Migraines and the Efficacy of Massage Therapy and Traditional Chinese Medicine

75% of adults ages 18-65 have reported experiencing a headache in the last year. 14.7% of the world population suffers from migraines, typically one a month. 2% suffer from chronic migraines, suffering 15+ days per month. Women are three times more likely than men to be afflicted. While headaches are common and tolerable, not affecting daily life, migraines are deeply misunderstood. The suffering is invisible, left at home, the afflicted cancelling plans last minute, calling out of work, remaining isolated for hours or even days. For those not understanding migraines, the thought of staying home from work or cancelling on friends for a mere headache seems like a cop out or of weak constitution. The misunderstanding is that a migraine is just another word for headache, synonymous in meaning, which couldn’t be further from the truth.

Migraine is defined by the Mayo Clinic as a severe throbbing pain or pulsing sensation, often presented on one side of the head (usually the left), and may be accompanied by nausea, vomiting, sensitivity to light and sound. They can last for hours or even days, with pain so severe it interferes with daily life. Four typical phases have been identified:

Phase 1 - Prodrome: warning signs up to 72 hours before a migraine hits, include severe exhaustion, hyperactivity, difficulty concentrating, food cravings, sleepiness, and/or neck pain;

Phase 2 - Aura: visual disturbance reported in 33% of those suffering from migraines and may last from 20-60 minutes. Vision may be interrupted by sparkly spots, zigzag lines, or tunnel vision; can present in vertigo, ear ringing, or temporary paralysis on one side of the body; pins and needles sensation in face, hands, arms or legs;

Phase 3 - Migraine Attack: throbbing, piercing, or pulsating, difficult to manage the pain with medication; sensitivity to light, sound, smell; nausea and vomiting; can occur over hours or days;

Phase 4 - Postdrome: recovery period in which the afflicted may feel exhausted, sluggish, confused, and/or depressed.

The cause behind migraine is fairly unclear, however, it is generally accepted that genetics and environmental factors play a role. Although previously considered a vascular issue, migraine is actually a neurological disease. Leading research focuses on interactions with the trigeminal nerve (a major pain pathway) or imbalances in brain chemicals (like serotonin) to try to find a cause. Triggers include: 

• hormonal changes in women, 
• drinks: alcohol, too much caffeine
• stress
• sensory stimuli: bright lights, sun glare, loud sounds, strong smells 
• sleep changes: lacking sleep, too much sleep, jet lag
• physical exertion
• weather changes/barometric pressure
• medications: oral contraceptives, vasodilators
• foods: types of food eaten or the lack of food/skipping a meal
• food additives: ex. aspartame

Traditional Chinese Medicine (TCM) views the cause of migraines either an environmental invasion of external wind, cold, heat, dampness (i.e. sitting directly in the fan of frigid air-conditioning) or poor lifestyle creating imbalances of the body’s vitals (i.e. poor sleep, high stress) (Quek). There are five types of migraine, according to TCM:

“1. Liver-Yang Aggression: Pulsaing/throbbing headaches triggered by heat, stress or foul temper, dizziness and confusion, dry mouth, insomnia, painful and itchy eyes, yellowish urine. 

2. Stagnant Blood: Localized sharp piercing pain with throbbing sensations, painful when pressed on even when not going through a migraine attack, dry mouth in the night, dried and flaky skin, sharp pains in the eyes. 

3. External Wind and Cold: Headaches triggered by cold or dry air, mild dizziness, stiff neck, aversion to cold environment, pain alleviated by a hot compress. 

4. Liver-Qi Stagnation: Expanding, throbbing headaches, triggered by stress or negative emotions, depression, mood swings, breathlessness, loss of appetite. 

5. Phlegm Blockage: Heavy and pulsating headaches, extreme dizziness and sleepiness, nausea and vomiting, blurred vision, indigestion, reduced urination, irregular bowel movements.” (Quek)

TCM suggests treating migraine with acupuncture, typically most effective in the middle of an episode, but also effective at the prodrome or aura stages. TuiNa, especially for those with an aversion to needles, is effective for all stages of migraine and help with migraine prevention and symptom reduction. Scraping, to remove myofascial trigger points. And herbal medication, for all stages, to help alleviate symptoms.

Because TCM treats the person as an individual, there isn’t one single diagnosis. Western medicine has options for injections and medications, both prescription and over-the-top, to assist with oncoming attacks, during attacks, and the prevention of attacks. Research is still developing, and as with TCM, there is no one size fits all treatment in Western medicine. 

SOURCES

“Facts and Figures.” The Migraine Trust, 5 July 2019, www.migrainetrust.org/about-migraine/migraine-what-is-it/facts-figures/. 

Golden, Katie M. “Tackling Migraines Head-On: Massage Therapy Journal.” American Massage Therapy Association, 23 May 2017, www.amtamassage.org/publications/massage-therapy-journal/tackling-migraines-head-on/. 

“Migraine.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Jan. 2020, www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201. 

“People with Migraine Endure More Social Stigma than Those with Asthma.” American Headache Society, 16 Feb. 2016, americanheadachesociety.org/news/people-with-migraine-endure-greater-social-stigma-than-those-with-asthma-same-as-those-with-epilepsy-or-panic-disorder-2/. 

Quek, Ardy. “Migraine 101 - Causes & TCM Treatments.” PULSE TCM, 28 Oct. 2020, www.pulsetcm.sg/migraine-101-causes-and-tcm-treatments/#:~:text=There%20are%20two%20causes%20of,head%20and%20triggering%20migraine%20episodes. 

images: 

https://americanmigrainefoundation.org/resource-library/can-headaches-worsen-in-number/

https://migrainebuddy.com/migraine/2018/9/27/the-stages-of-a-migraine-migraine-attack

https://sofiatrends.com/?s=headacheno,%20headache%20relief,%20tension%20headaches.html