Understanding Migraines and Headaches
We are shedding light on conditions that affect over 1 billion people worldwide.
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Migraines are more than just bad headaches. They are a neurological disorder involving changes in brain activity and blood flow. Common symptoms include:
ā¢ Pulsating pain (usually on one side)
ā¢ Sensitivity to light and sound
ā¢ Nausea or vomiting
ā¢ Visual disturbances (aura)
There are many types of headachesātension, cluster, cervicogenic, and sinus-relatedāand each has a different root cause and treatment approach.
At Precision Brain Center, we take a neurological perspective to migraines and chronic headaches. By evaluating brain function, vestibular balance, blood flow, and stress regulation, we identify patterns that may be contributing to the frequency or severity of your headaches.
What is the difference between migraines and headaches? The answer can be complex. Watch the video below to learn more about this topic.
We traditionally think of migraines as a neurological disorder. The reason for this is a migraine is usually accompanied by a lot of neurological symptoms. The neurological body of knowledge has come to the understanding that there are changes in the brain that correlate with a high firing rate, almost like epileptic seizures. This is the reason why it has transitioned into the category of neurological disorders.
With that being said, we also see lot of headaches that are symptomatology of what is going wrong in the brain. For example, post-concussion syndrome can present with post-traumatic headaches that are debilitating and can accompany neurological symptoms as well, including dizziness, nausea, etc.
Traditionally, when we talk about migraines, we are referring to the presentation. What is interesting about migraines is that sometimes people do not experience pain while having a migraine. To name a few categories of migraines, there are vestibular migraines, optic migraines, and traditional migraines, but there is an array of symptoms including nausea, sensitivity to light, the aura where you see lights flashing, etc.
There can be a lot of confusion around headaches and migraines and can be difficult to differentiate for some people. What are the similarities? What are the differences? Why is there confusion between the two?
There can be a lot of confusion on the types of headaches and if you are experiencing a migraine versus a headache under primary or secondary. Primary means that there is not something causing the headache or no underlying condition that is the cause of it. Secondary means that there is a cause for the presence of a headache. An example of a secondary headache is a dehydration headache. Lack of water intake could be causing the headache or something metabolic. For example, during a menstrual cycle, someone may experience headaches.
Migraines can be unilateral, throbbing, pulsating, and even focus behind the eyes. Many times an individual experiencing a migraine may think “This is the worst headache I have had in my life. It has got to be a migraine.” That may not always be the case. Not every headache is created equal. Cluster headaches are sometimes argued by neurologists as one of the most painful headaches. Cluster headaches occur behind the eyes and may cause the individual to have a runny nose or water eyes. It can be a common misconception that just because you are having a bad headache, it has to be a migraine. However, this is not always the case.
It is helpful to note in looking at the commonality between migraines and headaches what areas of the brain experience pain and also how pain occurs in migraines or headaches. Our brain does not actually have nociceptive receptors so it does not feel pain. However, the nociceptive receptors are lining our blood vessels. The outer layer that keeps the brain nice and secure, the pia and dura mater, do have nociceptive receptors in it as well. These areas experience pain. One of the things that triggers a nociceptive receptor to fire and send a pain signal is going to be changes within the diameter of a blood vessel, called vasospasm. This is when our blood vessels constrict and dilate abruptly.
One of the most important things for the brain and neurons is to get proper blood flow. If we can’t get proper blood flow to neurons, they die. This is an emergency alert situation where we need to feel pain because something is wrong. When talking about both migraines and headaches, their underlying physiology is going to be the same: the nociceptive fiber relating to blood flow and vasoconstriction.
Here are some tips that are helpful for you to do at home. Each individual has a different brain, a different baseline, and vastly different reasons for having headaches based on their individual brain function. Different things will work differently in one person compared to another. So let’s figure out what is going on with your nervous system, specifically the autonomic nervous system.
As a refresher, the autonomic nervous system is the combination of the sympathetic and parasympathetic nervous system. The sympathetic and parasympathetic nervous system do very different things. Some areas will dilate blood vessels and other areas will constrict blood vessels. The sympathetic and parasympathetic nervous system work together in tangent. Both systems are important and need to be balanced. Some people may think of the sympathetic nervous in a negative light, but it is so important and has some beautiful and wonderful jobs that we need for it to do and that allow us to thrive as human beings.
For those of you at home, there are a couple of areas that will change our autonomic nervous system and change the response. The way we can utilize this is with temperature changes. Temperature is going to have a constriction effect with cold and then a dilation effect with hot. One person may need more constriction while another person may need more dilation within their blood vessels controlled by the autonomic nervous system. There are three locations where we can test this out. One is right on the forehead. Another is over the carotid arteries in the front of the neck. Another is at the base of the skull in the back.
Starting with the forehead, take an ice pack or a heat pad depending on your temperature needs. For example, if you take a cold shower and your headaches feel better, start with an ice pack. If you take a hot shower and your headaches feel better, start with a heat pad. Each of the three locations you hold the heat or cold to will have a different consequence centrally in the brain. Therefore it is worth trying applying heat or cold to all three areas and notice your specific results. Start with 5 minutes at least. Be sure to start with a gentle, comfortable temperature: not too hot, not too cold. After holding this for 5 minutes in each location, ask yourself “Is this making the headache better, worse, or is it staying the same?” If it is worse or the same, stop applying and move on to the next location.
After applying the hot or cold in each of the three locations, switch to the other temperature than what you had done previously. For example, if you did cold first in each location, now do hot and vice versa. After holding this for 5 minutes in each location, ask yourself “Is this making the headache better, worse, or is it staying the same?” There should be at least one of the temperatures in one of the three locations that works for you to bring relief to the headache.
For those who like spicy foods, they contain capsaicin which can be helpful as well. Spicy foods can help a headache because it has a dampening effect on our nociceptive fibers.
Another thing worth noting is that some individuals have migraines and headaches due to magnesium deficiency. You can take this and see if it starts helping relieve the headaches. If you take it at night time it should help you sleep as well.
Water is important. Electrolyte balance is important. When we are talking about the autonomic nervous system and blood vessels, we are also involving our heart rate, our blood pressure. How hydrated you are and how concentrated your blood is with electrolytes is important for blood pressure and heart rate consequences. These factors change vascular peripheral resistance. Make sure you are getting enough salt. Even though sometimes salt is spoken negatively of, it does have an important role in our body.
How long can a migraine last and is there a certain point where someone should seek extra medical attention?
We are all very different individuals, and sometimes we may not have access to medical care. With that being said, migraines are very serious. At times they resemble epileptic seizures because we get this spontaneous firing rate. When that happens, we lose blood supply. We will get a little ischemia in these areas. When neurons lose blood supply, they start spontaneously firing. Especially if this is a new migraine or a new onset of headaches, you should go see your primary care. That is the first place to start. Next, if you are worried about something acute, emergency types of situations, you want to go to the ER and see a neurologist. Precision Brain Center can help individuals who may not be responding to medication or your migraines are getting worse. If that is the case for you, it is worth checking out functional neurology. First and foremost is making sure you are safe and that there is nothing going on in terms of an emergency.
The length of migraines can be very different for many people. Sometimes they escalate. Initially they may start and there is about 24 hours and the longer someone has had migraines, let’s say for 5 years, they could be out for days to weeks. These migraines can have a massive impact on your nervous system.
š¬ Have questions about migraines or chronic headaches? Call or send us a message.
