Thanks so much for visiting! I hope you’ve been finding the news and tips here useful. Now’s your chance to catch up on what you might have missed – the most popular posts from the last three months! The most popular comes first…
COVID-19 Headache – Is COVID-19 headache something you should be concerned about? Is headache even a symptom a COVID-19?
The Humble Tennis Ball, and Headache – I have a tennis ball and a racquetball in a drawer in my bedroom. Why? Because they’re handy, inexpensive self-massage tools.
CGRP Inhibitor – but, I hate injections! – But I know, some of you are saying – seriously, I don’t care how often it is. I don’t do injections! You might want to keep an eye on a new preventative that may come out in 2021…
Tense Jaw During the Day? – Do you find that your jaw is often tense during the day? Are you clenching, or even grinding your teeth?
I have a tennis ball and a racquetball in a drawer in my bedroom. Why? Because they’re handy, inexpensive self-massage tools.
I was recently looking at an article on massage, and saw this quote:
My orthopedic surgeon didn’t know about using tennis balls for massage! He asked what helped my back pain, and I told him I always lie on a tennis ball. He looked at me like he was going to refer me to a psychiatrist! How can an orthopedic surgeon not know about the tennis ball thing? Doesn’t everyone know about the tennis ball thing?
Well, yes, exactly! There are some great massages that you can do with a tennis ball, and you can get a pack of three for under $10. A raquetball is a little smaller and harder (and even cheaper). A lot of people also recommend lacrosse balls, which are almost as big (sometimes as big) as a tennis ball, but they have a nice rubbery texture, perfect for massage (and they come in lots of fun colours). (I have to support lacrosse – it’s the official summer game of Canada, did you know that?)
And, of course, there are balls made especially for massage such as the TriggerPoint Foam Massage Ball for Deep-Tissue Massage, which has gazillions of high ratings. You can choose the size and firmness of these, which is handy. But again, if you already have a tennis ball around the house, try that first and see how it works for you. Save your money and give it to the Migraine Research Foundation instead.
Massage is a very personal thing, so I won’t share the “ultimate headache massage” here, although we would love to hear your comments about what has worked for you. And massage for headache isn’t just head massage – and not just shoulders. Even a foot massage (grab the racquetball for this one) can help with headache.
Now I’ll let you go, because you’re going to want to check all that out, and hunt down the tennis ball from the garage. Hmmm… might want to wash it first…
Tulsi tea*, a common tea in India, is a traditional headache remedy. But what is it?
Tulsi is a type of basil. Not exactly the kind you typically cook with, which is sweet basil, but a different variety called holy basil (ocimum tenuiflorum). It is sweet and aromatic, and can be used in hot tea or iced tea.
Using basil for migraine is actually fairly common. You may remember that Drs Young and Silberstein mentioned a basil oil massage in their book Migraine and Other Headaches. Some people use it in diffusers, and yes, some cook with it.
Aside from headaches, holy basil may have other benefits that migraine and headache patients may be interested in. It may help decrease inflammation, and help with stress and anxiety. There is even some evidence that it could help prevent cancer. (Read more: 10 Holy Basil Benefits: Tulsi Helps Anxiety, Acne & More and Holy Basil)
To make tulsi tea*, use about a tablespoon of dried leaves per cup, and pour freshly boiled water over. Brew for 5-10 minutes, or longer. For an iced tea, use double the leaves, let it cool, and add ice.
* Yes, I’m aware that “tulsi tea” is not actually a tea, but a tisane. But it is commonly known as tulsi tea. Which does have a ring to it, even if it’s wrong. However, maybe you should tell your friends that you’re making a tulsi tisane, and impress them with your smarts (which may be another benefit of tulsi tisane – increased mental powers).
Migraine symptoms are sometimes “endured” for months or years without serious focus on treatment. Many people are being told that migraine is “normal” and that they just have to “put up with it” and “take an aspirin” (not that aspirin is always a bad idea).
There are other patients who have tried many treatments, and are still, or now, experiencing several headaches a week, or almost constant migraine symptoms. And so “aggressive” treatments are finally tried.
One such aggressive treatment is used for children and teens as well as adults who haven’t responded to many of the most effective drug or even surgical treatments. It’s intravenous dihydroergotamine (DHE) therapy.
This is a serious, aggressive therapy because it generally involves hospitalization. Patients are given DHE every few hours (perhaps 3 times a day).
In spite of the positive results, one of the biggest drawbacks to this treatment is that full hospitalization is very expensive.
But trying to take the treatment to the next level, some specialists in Kansas City are using what they call the “Comprehensive Aggressive Migraine Protocol”, or CAMP. This is a 5 day treatment protocol for 11-18 year old patients. CAMP aims to make two major improvements:
This is “outpatient” treatment, so full hospitalization is not required.
Instead of full focus on DHE, the DHE treatment is combined with other treatments, such as massage therapy, relaxation training, and aromatherapy.
This type of treatment may not only save money, but also save on the extra stress of full hospitalization, as well as the possible stress of having the full focus on the intravenous DHE treatments. Also , it helps the patents take control of their condition by learning techniques that they can use at home in the months ahead. Finally, it brings a number of treatments together, which could mean better long-term success.
CAMP was the focus of a recent study, and here are the results
On average, headache intensity declined by 58% over 5 days of treatment (P<.01). Headache frequency decreased by a mean of 1.5 days per week (p=.01) through 3-month follow-up, with a 27% reduction in the proportion of patients reporting a continuous headache (p<.01). There also was an average reduction of 76% in school days missed per month (p<.01) and significant reductions in indices of healthcare utilization (healthcare provider calls and ED visits) (p<.01).
One statistic alone – the 76% decrease in missed school days – should get our attention. That’s pretty significant.
Sometimes migraine does require “aggressive” treatment. This study reminds us that there are times when we should consciously take time out of “normal life” to really focus on serious treatment, because the benefits for ourselves and those we love in the months and years ahead can be very significant.
Aggressive treatment may take many forms, and one way specialists can help is by giving options to migraine patients – protocols of well-researched and carefully planned treatments, that can break the cycle of migraine symptoms.
Thanks to Adrie from South Africa for this question about migraine attacks around the time of her menstrual period (ask your own question here!).
First, a quick definition, because it is important for treatment. There are two classes of migraine here. One is menstrually-related migraine. This is when attacks occur at least 2/3 of the time day -2 to +3 of your menstruation, but attacks also occur other times of the month.
For the purpose of this question, however, we’ll focus on pure menstrual migraine, in which attacks occur 2/3 of the time day -2 to +3 of your cycle, but at no other time. (Here’s a summary of menstrual migraine in graphic form.)
There is no doubt that hormones are related to these attacks – but, surprisingly, just how they’re related is a bit of a mystery. The theory that we should simply be able to adjust hormone levels to solve the problem has not been the silver bullet.
Adrie is actually already a ways down the road searching for treatment, but hopefully we can help her or some other reader consider some options that haven’t been investigated fully. And remember, we’re speaking more generally anyway, because we will not diagnose a specific case here (even if we had enough information, which we don’t).
But first, the “treatment” that should not be tried – hysterectomy. Dr. Robert Cowan explains well in his book The Keeler Migraine Method:
In the past, doctors tried to modify this trigger through hysterectomy but today we know that hysterectomy will not improve migraines and can in fact make them significantly worse. Hysterectomy causes chaos in estrogen levels, estrogen receptors, and the chemicals that estrogen modifies. A migraineur’s brain does not like chaos. It likes things nice and regular and predictable.
So what are better options? Here are a few:
All-month Lifestyle: If certain things make your attacks worse, don’t fall into the trap of being careful only when the symptoms start. Even something you do days before can impact your symptoms. Are you eating properly? Getting enough sleep? A healthy diet and balanced lifestyle overall can improve things significantly.
Drug options: Taking an abortive even before the attack hits, or early on, can help you avoid the migraine monster. NSAIDs are commonly prescribed. One of the most helpful targeted migraine drugs is frovatriptan, taken twice a day for five days starting two days before you expect your menstrual cycle to begin. Here’s a quick summary of other medications.
Hormone Replacement Therapy: If I understood correctly, this is something Adrie is trying, but so far without success. This has helped many women, but again, it’s not the solution for everyone.
Contraceptive Changes: If you’re using a contraceptive that’s affecting your hormones, there are a number of options you could try, either to help narrow down what’s causing the problem, or to alleviate symptoms. For example, trying a low-estrogen pill, or investigating other forms of contraception.
Hydration: Dr. Angela Stanton, the “Queen of Hydration” thanks to her book Fighting the Migraine Epidemic, discusses in detail systems of hydration for migraineurs. Jumping of current research into the reason for menstrual migraine, she suggests that the female brain needs more “voltage” to run the menstrual cycle. Her suggestion (along with her full system that you can read about in the book) is to prepare 5 days ahead – no sugar, and more water (along with more salt). In her system, that would be an extra glass of water and an extra salt pill a day.
Preventative Medications: Preventative meds should be used cautiously with pure menstrual migraine, because they will affect your body 24-7, not just once a month. However, in severe cases, doctors may suggest a preventative.
Supplements: Adrie has tried some supplements without success. But some of the top ones include magnesium (and if one doesn’t work, try another – see Which Magnesium Supplements Work?) and vitamin E.
Other Treatments: If drugs can be avoided, or fewer drugs taken, that’s a better road to travel. Some excellent treatments include biofeedback, massage, deep breathing, and essential oils.
Final note: Keep a diary. Keeping track of your attacks is extremely important with menstrual migraine, even though you would think it isn’t. Some women find that, for example, when they give into a premenstrual craving, they make symptoms worse. Dr. Cowan, mentioned above, gives one story of a patient that illustrates well the need to keep track:
Partial triggers may show up in association with other triggers. For example, I had a patient who got her most severe headaches when she had her nails done during her period but not at other times. It took her about four months of journaling to pick this up. When she changed salons to a place that didn’t use heavy lacquers, she was fine.
Menstrual migraine is a difficult beast to fight (see 8 Reasons why Menstrual Migraine is “different”). But there are good solutions out there. Feel free to leave a comment, letting us know what has worked well for you!