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Migraine Triggers - Cause or Effect?

Posted in Head Pain Disorders on Jun 22, 2020

Migraine Triggers - Cause or Effect?

Are you treating the cause or just the effects?

Migraine triggers are common: lights, odors, stress, physical tension. However, these triggers are seldom the true cause of migraines. They are simply the things that trigger the pain.

 

What is a migraine?

A migraine is the result of irritation to the nerves and blood vessels that supply the connective tissue around your brain. The particular nerve is called the “Recurrent Meningeal Branch of the Vagus Nerve,” which sends the information into the major pain processing center of your brainstem called the “Spinal Trigeminal Nucleus.”

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Unlike a headache that involves the C2 or C3 nerves, a migraine often involves other sensations including nausea, visual problems, balance problems, and aura with a headache.

Many people who experience migraines believe that they are hereditary or that they are caused by stress or hormonal imbalances. However, many times this is not entirely the case. True, some people may have a susceptibility to migraines or cluster headaches. However, stress and other chemical imbalances are usually only the things that set off or trigger the migraines.

In other words, there is often a separate underlying cause that is simply “woken up” by these triggers.

If so, many of the common treatments that people use for migraines including drugs, injections, etc may only be treating the effects, but not actually resolving the underlying cause.

 

Is the underlying cause coming from your upper neck?

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Many people who experience migraines or cluster headaches also experience neck pain.

One of the most common but under-diagnosed causes for migraines and aura with headaches may well be because of a problem with the alignment of one of the top two bones in your neck, the C1 or C2 vertebrae.

The C1 (atlas) and C2 (axis) are unlike any other bones in your spine. They support the weight of your skull and provide approximately 50% of your total head movement. However, they are also most susceptible to injury.,

If either of these vertebrae shifts from their normal center of gravity and get stuck, they may exert a physical tension on the connection tissue around your brain, thereby producing increased neurosensitivity of all the blood vessels and nerves in that delicate area. 

In other words, mechanical problems with the alignment of your neck may be the very thing that sets the stage for migraines to be then triggered by something else.

And this is not a new idea! Doctors have been prescribing neck exercises and doing nerve blocks for many years for people suffering migraines in an attempt to relieve the pain. (What is an occipital nerve block? It is an injection into the branches of the C2 and C3 nerves at the base of the skull.)

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The problem with the procedure often is that the diagnosis of a problem with the nerve is correct … but what is causing the problem with the nerve in the first place is not being addressed.

The hallmark of that is when you do all the right exercises, and you’ve even had minor surgeries including the occipital nerve blocks, but the problem keeps coming back (or never goes away in the first place).

So, you can spend thousands of dollars focusing on treating the effects OR you can take the important step to identify the underlying cause.

 

Headaches, migraine, and exercise

An exercise headache - or more appropriately a headache after exercise - may involve a problem with blood flow from the brain involving an upper neck misalignment.

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When you are in an upright position, the normal flow of blood from your brain back to your heart exists your head via the cerebrospinal veins (CSV). The CSV pass through the base of your skull turns through the C1 and C2 vertebrae at the top of your neck and then transmits through the bones in your neck where they ultimately return to your heart.

Think of it like fluid moving through a garden hose. When the alignment of the C1 and C2 vertebrae are normal, fluid is expected to flow normally. However, if either of these two vertebrae is misaligned, they may partially obstruct the normal flow.

When you are sitting or standing at rest, any obstruction of the CSV may not have any significant effect. However, when your heart rate increases or when your blood pressure increases such as when you exercise, blood may not be able to drain at the appropriate rate. 

The result may produce heat along the back of your necka “thumping sensation” at the base of your skull, dizziness, or even an “exercise headache.” 

If so, it is important to realize that exercise may not be the actual problem. Exercise may only be the trigger … but the underlying cause is likely something else.

 

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What about migraines and weather changes?

The same thing may also be true of migraines and weather changes.

In addition to the cerebrospinal veins (CSV) that drain blood from the base of your brain, you also have a dense network of veins on the outside of your skull called the suboccipital venous plexus (SVP).

As a bit of an anatomy lesson, veins are relatively thin tubes that can bulge with changes of internal or external fluid pressure. Furthermore, veins are closely associated with lymphatic channels that assist to drain fluid and debris from the cells in your body. These vessels are ultimately regulated by nerves.

Everywhere you have a blood vessel in your body is an associated nerve that controls it. Furthermore, these same nerves are also sensitive to mechanical pressure or even damage, which your brain may interpret as pain.

Bearing this in mind, a vein is not unlike a barometer: a fluid-filled receptor that can change with variations in barometric pressure, aka humidity, and/or changes in the weather.

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Especially when the air pressure or humidity rises in summer, if this area at the base of your head is sensitive because of a physical injury or pressure in that area, it may be enough to cause the so-called “summertime headaches” or even migraines.

So even though there is no formal medical or specialist diagnosis for migraines and weather changes, the two may be truly connected when you consider the role of your neck affecting the nerve s and veins in that area.

 

A different treatment to help with migraines

If you are seeking a different approach to resolving your migraines - ideally a natural, non-drug approach that considers the underlying cause of the problem and not just treating the effects - then a special division of chiropractic may be able to assist.

It is called “Atlas” or “Upper cervical care.”

Upper cervical care is NOT the same as general chiropractic, in case you have tried that before to help with your migraines. Foremost, an upper cervical practitioner is an advanced-trained chiropractic doctor, who has gone on to receive advanced certification in the role of the upper neck  (the C1 and C2 vertebrae) and their impact on the nerve system.

To this end, an upper cervical chiropractic doctor performs a series of precise tests and measurements before making any recommendations of care to ensure that you receive the right treatment.

With regard to the treatment itself, there two are main differences. Foremost, there is no spinal manipulation. In other words, no twisting or cracking the neck! 

Furthermore, an upper cervical chiropractor does not look to adjust you every single time you need an appointment. Think of it as seeing a dentist. You have a procedure performed, but then ideally do NOT need it done every single time you go back.

The same does with an upper cervical chiropractic doctor. We want to see when you are capable of healing naturally - the way your body is designed - with the least amount go intervention that is necessary.

In addition, an upper cervical chiropractor also helps you to identify the activities in your daily life that you can do to minimize the chance of a relapse. Indeed, migraines may be likely to recur. However, if it is possible to reduce the intensity, reduce the frequency (especially if they are cluster headaches or cluster migraines), or both (!), THAT would be ideally how an upper cervical chiropractor may be able to help you.

 

Are you ready to do something different?

If you have been dealing with chronic headaches or migraines and you’ve noticed these patterns - 1) that there is a link with your migraines and weather changes, 2) that you suffer an “exercise headache,” or 3) that you’ve done everything else that you know about but have NOT seen an upper cervical chiropractor, we would like to be able to help you.

We would like to offer you a 15-minute complimentary over-the-phone consultation where you can speak with one of our upper cervical chiropractic doctors to find out if care might be right for you. 

Our practice, Atlas Health, is located in North Lakes (north Brisbane), to provide care for people in the greater Brisbane area plus the Sunshine Coast. We believe in the innate potential for every human being to be well and to have an extraordinary life.

However, when it is your health that gets in the way of your ability to enjoy life to the fullest, that is when we are there to help.

Our focus is providing hope for people who have been to all the migraine and headache specialists (but who can’t find anything wrong) and in providing the healthcare they need so that they can have a long term solution to enjoy the quality of life that they desire most.

Our principal upper cervical chiropractor, Dr. Jeffrey Hannah, is an advanced certified Blair upper cervical practitioner. He is an international instructor, speaker, author, and recognized leader in the field of upper cervical chiropractic care.

If you would like to schedule a time to speak with Dr. Hannah to discuss your condition and if upper cervical care may be right for you, you can send us an email through the Contact Us link on this page, or you can call us direct at 07 3188 9329.

It is our privilege to assist you, and we appreciate your trust in your health.

Atlas Health Australia - “Hope, healing, and wellbeing from above-down, inside-out.” 

 

References

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Calhoun AH, Ford S, Millen C, et al. The prevalence of neck pain in migraine. Headache. 2010 Sep;50(8): 1273-7. doi: 10.1111/j.1526-4610.2009.01608.x. Epub 2010 Jan 18. 

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Enix DE, Scali F, Pontell ME. The cervical myodural bridge, a review of the literature and clinical implications. J Can Chiropr Assoc. 2014 Jun;58(2):184-92. 

Gaul C, Meßlinger K, Holle-Lee D, Neeb L. [Pathophysiology of Headaches]. [Article in German]. Dtsch Med Wochenschr. 2017 Mar;142(6):402-408. doi: 10.1055/s-0042-111694. Epub 2017 Mar 22. https://www.ncbi.nlm.nih.gov/pubmed/28329901

Gryglas A, Smigiel R. Migraine and Stroke: What's the Link? What to Do?. Curr Neurol Neurosci Rep. 2017;17(3):22. doi:10.1007/s11910-017-0729-y. https://pubmed.ncbi.nlm.nih.gov/28283957/ 

Hamamcı M, Göcmen AY, Say B, et al. Why do multiple sclerosis and migraine coexist?. Mult Scler Relat Disord. 2020;40:101946. doi:10.1016/j.msard.2020.101946. https://pubmed.ncbi.nlm.nih.gov/31982663/

Lewis DW. Headaches in children and adolescents. Am Fam Physician. 2002 Feb 15;65(4):625-32. https://www.ncbi.nlm.nih.gov/pubmed/11871680

MacGregor EA. Migraine, menopause, and hormone replacement therapy. Post Reprod Health. 2018;24(1):11‐18. doi:10.1177/2053369117731172. https://pubmed.ncbi.nlm.nih.gov/28994639/

Millstine D, Chen CY, Bauer B. Complementary and integrative medicine in the management of headache. BMJ. 2017 May 16;357:j1805. doi: 10.1136/bmj.j1805. https://www.ncbi.nlm.nih.gov/pubmed/28512119

Rothner AD, Linder SL, Wasiewski WW, O'Neill KM. Chronic nonprogressive headaches in children and adolescents. Semin Pediatr Neurol. 2001 Mar;8(1):34-9. https://www.ncbi.nlm.nih.gov/pubmed/11332864 

Viana M, Sances G, Terrazzino S, et al. When cervical pain is actually migraine: an observational study in 207 patients. Cephalalgia. First Published December 7, 2016: https://doi.org/10.1177/0333102416683917.

Yan J, Melemedjian OK, Price TJ, Dussor G. Sensitization of dural afferents underlies migraine-related behavior following meningeal application of interleukin-6 (IL-6).

Mol Pain. 2012 Jan 24;8:6. doi: 10.1186/1744-8069-8-6. 

 

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