause the pounding headache of a migraine.

From this theory, the development of drugs of the 5-HT agonist class (drugs like the triptans used heavily to control the pain of migraines–notice I did not say “treat…”) that helps to shrink the blood vessels back down again.

With this history in mind, when I mention that chronic migraine headaches are strongly linked to problems with the blood vessels, I am NOT talking about the theory noted above. Rather, I am talking about vascular health. The inside lining of the blood vessels of your body is called the endothelium. Endothelial dysfunction refers to a condition where the blood vessels no longer react the way they should. In general, there is an imbalance between substances that help open and close the blood vessels when needed. This begins to disrupt the normal functions like clotting, immune function and ability to control the diameter of the blood vessel.

Poor vascular health is the precursor to, and begins years and years before, heart disease, stroke and dementia. And, most importantly, this is a process that occurs in ALL of the blood vessels, not just the blood vessels of the heart or just the vessels of your pinky finger. Or, relevant to this article, the brain.

THIS is why migraines are not, and have never been, a problem in the head. This is just where you feel the most notable symptom first. Let poor vascular health leading to chronic migraine headaches go on for years and heart attacks, strokes or dementia are sure to follow.

Any headache specialist who does not understand this is NOT a headache specialist. They are, most likely, an expert in using medication to alleviate the pain of a migraine.

And just in case you think I’m surely mistaken because you’re never heard of this relationship before, I present this particular study. Researchers compared the blood flow in the heart of 40 patients with migraine to 35 healthy volunteers. Here’s what they found:

In the chronic migraine headache patients, the blood flow reserve in the heart was about 1/3 less.
In addition, blood flow through the left ventricle was reduced in the migraine group.

Basically, the endothelial dysfunction was causing problems with the blood flow through the heart. This is not a cardiac problem and it is not a headache problem; IT IS A BLOOD VESSEL PROBLEM. Until we begin to view chronic migraine headaches through this lens, we will never fix the problem. We will just manage it.

For those migraine sufferers looking for natural remedies for headaches via better vascular health, the most bang for your buck is going to be an anti-diabetic lifestyle. Diabetes and prediabetes destroys the blood vessels, contributing to endothelial dysfunction. For a more complete review, consider my Chronic Migraine Relief eBook or my Migraines and Seizures eBook, both available through Amazon.