SEVERE MIGRAINE HEADACHES

Chiropractic care is a safe, non-invasive way to relieve migraine suffering without the use of medication. Chiropractic migraine treatment is not for everyone, but it may be particularly useful for patients who cannot use prescription medication due to other risk factors.

Migraine headaches are idiopathic. This means that despite the last century’s advances in medical science their cause is still unknown. A number of theories exist to explain migraines. They include a possible serotonin deficiency in migraineurs, genetics malformations, and arterial swelling in the cranium.

A common chiropractic theory is that subluxations in the muscles at the base of the skull and the neck cause, or contribute to, the formation of migraine headaches. Subluxations are tense areas in the muscles adjoining the small bones of the upper spinal column. On an x-ray, the bones appear to be in the correct place and medical doctors often miss the tension in the muscles. A chiropractor gently manipulates the spine to relax these subluxations.

Chiropractors offer two varieties of care for migraine patients, straight chiropractic and mixed chiropractic. Straight chiropractic only involves manipulation of the spine and spinal subluxations. Mixed chiropractic care combines traditional manipulation with other complementary techniques. The focus in mixed chiropractic is to reduce overall neck strain and tension.

Researchers at Northwestern College of Chiropractic in Minnesota recently compared chiropractic care with drug therapies for migraines and chronic tension headaches. The study was published in the Journal of Manipulative and Physiological Therapeutics. Two hundred eighteen headache patients were given either drug therapy or regular chiropractic care. Both groups reported a 40-50% reduction in headache pain at the end of the study.

Follow ups four weeks after discontinuing all care showed only the chiropractic group still enjoying the pain reduction the treatment initiated. Only 20-25% of the drug therapy patients were still benefiting from their treatment at this follow up.

Being in pain so fierce that the only recourse is to hide in a dark, quiet room until it is over several times a year would make anyone sad.  Migraineurs, though, are five times more likely to develop clinical depression than people who do not have these debilitating headaches.  Conversely, people who are depressed are three times likelier than happy people to become migraineurs.

Many scientists view the intertwining of migraine and depression as a chicken or egg situation.  They are patently comorbid, but does one cause the other?  If so, which one starts the process, the migraine or the depression?  The answer is not that simple.  Migraines, depression, and, unsurprisingly, insomnia, a state associated with both conditions have something in common.  All three are associated with neurotransmitter deficiencies in the brain.

Doctors believe that while they are related, depression and migraine headaches have distinct causes with a similar neurobiology.  For years, doctors blamed depression in migraineurs on their resultant loss of quality of life due to headaches.  Now it looks as though the link is a biologic shared mechanism rather than psychology.

One danger for clinically depressed migraineurs is possible drug interaction between their depression medication and their migraine drugs.  In July 2006 the FDA recognized one such danger, that of mixing triptans for migraines with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (serotonin and norepinephrine reuptake inhibitors), used to treat depression and mood disorders. Combining the drugs can lead to a condition called serotonin syndrome.

Serotonin syndrome occurs when there is too much serotonin in the body.  Symptoms include hallucinations, increased heart rate and body temperature, fast changes in blood pressure, and gastrointestinal upset.  Sometimes a patient has no choice but to take these medications together, but they need to weigh their options with their doctor and be monitored closely for serotonin syndrome.