Like ice cream, migraine comes in a variety of different 'flavors' and 'tastes' different to each of us. Yes, the base ingredients are the same, but symptoms and severity can vary by person, attack, and over time.
Knowing exactly which type of migraine you have is essential to finding the most effective treatment.
Getting an accurate diagnosis is critical for the right treatment. Some medications are dangerous to people who actually have migraine with aura, for example. And sadly, 60% of women and 70% of men with migraine aren’t diagnosed correctly.
According to the International Headache Society’s ICHD-3 classification system, there are seven types of migraine. They’re classified by how doctors diagnose and treat them, not when we feel them.
The two major types of migraine are:
1. Migraine without aura, (formerly called Common Migraine), is the most frequent type of migraine. Symptoms include moderate to severe pulsating headache pain that occurs without warning and is usually felt on one side of the head, along with nausea, confusion, blurred vision, mood changes, fatigue, and increased sensitivity to light, sound, or smells. Attacks typically last 4-72 hours, and repeat a few times a year to a few times a week (see Chronic Migraine, below). Movement generally makes the attack worse. Importantly, this Migraine Without Aura is the type most prone to worsen with frequent use of symptomatic medication.
2. Migraine with Aura, (formerly called Classic or Complicated Migraine), includes visual disturbances and other neurological symptoms that appear about 10 to 60 minutes before the actual headache and usually last no more than an hour. You may temporarily lose part or all of your vision. The aura may occur without headache pain, which can strike at any time. Less frequent aura symptoms include an abnormal sensation, numbness, or muscle weakness on one side of the body; a tingling sensation in the hands or face; trouble speaking; and confusion. Nausea, loss of appetite, and increased sensitivity to light, sound, or noise may precede the headache. Migraine aura can also occur without a headache.
Many patients who have Migraine with Aura attacks also have Migraine without Aura attacks and Tension Type Headaches, so it’s possible for your migraine case not to fit neatly into one “type.”
Migraines often are brought on by triggers: sights, smells, and sounds. The exact cause of migraines is unknown, but it is believed they are caused by genetic and environmental factors. Changes in the brainstem and how the brainstem interacts with the trigeminal nerve may be related to frequent migraines. Imbalanced brain chemicals may be involved. When you're having a migraine, your serotonin levels decrease. Decreased serotonin levels are believed to signal the trigeminal nerve to release neuropeptides, which travel to the brain's casing, the meninges, causing headache pain.
People have their own sets of triggers than can potentially cause headaches, but common triggers include:
- Hormonal fluctuations, such as during puberty or menstrual cycles
- Smell or taste of certain foods
- Loud noises
Migraine is very common with a prevalence of 16% of the population surveyed. In both males and females, the prevalence distribution of migraine is an inverted U-shaped curve. Prevalence rises through early adult life and then falls after midlife. The second important point to emphasize is that, at all postpubertal ages, migraine is substantially more common in women than in men.
The prevalence of migraine varies as a function of age. Migraine is a disorder that is most prevalent between the ages of 25 and 55. Part of the reason the condition has such a big impact in the workplace is that it affect s people during their peak productive years.
At prepubertal ages, the rate of onset for migraine is actually a little bit higher in boys than in girls, but at all postpubertal ages, the in cidence is higher in girls than in boys. The incidence of migraines without aura peaks around age 12 in boys and age 15 in girls.
Although half of all migraine onsets begin before the age of 20, migraine can begin at age 1.
Chiropractic management of migraine
There aren’t many large studies on the value of chiropractic treatment in managing migraines. One study examined chiropractic treatment for different types of headaches, including migraines. The study combined the results of 22 studies, which had more than 2,600 patients total. The studies show that chiropractic treatment may serve as a good preventive treatment for migraines.
Another trial found that 22 percent of people who had chiropractic treatment saw the number of attacks drop 90 percent. In that same study, 49 percent said they had a significant reduction in pain intensity.
Chronic migraine and chiropractic treatment
One study of 127 migraine sufferers in Australia found that those that received chiropractic treatment had fewer attacks and needed to take less medication. The 1999 study found that more than 80 percent of the patients blamed stress for leading to their migraine attacks. Therefore researchers believe chiropractic care might physically help reduce the body’s reaction to stress.
In addition, researchers reviewed 9 studies that tested chiropractic for tension or migraine headaches and found that it worked as well as medications in preventing these headaches. More research is needed to say for sure whether chiropractic care can prevent migraines.
Manual therapies for migraine: a systematic review. Chaibi A.,Tuchin P.J. and Russell M.B. J Headache Pain. 2011 Feb 5.
Efficacy of spinal manipulation for chronic headache: a systematic review. Bronfort G., Assendelft W.J., Evans R., Haas M. and Bouter L. J Manipulative Physiol Ther. 2001 Sep;24(7):457-66.
A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Tuchin P.J., Pollard H, Bonello R. J Manipulative Physiol Ther. 2000 Feb;23(2):91-5.
A twelve month clinical trial of chiropractic spinal manipulative therapy for migraine. Tuchin P.J. Australas Chiropr Osteopathy. 1999 Jul;8(2):61-5.
The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Nelson C.F., Bronfort G., Evans R., Boline P., Goldsmith C. and Anderson A.V. J Manipulative Physiol Ther. 1998 Oct;21(8):511-9.