Migraine Headache Diagnosis — Treatment
The Migraine Mystery
Medical researchers estimate that at least 20% of the population suffer weekly, and even daily, from some kind of headache or common migraine. Migraines occur more often in women than men. Approximately 25% of women and 8% of men suffer from migraine at some time in their lives.
Migraines are different from other headaches and can occur with additional symptoms besides those associated with “regular” headaches, such as nausea, vomiting, fatigue, and sensitivity to light. A migraine episode can last hours, days, or weeks, leaving the sufferer virtually disabled for that time. A migraine attack can be induced by various triggers, including bright light, certain food items, and alcohol. Uncontrollable triggers include changes in the weather and menstrual cycles. Migraine can be caused by psychological factors, although stress and depression can also result as a consequence of the debilitating and chronic pain.
The headaches tend to start between the ages of 10 and 46, and normally have some genetic components. The genetic factors are due to skeletal imbalance problems that are passed on from generation to generation. It is these skeletal imbalance problems that must be diagnosed and treated in order to eliminate the chronic pain.
Migraine headache may be diagnosed by your family doctor based on your symptoms. Your doctor will take a detailed history to make sure that your headaches are not due to sinus inflammation, or a more serious underlying brain disorder. During the physical exam, your doctor will probably not find anything wrong with you.
Your doctor may refer you to a neurologist and possibly order an MRI or CT scan to rule out other causes of headache, such as sinus inflammation or a brain mass. In the case of a complicated migraine, an EEG may be needed to exclude seizures. Rarely, a lumbar puncture (spinal tap) might be performed.
Stroke is an extremely rare complication from severe migraines. This risk may be due to prolonged narrowing of the blood vessels, limiting blood flow to parts of the brain for an extended period of time.
All treatments for migraine have the same goals in common: halt, or at least reduce the excruciating pain and minimize the other significant symptoms, such as nausea and vomiting. Today’s medical treatment methods employ a variety of different strategies to control and ease the pain. Patients are instructed to use anything from common NSAIDs (Advil, Tylenol, Excedrin) to more powerful narcotics (Vicodin, Tylenol 3, etc.) or other so-called “migraine” drugs as Imitrex, Topamax, etc.
None of these drugs have been shown to have any significant ability to control migraine pain long-term and none of them are able to properly treat or reduce the actual cause of the migraine. Significantly, long-term use of popular medications can cause the sufferer more pain and worsening symptoms.
So, how do you find the correct diagnosis and the proper treatment for your migraine problem? Fortunately enough, today’s modern craniofacial pain treatments are curing frequent headaches, migraines, and facial pain with nearly 100% success rate. The explanation for your migraine problems follows.
Maintaining the Medical Mystery
Most migraine sufferers go from doctor to doctor looking for the definitive treatment that will permanently resolve their pain. Each new physician, or therapist, claims expertise in pain management and proceeds to treat it accordingly. Many doctors unfortunately do not coordinate their treatment efforts for the best care possible.
Based on our experiences in our clinic, a good number of practitioners fail to recognize and therefore fail to address the most critical problem: abnormal muscular activity causing compression, thereby shifting blood flow and changing the electrochemistry of the head.
Most common headaches start out as simple muscle tension problems. Remember that bad day at work? You probably clenched your teeth all day and assumed a “tense” postural position while working. For a majority of us, a couple of Advils take away that sporadic problem. Unfortunately, for the migraine sufferer the Advils stopped working a long time ago. The reason is simple: the migraine patient has an undiagnosed skull imbalance or jaw joint problem. This problem is either the result of genetics or long-term wear and tear. The patient who had orthodontics (braces) because they were born with crooked teeth has the same possible jaw joint damage that a person who wears down their jaw joints due to constant clenching and grinding. The common denominator is that the migraine patients, regardless of the underlying cause, has some abnormal muscle function and usually extensive damage to the jaw joint that has been improperly misdiagnosed. These two problems lead to worsening muscle function and blood flow alteration.
Migraine headache patients who have been inadequately or incorrectly diagnosed are usually told it’s just stress or a sinus problem or perhaps some residual, lingering effect of an accident we had years ago. Sadly, a sizeable number of these inadequately diagnosed patients are recommended to use popular pain medications, which do nothing to address the root causes of pain.
Critical Diagnosis for Effective Treatment
Research has well established the association between intense chronic muscle contraction and chronic headaches. When the muscles become overused, pain begins to develop. The bulk of this dysfunctional muscular activity starts to eventually damage the joint. When the joint becomes damaged, the muscles try to protect it by splinting themselves into even more activity. An endless cycle ensues… pain worsens.
Stress or Tension?
Research has now shown that the jaw muscles of a migraine patient are in a constant state of tension (or contraction). Other factors begin to develop as a result, which can cause the nervous system to become unbalanced. The sympathetic nervous system subsequently begins to overwork itself. Increased input to the muscles from the sympathetic nervous system increases the tension and contraction of the muscles.
Eventually the facial muscles begin to cramp. The intense and debilitating pain from the cramping can cause nausea, sensitivity to light, and all of the other symptoms of the common migraine. Understandably… the near constant tension becomes, and is perceived as, stressful.
Stress — Daytime and Nighttime
It’s during certain stressful parts of the day that we clench or grind and cause muscular damage. At night, the stress can continue. During sleep even the slightest touching of the teeth requires contraction of the temporalis and masseter muscles. You can’t put your teeth together without contracting these two powerful muscles.
As a basic rule of Mother Nature, your teeth should never be touching! They don’t even touch when you chew! It’s a good bet that your teeth are probably touching right now as you read this page. Allowing the teeth to touch requires contraction of the temporalis and masseter muscles. Continual contraction of the closing muscles creates a dysfunctional state, which may not be painful until later in life. This end-point usually happens when the jaw joint wears out and all surrounding tissues go into a “silent” dysfunction due to the damage. This “silent problem” is called Migraine. Please remember that the migraine patient also normally has a genetic problem of jaw imbalance that they inherited from a parent. The jaw imbalance causes faster and more rapid wear and tear of the joint, especially when coupled with abnormal muscle activity.
Stress or Tension or Genetics?
Research has now shown that the jaw muscles of a migraine patient are in a constant state of tension (or contraction). The migraineur just simply does not realize it! Other factors begin to develop as a result, which can cause the nervous system to become unbalanced. Remember, the nervous system has 3 parts: the voluntary one, which you control, and the 2 involuntary parts that you cannot control (sympathetic, which gets you into high gear and parasympathetic, which allows you to heal.) The sympathetic nervous system begins to overwork itself in patients with abnormal muscle function. Increased input to the muscles from the sympathetic nervous system further increases the tension and contraction of the muscles. It’s a “silent” action, one that is not readily observed clinically. For more information about nervous system function: http://www.michigan-headache-tmj-doctor.com/nervoussystemtmj.html
Eventually the facial muscles begin to cramp. The intense and debilitating pain from the cramping can cause nausea, sensitivity to light, and all of the other symptoms of the common migraine. Understandably… the near constant tension is perceived as stressful in some patients. However, in a majority of migraineurs the muscle spasms have become so chronic that the patient does not know that they are happening.
If the sufferer has a genetic component of jaw imbalance problems, then the body senses this inherent dysfunction as damage to the body and tries to protect it by sending even more muscles into spasms. The muscle function is not readily diagnosed or observed by a majority of doctors.
Nervous System Overstimulation
People with chronic pain feel as though their bodies are burning up. This is a normal response to the pain being caused by the nervous system. Pain eventually leads to loss of sleep, and prevents the nervous system from coming into balance. The sympathetic nervous system (the accelerator) does not shut down and our bodies get depleted. We feel tired, irritated, nervous, depressed, and angry. The parasympathetic nervous system requires time to replenish the body with the hormones and nutrients that it needs. The sympathetic system overtaxes the system and thereby causes the parasympathetic system to function inefficiently by not allowing it to turn on. Health problems kick in.
Understanding the Nervous and Muscular System Role in Migraines
What is important to understand is that there is a balance between your jaws, skull bone, and neck that determines your diagnosis and treatment guidelines. Head pain (including migraines, headaches, earaches, neck problems, etc.) is a symptom of a neuromuscular and skeletal imbalance above your shoulders. This imbalance causes stress to the nerves, sending them into “irritability.”
When this balance comes out of alignment, the Trigeminal and Facial Nerves go into dysfunction causing unusual and chronic muscle contraction.
Trigeminal Pain Stimulus
The trigeminal is the primary nerve that carries pain impulses from your mouth, teeth, head, face, ears, and neck to your central nervous system. Pain from any of its pathways can trigger migraines.
The following illustration shows the complexity and the intimate contact of the trigeminal nerve to the jaw joint. nerves of the Tempomandibular RegionAs this nerve continues to be irritated by jaw joint problems and abnormal muscle activity it begins to send continuous messages to the sympathetic nervous system to constrict blood vessels and fire up more muscle cells. The trigeminal nerve is also responsible for directing and “managing” the actual blood flow of the arteries of the brain. That’s the “vascular” headache that you hear so much about. An unhappy trigeminal nerve causes all sorts of irregular changes to the blood flow of the brain.
The trigeminal nerve is connected to your brain stem and can actually affect many pathways of the entire nervous system. It acts like a gatekeeper, allowing or blocking nerve flow in your spinal column. Consistent stimulation of the trigeminal nerve can cause dysfunction in other areas of your body. The nervous system requires that your body continues to produce the common neurotransmitter, serotonin, which is the fuel for your nerves. Normal function dictates that the nerves need a break, similar to stopping your vehicle at the gas station for refueling or resting while you sleep. Think of lifting weights in the gym. After a few reps you need a break. The nerves and the muscles have to bring in more nutrients in order to allow you to be able to do more sets of reps. Unfortunately, in headache patients, this rest stop never happens. Not even when you sleep!
The body’s supply of serotonin quickly depletes and the nervous system is unable to function properly. The body begins to be unable to carry on normal functions such as perceiving normally, sensing properly, concentrating on work or studying, controlling emotions, completing physical activities, caring for family, or working. The depletion of serotonin affects your entire nervous system. Your doctor’s answer to this problem is to prescribe common medications such as Maxalt, Imitrex, Lyrica, or Prozac. Give the body some serotonin so that it can work normally again. Unfortunately, the body stops learning how to produce it’s own serotonin and the levels of the medications cannot be adjusted high enough, long term, to have any efficacy. Result: pain worsens over time because the cause of the problem has not been found and treated properly.
Contemporary research indicates there is general agreement in the medical community that the trigeminal vascular complex is involved in all migraines. This complex is comprised of the trigeminal neural system and associated blood vessels. The trigeminal system is one of the major pain signaling structures of the brain. Your brain spends over 40% of its daily energy deciphering the impulses created by this nerve. The trigeminal and facial nerves account for over 50% of the function of your head. Furthermore, over 30% of the nerves that travel to the rest of your body pass near the jaw joint. 25% of the total nerve impulses of your body go to your mouth and jaws!
Function Can Affect Structure
It is critical to realize that human beings use their lower jaw over 5,000 times a day. Think about what would happen if you tried to ride 1,000 miles on a bicycle that had missing spokes.
Also notice how your teeth, jaws, and nerves control such a large part of your head, in the photo below.
It is important to realize that there are over 300 muscles that attach to the jaws, skull, and neck. 298 of these muscles do one and only one thing: they close the lower jaw, squeezing it into the skull bone (in close intimacy to the brain tissue)! Any misalignment problems, or deficiencies, cause unusual nerve activity which leads to chronic muscle activity, thereby eventually causing compression and dysfunction in the joint, skull bone, and brain. Subsequently, this leads to blood flow changes in the brain, causing migraines.
Vascular System Involvement
The trigeminal pathway also controls and regulates the blood flow of the arteries inside of the brain. That is why so many doctors call migraines “a vascular event.” Now you know why a tooth issue and a jaw misalignment problem can cause migraines.
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