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Migraine - causes and therapy

Reading time: 7 mins

About ten percent of the population suffer from the neurological disease migraine. It occurs in women about three times as often as in men. Unbearable and pounding headache attacks in connection with nausea, vomiting and neurological deficits can be indications of an existing migraine.


How do migraines occur?
How is a migraine different from a headache?
When is it a migraine?
Where do migraines come from?
How do I know if I have migraines?
What triggers a migraine?
What helps with migraines?
How does neuroathletics help with migraines?

How do migraines occur?

The number of people suffering from migraines has steadily increased in industrialized countries over the past four decades. That is why this neurological disease, along with diabetes mellitus, obesity, diseases of the respiratory tract and the cardiovascular system, is even counted among the diseases of civilization.

Based on so-called twin studies, it is assumed that susceptibility to migraines is inherited. However, the actual occurrence of the disease depends on other factors. Such a hereditary predisposition is suspected in about 50 to 60 percent of the affected women and 40 percent of the affected men.

How is a migraine different from a headache?

The human brain cells react to a wide variety of external stimuli, such as sounds, light or temperature changes, in a specific individual way. These responses are measurable, as is the brain's "expectation voltage." If the neuronal cells are repeatedly exposed to such stimuli, they usually become accustomed and the expectation voltage drops or normalizes.

However, this is not the case with a migraine patient. Due to the lack of habituation and the lack of a drop in expectation tension, the brain of those affected is also very easily excitable between migraine attacks. This suggests that the brain cells of a migraine sufferer are constantly particularly sensitive to certain stimuli, and the reactions to these are also much stronger than usual. This could explain the frequently occurring sensitivity to light between migraine attacks.

Another theory of how migraines develop assumes that external factors such as stress, changes in hormone levels, weather changes, etc. lead to a short-term, temporary constriction of the blood vessels in the brain and meninges in migraine sufferers. This is followed by vasodilatation and increased blood flow in the area of ​​the scalp and face. This extreme stretching of the veins then manifests itself as a throbbing headache.

When is it a migraine?

According to another view, a migraine attack begins with an overactivity of nerve cells in the brainstem. This activity stimulates the fibers of the trigeminal nerve, the finest branches of which reach into the walls of all cerebral blood vessels and thus transmit pain signals to the brain. This in turn leads to a release of various messenger substances, which cause the blood vessels to widen and the vessel walls to become more permeable. This creates a temporary, painful neurogenic inflammation in the immediate vicinity of the veins, which is caused by nerve impulses and not by bacteria or viruses.

This vascular inflammation in turn increases sensitivity to pain so much that the pulse of the blood is perceived as a pulsating, throbbing headache. Other areas of the brain are also activated by the pain, which explains other side effects of migraines, such as nausea and vomiting, as well as sensitivity to light and noise.

Where do migraines come from?

According to the current state of science, it has been clearly proven that there really is a long-supposed migraine center in the brain . With the help of special procedures, an area with increased blood flow in the brainstem during an acute migraine attack can be identified, which doctors call the "migraine generator". This area of ​​the brain is activated by overstimulation due to the migraine-typical hypersensitivity to certain stimuli and then triggers a migraine attack.

How do I know if I have migraines?

For most migraine sufferers, a migraine attack occurs without any premonitions or prior cognitive disturbances. Suddenly and seemingly unexpectedly, it overwhelms those affected with a throbbing headache that may last up to seventy-two hours. Daylight becomes almost unbearable and the intensity of smells and sounds suddenly increases.

For these reasons, those affected instinctively look for a quiet and less bright room. In addition, the excruciating pain is often accompanied by nausea and vomiting. Tiredness and exhaustion, but also constipation and cravings for a certain food are also possible symptoms.

Some sufferers can already recognize a migraine attack before the severe headache sets in. The harbingers of an impending migraine can be very different and individual. Psychological, neurological and vegetative abnormalities can already occur several days beforehand.

Some patients also suffer from the so-called "migraine aura" that occurs before the headache. It covers the head like a dark veil and triggers visual disturbances (single-sided vision), speech disorders, hearing loss and other neurological symptoms. They include, for example, motor failures such as a significant reduction in strength in the arms and legs and unpleasant sensory disorders in the extremities. Due to the sudden weakness in the extremities, some patients have enormous movement disorders up to and including symptoms of paralysis. The phase of the migraine aura usually resolves completely before the pain first occurs.

The neurological and very uncomfortable disorders associated with the migraine attacks are completely reversible. No symptoms remain after an attack.

What triggers a migraine?

The increase in migraine diseases in recent decades has confirmed the assumption that migraines can be negatively influenced and triggered by environmental factors, distress, lack of sleep and an unhealthy diet . However, hormonal fluctuations in women, especially during the menstrual cycle, sudden changes in the weather or smells can also be triggering factors for migraines.

In addition, a connection can often be made between the consumption of a certain food and luxury food and the onset of a migraine. Alcohol, coffee or special types of cheese in particular are mentioned by patients as triggers.

Other possible causes of a migraine can be muscular tension and the resulting blockages throughout the body. In particular, muscle hardening in the shoulder and neck area, combined with blocked joints in the area of ​​the skull, cervical spine and jaw, can trigger migraines. Malpositions of the feet (flat feet, fallen arches) should also be taken into account. Because deviations in the lower extremities can also cause problems in the upper body sections and even initiate tension headaches or migraines.

Mental stress can also promote a migraine attack. If your own fears and worries get too big and get the upper hand, a migraine attack can flare up in a very short time.

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What helps with migraines?

Keep a migraine diary

Since the causes of a migraine seem to have many faces, everyone affected should keep a migraine diary in order to find out individually which stimulus triggers the symptoms or even intensifies them. Since not every body reacts immediately to the triggering stimuli, but only several hours or even days later, a precisely kept diary is indispensable in the search for the cause.

Younger people in particular should also pay more attention to mental and emotional stimuli in particular. For example, lovesickness and the search for oneself, especially as a young adult, can lead to a flooding of the brain.

Be sure to see a doctor

A specialist in neurology should definitely be consulted when clarifying the pain attacks in the head. Due to the different forms of migraine and the different symptoms associated with it, there are a large number of treatment and therapy options that can best be examined and determined by a doctor.

There is also the possibility that a more serious illness is hiding behind these recurring attacks of pain. To rule this out, the cause of the symptoms should be clarified as soon as possible.

Physiotherapy for migraines

If the attending physiotherapist determines that the migraine problem is possibly caused by a physical imbalance, he can treat it with various treatment techniques. Depending on the localized and pain-triggering body region, individually tailored therapy options can be offered and applied to the patient.

With manual therapy, imbalances in the muscles and possible joint blockages are gently and successfully resolved. The special form of manual therapy for migraines is the treatment according to Kern. This is used in a targeted manner in acute and chronic disease processes as well as prophylactically.

Good results can be achieved more holistically with osteopathic treatments. An osteopath feels and recognizes possible energy blockages comprehensively and comprehensively, dissolves them and gets them flowing again.

Trigger point treatment is also a promising therapy for migraines. Even "pain-distant" muscles may be the source of pain. For example, certain neck muscles are treated intensively, which can radiate pain to the head in a tense situation.

Specific massage techniques such as the Asian Thai massage, or the treatment of the meridians with acupressure, are ways to combat the crippling and recurring migraines.

Do sports and take care of relaxation

For each patient, the individually correct form of therapy is determined by the physiotherapist and then applied. In addition, an ideal compensatory sport should be pursued in your free time.

Especially those affected, who pursue a rather static and one-sided professional activity, should offer their body sufficient relaxation phases and balance and create space for themselves. Relaxation techniques also offer the opportunity to harmonize body and soul. Autogenic training can also be learned in physiotherapy. Yoga and progressive relaxation according to Jacobsen, for example, are among the techniques with which those affected can learn a body feeling for the change between tension and relaxation.

How does neuroathletics help with migraines?

Contribution by physician and neuroscientist Hady Daboul

Which brain areas should be built up and strengthened differs from person to person. In the training we use easy movement tests to find out exactly that. Among other things, we are currently using the approach in our “heyvie” app (download: Google Play | App Store ) for use in migraines.

Eyes, balance system and neck muscles work closely together. No muscle in the body can move as precisely as our eyes. However, if our neck is unstable and our balance system is not accurate, our eyes cannot perform to their full potential. They have to perform extremely precise movements on a shaky foundation, so to speak.

The result: visual stimuli are overwhelming. This is where neurocentric training comes in. Systems around the neck, eyes and balance are stabilized through targeted stimulation and structural work-up of central structures. Visual stimuli are no longer overwhelming and attacks can be reduced - in frequency as well as in intensity.

How exactly does this work?

Roughly one can say that movement is built on three pillars. On the one hand, the work that our eyes and thus the visual system do, then proprioception, i.e. the ability to know the position of our body in space, and finally balance - the knowledge of orientation in relation to gravity and the control of muscles that make us the erection against just this allowed.

If we want to reach for the cup of coffee with our hand, the movement plan that our brain has created must be carried out. To do this, we need to know where our hand is in space, so the proprioceptive system is being used. We need to be able to judge the distance between our hand and the cup of coffee so that our gripping motion is precise and we don't spill the coffee over our desk thinking it's further away.

The visual system estimates distance through depth perception. At the same time, our spine must be stabilized. The movement of our hand changes our body's center of gravity. Especially small movements on the outside of the body have a strong impact on the middle of the body due to the large lever.

So what happens if information from the respective systems is missing and how can these systems be built up systematically? For example, we lack information on our right wrist. We have a scar from an older injury and the feeling over the scar is reduced. The consequence: our brain no longer knows 100% where our wrist is in space. So instead of flexing our wrist while reaching for our cup of coffee, we might move the entire arm from the elbow and shoulder joints. In this way we unconsciously avoid the tilting movement of the wrist.

Anything that in any way affects our safety and physical integrity is dangerous as a first step and will be avoided if possible. If we lack information about our wrist, our brain cannot predict what will happen if we move it. According to the motto "better safe than sorry", our brain now adjusts the movement so that we don't have to move our wrist. In the first step, our physical integrity remains and we do not have to deal with situations that we cannot predict. For our brain, that means security.

From a purely energetic point of view, it takes a lot more effort to move the whole arm instead of tilting the small wrist. It just uses more energy.

We don't just have one system to compensate for, we have several. Although these systems work redundantly and can take over parts of the work of the other, this compensation is exhausted at a certain point. The consequences: pain, immobility or illnesses such as migraines.

How does this help people with migraines?

In people who suffer from migraines, we often start with the proprioception and surface sensitivity of the neck. When we are unable to consciously feel and move our neck adequately, the reflexive control we depend on is compromised. So we teach our customers to precisely control their neck muscles.

The goal of it all: relearning movements that may no longer have been performed because the brain has blocked these movements for safety reasons. Similar to the tilted wrist, we often see a lack of control in the neck muscles in migraine sufferers: Inside.

How can neuroathletic training help with migraines?

Ultimately, proprioception is the ability to absorb information from the body's periphery, to process it and then to know where the individual limbs are in space.

Neurocentric training looks at all the steps, from the acquisition and processing of information to the development and execution of movement, and checks where exactly compensation is being made. Solving these compensation mechanisms has great potential, both for movement and pain problems.

>> Download white paper: NTC in migraine

>> Advanced training tip: Migraine course by and with Hady Daboul

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