10 Headache and Migraine News Highlights from the past 3 Months (July 2017 edition)

Hi everyone! It looks like our Facebook problem is resolved, although it’s taking a while for everyone to remember we’re here. 🙂

So, if you’ve missed some recent posts, here’s your chance to see what’s been most popular with visitors to this site. The most popular post is first. Also, the three posts in bold received the most “likes” on Facebook.

You can help remind people about the information that’s here – share a post that you think is useful!

Also, continue reading below the list for some important reminders…

  1. New Migraine Medication Ready to Apply to the FDA for Release
  2. Migraines and Blue Light – Or Maybe Green Light…
  3. The Low Tyramine Diet for Migraine – Is it time to rethink it?
  4. Back to Sleep: Simple Lifestyle Changes to Fight Chronic Migraine
  5. Pulsed Shortwave (Electromagnetic) Therapy For Headache Pain
  6. New Device Approved by FDA to Fight Cluster Headache (video)
  7. Restless at Night? More Links to Migraine…
  8. Migraine because your Weight isn’t “Normal”?
  9. Warning Signs of Migraine in Children
  10. More Positive Results from the CGRP Migraine Treatments

Thanks for reading! Here are some important reminders. First, if you check the right sidebar on the Headache and Migraine News site, you’ll see a button you can press to ask your questions. This is a new experiment – so ask now and I’ll try to answer some of your questions here in the future.

Secondly, the fantastic Migraine Summit library is still available. For more information, whether you have already invested in this resource or not, see Get the Most out of Your Migraine Summit Library.

Finally, we have a new poll! Check out the right sidebar here and be heard!

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Could Stress Levels Predict Migraine Attacks?

A study published this month in the journal Headache is suggesting that daily stress could actually predict migraine attacks. Could this be a valid way to predict and even avoid migraine attacks?

The relationship between stress factors and headache and/or migraine is well known. However, concern has been expressed (by myself and others) about the way that this relationship is expressed and used in actual migraine treatment.

Could stress predict migraine?The study is Forecasting Individual Headache Attacks Using Perceived Stress (abstract), based on over four and a half years of information from 95 migraine patients. The patients filled out a daily “stress diary” known as the Daily Stress Inventory (DSI). The DSI is designed especially to measure the common daily stressors we all face.

The study authors, who have studied the link between stress and chronic headache before, believe that stress “let-down” is a major factor when it comes to headache and migraine. In other words, they believe that when you have a lot of stress, after that stress is gone you may experience a “let-down” migraine attack.

The authors were generally encouraged by the results, indeed seeing a connection between stress (or, more accurately, stress let-down) and migraine symptoms.

The authors also point out the benefit of being able to predict a migraine attack – the ability to stop an attack before it starts with treatment.

Up to this point, there would be few people who would disagree. Yes, migraine attacks and stress are related. Yes, being able to predict an attack is very valuable.

However . . .

But bear with me. Headlines such as “Today’s Stress Level Predicts Tomorrow’s Migraine Risk” are going to give you quite a false impression of this study and its implications.

First, the authors admit that this is only the first step in an attempt to create a good predictive model (“The stress model in this analysis should be viewed as representing a first step in the new venture of forecasting headache attacks and not a final model for widespread clinical use.”). In other words, no, they have not created a model that will always or even mostly predict an attack. In fact, they found about a 25% success rate in predicting attacks. This is, as they say, “better than chance”. In other words, it’s significant, it shows a connection, but having a 1 in 4 chance of being right is not a great model of prediction. (They use the illustration of a weather forecast – to say that it will rain tomorrow, and being right only 25% of the time, is not very useful!)

Second, there are a number of reasons why stresses one day could lead to a migraine attack the next day. For example:

  • Did the stressful events cause you to lose sleep? In that case, did the stress trigger the attack, or did the lack of sleep?
  • Had the migraine attack actually already started? If there were early non-headache symptoms, such as irritability or fatigue the day before, that could lead to stress. But the stress would actually be a result of the migraine attack, not a cause.
  • There are a lot of things that can cause stress. Did a lack of sleep lead to stressful situations in the first place? Are you always stressed when you’re at that weekly meeting – when you also drink too much coffee? Does the commute mean not only stress, but missing that healthy mid-day meal? In other words, there are hundreds of factors that could be involved, beyond just stress.

For every stress-let-down headache, we’re also seeing a let-down day with no headache. Why is that?

This is not so much a criticism of the study, but a caution against how we interpret it. This study does not show that stress is the cause of migraine attacks, or even the sole trigger. In fact, in most cases, it may not be a trigger at all.

Why is this important? Let’s use a simplistic example. Emily finds that weekly meeting very stressful. It usually causes her to be late to lunch, and she drinks too much coffee during the meeting.

She has migraine attacks, and the doctor blames it on stress. Sure, she could skip the meeting (could that have career consequences?). It might help. But what if she could just drink one less coffee, and bring a healthy snack?

Do not believe the idea that stress=migraine attacks. Many people with very stressful lives have no more headaches than the rest of us.

Besides, we have a lot less control over stress than we do over other things – bringing along that healthy snack, getting to bed at a regular time, exercising regularly, and getting good migraine treatment. In fact, a life without stress would not be very good for you.

Of course this is a complex issue. But again, taking a complex issue and over-simplifying it by saying,”Migraines? It’s just stress.” is not helpful for the patient.

Studies like this are helpful as we continue to try to understand the physiology of migraine. But let’s not be fooled by the headlines.

The full study is available here: Forecasting Individual Headache Attacks Using Perceived Stress

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Migraine, Headaches, and Support (poll results)

Having people around you who are supportive – even one person – can make an incredible difference. Recently we ran a poll to find out about the closest person in your life – just how supportive are they?

First of all, for about 9% of you, the closest person is someone who is not only very supportive, but also has the same condition. But let’s leave those aside for the moment, and look at the rest.

The support of friendsActually, I was happy to hear how many of you have a very supportive person close to you. 13% just raved about the amazing support, another 11% also incredibly supportive, and then 13% very supportive – getting us to 37%, plus those with the same condition, getting us to 46% who are very supportive to varying degrees.

But that is less than half. What’s next? Another 10% have at least taken some time to understand. So that gets us to 56% of friends/family who are at least pro-active.

Next are those who are at least aware that you get headaches/migraine attacks – 35%. Another 5% are only vaguely aware.

Finally, 6% reported that the closest person to them didn’t even know that they had headache/migraine attacks!

So I’m glad to see that many of you have friends and family who are extremely supportive. But really, that’s only half of you. For the other half, the closest person to you has either done very little to try to understand, or – let’s face it – you haven’t shared much!

I realize there are a lot of reasons why this might be. But we need to be pro-active ourselves to make sure that we have people very close to use who know what our struggles are. If it isn’t going to be the person closest to you, look to others who are close to you. Find someone you can talk to, and actually sit down with them this weekend and have the conversation. If you have to, tell them your friend James said it was important for your health. 😀

Let’s get the percentage up to 75% – then to 100% – so that we all have a person close to us who is very supportive. And remember – we need to be supportive of others too!

Here are some inspiring notes from people who do have a supportive friend/family member. And here are some ideas about how faith communities and others can be supportive.

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Pulsed Shortwave (Electromagnetic) Therapy For Headache Pain

Researchers continue to look for non-invasive treatments for headache and migraine, and pulsed shortwave therapy may be one of the candidates.

Pulsed shortwave therapy (PSWT), less precisely known as electromagnetic pulse therapy, is one of many pain-related therapies that have been around for many years. PSWT has been used on injuries and sore muscles with some success. And now researchers are asking if headache patients may benefit as well.

ActiPatch for muscle and joint painMost of you probably know that headaches are not necessarily about sore muscles. But this is not muscle therapy, like physiotherapy that makes your muscles twitch. In fact, patients using this particular device, known as ActiPatch, don’t typically feel any vibration or even heat – ideally, the pain just starts to dissolve.

It’s “pulsed” not because you feel a pulse, but because the shortwaves are turned on and off. They’re actually off more than they’re on, and so the “mean power” is very low.

Although, like most devices, we’re only starting to understand why it works, a working theory is that is works on the cellular level. PSWT may actually help to “fix” cells that aren’t operating properly, this returning them to normal, healthy function and alleviating your symptoms. For more, here is a short description of Pulsed Shortwave Therapy.

ActiPatch itself is already on the market, with good reviews, for back and muscle pain (check out the ActiPatch Muscle and Joint Pain Therapy Device). Now researchers are talking about a headache version, which will target nerves in the head, to see if it could cut down or eliminate migraine symptoms over time.

If you’re in the United States, you may qualify to be a part of the study. You must be over 17, with 3 or more migraine attacks per month. For more information and contact information, visit Migraine Prevention Using ActiPatch (PSWT).

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The Low Tyramine Diet for Migraine – Is it time to rethink it?

One of the most popular migraine-fighting diets over the past 20 years has been the low tyramine diet. Avoiding foods such as soy sauce, salami, aged cheese, nuts and alcohol have been pretty standard. But – is it time to start eating these things again?

Time to rethink the low tyramine diet?There’s no doubt that the low tyramine diet has helped a lot of people reduce their migraine symptoms. But as we have learned over and over again, sometimes something “works” for a completely unexpected reason.

For example, could it be that just avoiding processed foods and being more careful about what you eat is actually the key, no matter what common migraine diet you’re trying? Or is there another chemical or compound in the food that is actually causing the problem, and not tyramine?

For example, the debate about just why some alcoholic beverages trigger migraine attacks in some people is far from over.

The makers of the Curelator app continue to challenge common knowledge about just what triggers attacks – and their latest target is, you guessed it, tyramine.

Taking information from 488 individuals with chronic or episodic migraine, they checked to see if tyramine actually triggered attacks. It did – but not very often.

Tyramine was a “confirmed trigger” in less than 10% of episodic migraine attacks, and less than 5% of chronic migraine attacks.

Now, at first this sounds pretty shocking. But it’s not as simple as it sounds. Don’t forget the “unconfirmed” triggers. And — if we could wipe out 10% of our attacks for sure by avoiding tyramine – or if 10% of migraine sufferers could eliminate their attacks by avoiding tyramine — well, you get my point.

So tyramine does still seem to be a significant trigger. BUT.

But what about all the people avoiding tyramine that don’t need to?

The Curelator researchers found another surprising result. For many people who suspected tyramine to be a trigger, it actually turned out to be a “protector”. In other words, they were more likely to avoid a migraine attack when they ate foods high in tyramine!

Perhaps the biggest take-away from this study is that we’re not always very good at guessing what our triggers are. Life if very complex, and apps like Curelator are heolping us rethink migraine triggers and stop avoiding things that we really don’t need to avoid.

For more on these findings, check out Curelator Headache Presents New Data Underscoring Misconceptions About Migraine Triggers And Protectors At American Headache Society Scientific Meeting

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