Migraine is often associated with trouble sleeping. This means that a sleep disorder could be making your migraine worse, or your migraine may be contributing to your lack of sleep.
One of the comorbid conditions, a condition that tends to go along with migraine, is restless legs syndrome (RLS) (also called Willis-Ekbom Disease). In RLS, you have trouble sleeping because of sensations in your legs. Your legs feel restless, or throbbing, or aching.
In searching for the latest research for RLS, I was reminded of one that is being used currently that has also been used for a long time for insomnia itself – and that is, progressive muscle relaxation. It was first described in medical literature almost a hundred years ago, but it’s still being studied today.
The beauty of progressive muscle relaxation is that you can learn to do it at home in bed, with no devices or drugs, and no spending of money. 🙂 It’s a technique that has been used with migraine patients, restless legs syndrome patients, and insomnia patients alike. That means that it also may help improve symptoms in a number of related conditions.
Progressive muscle relaxation is a specific way to tense and then relax muscles throughout the body. Detailed descriptions can be found in the linked articles below, but it’s not complicated. And trials have had quite positive results.
If you have trouble sleeping, do yourself a favour and check out an article or two below. This is a simple technique that may make a significant difference.
Cryoneurolysis is a treatment that has been used for chronic pain, but what about headache?
You may have already guessed from the prefix “cryo” that this has something to do with cold, and you’re right. In this case, it’s extreme cold – we’re not talking about ice packs.
When we use cryoneurolysis to treat pain, it’s called cryoanalgesia. There are other applications, but that’s the one that’s important to us at the moment..
Cryoneurolysis involves inserting a probe (a “cryoprobe” – no kidding) into the body to apply extreme cold to a speficic area, usually nerve tissue. The cold breaks up some of the tissue, interrupting the pain signals that are carried by the nerve. The nerve will actually regenerate over time, making this a temporary procedure – although at times the regeneration may improve your symptoms.
Now we know that for many types of headache, simply cutting off a certain pain signal from a certain nerve isn’t the answer, and may cause more problems than it solves. However, when we have a more specific understanding of where the pain is coming from, this may be a useful procedure, although it isn’t widespread yet (for headache conditions).
When you see the word “neuralgia” – a certain kind of nerve pain – that’s a clue that this type of treatment might be useful. Patients have received surgery for occipital neuralgia, for example, a certain kind of head pain from certain nerves. This 2021 study is an example of the work that’s being done for this type of condition.
Cryoneurolysis has its drawbacks, which we’ve already mentioned. Its use for headache is not widespread. But it also tends to be unpredictable in its duration. How long will the pain relief be? That may vary quite a bit. And it is still a surgery.
However, researchers continue to investigate because it’s a relatively easy procedure, with few side effects. If it’s found to be useful, it can also be a very cost-effective treatment. And although the duration of relief may be unpredictable, it can last for a long time in some patients – much longer than the pills people are taking that only last a few hours at best.
Are older drivers with migraine more likely to have a car accident? If so, why? A recent study at the University of Colorado Anschutz Medical Campus, sponsored by AAA, asked this question.
Perhaps most interesting were the things that weren’t likely to increase risk of vehicle accidents. First of all, seniors (ages 65-79) who had a history of migraine were not, in general, more likely to be involved in car accidents. They weren’t worse drivers, they weren’t at a higher risk. Good news so far.
However, these drivers did tend to drive a little less (no surprise there). And they also tended to have more “hard braking events”. But no increase in accidents. So at least their reflexes are still good!
The researchers also failed to find a connection between certain medications and accidents, although there may not have been enough information in this particular study to come to a hard-and-fast conclusion.
But here’s the twist. Older drivers who experienced new migraine did have a higher chance of accidents. In fact, in the group who experienced their first migraine symptoms over the past year, the risk of car accidents was three times higher than in the other groups (people who had already experienced migraine, or those who had never had migranie symptoms).
Why would this be? Were these people simply not used to the symptoms? Is it possible that new medications were to blame (although it seems like this wasn’t the case)?
Is it possible that some of these cases were not actually migraine? This is an interesting question, because as we all know, sometimes getting a proper diagnosis can take much longer than a year. Also, finding a good treatment can take longer than a year.
While we don’t know exactly why the risk goes up for newly diagnosed migraineurs 65 and over, it’s worth it to be aware of the potential risk. Lead author of the study, Dr. Carolyn DiGuiseppi, puts it this way:
These results have potential implications for the safety of older patients that should be addressed. Patients with a new migraine diagnosis would benefit from talking with their clinicians about driving safety, including being extra careful about other risks, such as distracted driving, alcohol, pain medication and other factors that affect driving.
The researchers also recommend that future studies take a closer look at “timing, frequency, and severity of migraine diagnosis and symptoms, and use of medications specifically prescribed for migraine, in relation to driving outcomes”. With a significant increase in risk, it would be helpful to know exactly why this is the case. Is it the case for a certain type of migraine? A certain type of treatment?
If you’re 65 or older and have been newly diagnosed, be sure to do your research and if possible see a headache specialist, not just a family doctor. And be aware that migraine can have a significant affect on various parts of your life, even if you’re not in pain at a specific moment.
A recent study published in Neurology took a look at how stigma may affect migraine disabilty.
I put “stigma” in quotations in the title, not because it’s not real, but because sometimes it’s defined in different ways. This study used a very helpful measure, using a tool called the Migraine-Related Stigma (MiRS) questionnaire. MiRS divides stigma into two categories:
“feeling that others viewed migraine as being used for secondary gain” – for example, someone thinks you’re using migraine as an excuse to get out of work, or to make people sorry for you.
“feeling that others were minimizing disease burden” – for example, someone says “it’s just a headache – deal with it”.
These are very helpful categories, and most of us know exactly what they’re talking about from personal experience.
Researchers have noticed that, in the case of many diseases, stigma seems to actually affect outcomes. In other words, maybe your treatment won’t help as much if people around you are minimizing your symptoms. So – is the same true for migraine?
You would think that there would be some corrolation – for example, the person who has more “headache days” in a month is likely to experience more stigma. And you would be right – that is exactly what happens.
But one of the more interesting findings in this study was this: even if you account for that, even if you take away the factors of more or less headache days, or even the symptoms and severity of the attacks, stigma still seems to increase disability (or disability leads to more stigma). If you experience stigma, you tend to be more disabled (even between migraine attacks), and have an overall poorer quality of life.
In fact, researchers pointed this out: People with fewer than 5 headaches a month, but who often or very often experienced stigma, had a worse quality of life than those who had over 25 headaches a month and yet never experienced stigma!
One other interesting note: Researchers did not see a major difference between men and women regarding stigma – both experienced it to about the same degree.
However, there does seem to be a general picture emerging:
Migraine patients still often experience stigma from others (about 1/3 said “often” or “very often”)
That environment of stigma may be increasing migraine disability
In the end, you are you – you are not the other person, and you have a limited ability to control what they do or say. Yes, we do need to speak out when we can to help others understand and be more informed (while listenening to other points of view as well). Advocates with websites like this one or those who have various media platforms are certainly helping get the word out.
And sometimes just recognizing the problem can help us think through it. There are times when we need to be aware that someone else is just not understanding, and that no one really knows how we feel.
Migraine is serious, and can have a long lasting impact on health and on your life in general. Let’s keep working together to make migraine stigma a thing of the past.
Our friends at The Migraine World Summit have already announced the topics that they’re going to be covering (March 6-13) – topics based on questions that were sent in by migraine patients around the world.
Today’s Tip
In fact, if you go to the schedule page here, you can see the topics and click on the specific interviews to see what questions they’ll be addressing.
For example, being myself a fan of Dr. Dawn Buse, I wanted to know more about her topic, “Brain-Related Comorbidities of Migraine”. Here are some of the questions she’ll be dealing with:
What is multiple sclerosis (MS), and how is it related to migraine?
What is fibromyalgia, and how is it related to migraine?
How does the risk of stroke influence the choice of medications for treating migraine?
What is insomnia, and how is it related to migraine?
A few things to look forward to
Sounds pretty practical! Here are some other questions that might interest you – but please go and check out the schedule for yourself. (Be sure you’re signed in, or register now for the summit.)
How does a diagnosis of chronic migraine change the nature of treatment? (Controlling Chronic Migraine)
When should a patient seek a second opinion or specialized care for their headache disorder? (Beginner’s Guide to Headache Types)
What are the potential side effects and risks associated with Excedrin Migraine and other over-the-counter (OTC) headache medications? (How Much Is Too Much Excedrin Migraine?)
What safety data is available for CGRP-targeted medications? (Balancing Risks & Benefits of Migraine Treatments)
What advice would you give to someone who feels like they have tried everything to manage their headache disorder? (New Daily Persistent Headache: Pain That Won’t Stop)
How can we advocate for ourselves with our healthcare providers? (Migraine FOMO: Are You Missing Out?)
What is an effective but realistic way to schedule exercise if you have migraine disease? (Best Exercise Options for People With Migraine)
What are signs of an insufficient supply of energy to the brain? (Is Migraine a Brain Energy Problem?)
Why should people with migraine disease take dietary supplements? (Supplements & Foods That Ease Migraine)
How does a migraine attack change during perimenopause and menopause? (Menopause, Perimenopause & Migraine)
That’s just a few – there are dozens more.
And remember, these are fresh new interviews with some of the world’s leading experts – not recycled information that’s been stale for years.
