Neurostimulator Implants And Migraines

One out of every eight people suffers from migraine headaches. There is currently no treatment available to eliminate the condition; doctors merely help patients manage the symptoms. A new treatment is being tested that may offer more pain relief than any other method to date for migraine sufferers.

In September 2006, reports began surfacing about a surgical procedure that may help migraineurs. Dr. Sandeep Amin, an anesthesiologist at Rush University Medical Centre in Chicago, Illinois, is pioneering a radical new treatment.

Dr. Amin is studying the potential of a treatment he calls “occipital nerve stimulation”. The treatment calls for the implantation of a small neurostimulator in the neck. This device sends electrical impulses to nerves under the skin at the base of the head at the back of the neck.

The device being used Dr. Amin’s nationwide, double-blind study is the Boston Scientific Precision neurostimulator. The Precision neurostimulator is the smallest rechargeable, implantable neurostimulator on the market (as of 2006) and is already FDA-approved for spinal stimulation for chronic pain treatment.

If the study is successful, it offers new hope to migraineurs, particularly those who have found their pain resistant to currently available treatment modalities.

Dr. Amin’s study is not the first. In 2004, Medtronic, Inc., a medical technology company, conducted a study of occipital nerve stimulation for migraines using one of their own devices. The study was initiated after a Dallas doctor successfully used the experimental treatment to relieve pain for a migraineur. A review of the company’s website, www.medtronic.com, showed no information on the study, making it likely that, for whatever reason, the 2004 study was unsuccessful.

Dr. Amin states that his treatment is not for everyone, and, if it is successful, recommends it only for patients who have been unable to achieve pain relief through medication or other, more common, treatment methods.

Migraines And Rebound Headaches

A rebound headache, also known as a medication overuse headache, is one of the most unpleasant side effects of migraines for many sufferers. These headaches are often blindingly painful, and are sometimes migraines in their own right.

How do people get rebound headaches? Put simply, they try just a little too hard to find relief from their migraine pain. The migraineurs is in pain and takes medication. They are still in pain later and take a little more. That does not help, so they try more medicine to relieve their suffering.

A rebound headache is when a migraine (or other severe headache) spins off into another headache as a result of medication overuse. A rebound headache is basically the original headache, which is only temporarily masked by all the drugs. When the body is finally clear of all the medications, the headache pain returns or rebounds.

Sometimes the rebound is a migraine or a continuation of the previous migraine. Others it is a blindingly painful new headache in its own right. The new headache is excruciatingly painful but without the additional symptoms, like nausea and photosensitivity, that often accompany migraines.

The overuse of any over-the-counter or prescription pain reliever can cause a rebound headache, but the two most frequent culprits are aspirin and acetaminophen. Other drugs often involved in the rebound cycle include caffeine, opiates, prescription combination medications like Midrin, codeine, ergotamine titrate, and drugs that contain barbiturates.

While all really painful, chronic headaches should be discussed with a doctor, there are a number of indicators that someone is probably suffering from medication overuse headaches. These include:

* daily or every other day headaches * medications no longer provide the relief they used to * prophylactic medication use

With the help of their doctor, rebound headache patients can break the cycle.

Migraine Stages

Migraines develop in four stages. Patients with migraines with aura, also known as classic migraines, are most likely to experience all four stages. Patients who have common migraines, migraines without aura, will have the same stages, but are not consciously aware of them. The interval between migraines is sometimes referred to as the fifth stage of a migraine.

Stage One – Prodrome

The prodromal phase usually begins one or two days prior to the actual migraine headache. Many migraineurs call this the “premonition” phase. Feelings during this phase are all over the map. Each migraineur has their own personal prodrome profile. Some are giddy, happy, and full of energy, far more so than usual. Others feel a headache start with fatigue, weakness, and irritability. Anything can herald a migraine and each person has to learn their own prodrome signs if they want to learn to stave off the migraine.

Stage Two – Aura

This phase is skipped by most migraineurs, since most migraineurs suffer from common migraine, migraine without aura. For those who experience classic migraine with aura, auras can begin anywhere from five minutes to an hour before the headache begins. Auras are visual effects migraineurs experience. Objects appear to have bright auras or haloes around them. Lightning flashes arc over the field of vision until sight is whited out just before the pain begins.

Stage Three – Headache

This phase lasts anywhere from four to seventy-two hours. Most common is a one-sided headache with a throbbing or pulsing characteristic. The headache is frequently accompanied by stomach upset, nausea, vomiting, and sensitivity to light, sound, smell, or some combination of the three.

Stage Four – Postdrome

Coming away from a migraine can be as unpleasant as building up to one. Postdrome is often characterized by tenderness of the head, neck, and stomach. Weakness and fatigue are also common in this phase.

Migraine Myths

There are a number of commonly held beliefs about migraines that make it hard for sufferers to get proper diagnosis and treatment.

1) Migraines are not real (all in the head, an overreaction to a normal headache, etc.).

Not true. Migraines are a biologic primary headache disorder. Even migraine pain is not confined to the head, though that is generally where it is worst.

2) Migraines have a known cause.

Sadly, no. There have been several interesting theories put forward in the last decade, but no single, definitive biological cause of migraines has been identified thus far.

3) All migraineurs have the same symptoms.

No, they don’t. This is one of the things that makes migraines so hard to diagnose, particularly if a patient’s doctor is only familiar with the most common symptoms.

4) A doctor can tell if it’s a migraine or not.

Not always. The wide spectrum of symptoms that can accompany migraine can make it difficult to diagnose, more so if the patient is not forthcoming with their doctor about all their symptoms.

5) Migraines are curable.

Again, no. Once properly diagosed many migraineurs still have to devote a lot of time and energy to managing their condition through medications, natural and homeopathic remedies, and diet and lifestyle changes. The various available coping methods work differently for each individual, so there is not even a single protocol of care.

6) Migraines are a woman’s headache.

Women migraineurs do outnumber the men 3 to 1, but there is no evidence the condition is sex-linked in any way.

7) Only adults get migraines.

Migraines have been diagnosed in adolescents, children, and even infants.

Every headache a migraineur is a migraine

Not true. Migraine sufferers can have regular sinus, tension, or stress headaches just like anyone else.

Common Migraine Food Triggers

No one knows for sure what causes migraine headaches. The most likely to answer to-date is that a serious of small irritations or reactions pile up until, finally, a migraine headache is triggered. Migraine triggers are different for each individual, but many migraineurs claim that a particular food or combination of foods will push them over the edge into a headache.

Keep in mind that most science disagrees with migraineurs when it comes to food triggers. There are no conclusive studies indicating a link between certain foods and migraine headaches, so all information is anecdotal. The thing is there is a lot, tons in fact, of anecdotal evidence for the link.

While a migraine trigger food can be, quite literally, anything, some foods come up on the trigger list for enough people to merit discussion.

Cheese

Cheese is a major trigger for many migraineurs. Particularly likely to cause an attack are hard or aged cheeses. Soft cheeses like cream cheese and new cheeses seem to be fine and unlikely to cause problems.

Processed Meats

Nitrates are believed by many to be a major migraine trigger. For most people, the most common source of nitrates is processed meat, items like hot dogs, sausage, bacon, processed lunchmeats, etc.

Condiments

Salad dressings are a trigger for many. The reason is not known, but is probably tied to a combination of other triggers all coming together in one place.

Spices and Additives

Any spice can be a trigger. Spices as triggers may be tied, at least partially, to scent sensitivity, since many spices have a pungent odor. Seasonings that seem to give migraineurs the most trouble include monosodium glutamate (MSG), common in Asian foods, artificial sweeteners, food dyes, and vinegar.

Migraineurs who suspect a food trigger should consider trying an elimination diet to pinpoint the trigger food(s).

Chiropractic Care For Migraines

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.

Acupressure And Migraines

Acupressure is a completely non-invasive treatment option that has a high success rate among migraineurs (people who suffer from migraine headaches). It has a proven track record as a successful pain abatement technique. Acupressure is also efficacious in reducing both the frequency and intensity of migraine attacks.

In Traditional Chinese Medicine, there are over 800 vital energy points in the human body. These points lie along meridians that run throughout a person’s body. Chi, or life energy, flows along the meridians and through the energy points in healthy people. Chi that is blocked or overabundant near particular energy points causes illness and pain. Acupressure massage applies pressure to these energy points in order to release chi and stimulate the body’s own healing mechanisms. The energy points are massaged with the fingers, thumb, or occasional blunt object with medium pressure in a circular pattern. The simplest acupressure a migraineur can learn is an all-over head massage. This technique just requires the practitioner to massage the scalp as though they were washing their hair. Sit with the elbows resting on a table to prevent arm strain and the head resting lightly in the hands to perform head and neck acupressure.

Moderate pressure applied to the GB20 points offers the best relief for migraine pain. They are on either side of the neck, approximately one inch to each side of the spinal column just below where the skull and neck muscles connect. GB20 also goes by the more romantic-sounding Chinese name “The Gates of Consciousness”.

Migraineurs seeking to relieve their headache and neck pain should practice deep breathing while using the thumbs of both hands to press firmly on the GB20 points for one to two minutes. If this is painful at first, home practitioners can start out by pressing and releasing the points in five to fifteen second intervals.