Identifying Migraine Triggers

 

Migraines are a relatively common disorder that affects approximately 32 million Americans. It is a disease that we all see in the clinic. Chinese medicine is a phenomenal method for controlling migraines. One of the most important and overlooked factors in treatment is to identify what factors are triggering the patient’s headaches. This not only helps us in diagnosis and treatment but allows the patient to gain a degree of control over their migraines.

Migraines are a complex neurological disorder that are not well understood. However, they are termed a primary disorder meaning that they are not the result of another disease but are a discrete entity. What is known is that there are changes in neurotransmitter levels in the brain during attacks that create changes in blood flow to the brain and cause intense pain. There are a wide range of environmental and physical factors that can trigger these changes in a susceptible person. These factors are not causing the person to be a migraneur, they are just the acute factor that brings on an attack. The diversity of triggers and the fact that some people’s triggers may be therapeutic for others adds to the mystery of this disorder. While some people are aware of their triggers most are not. Below is a list of common migraine triggers.

Dietary triggers

 

Lifestyle triggers

 

Environmental triggers

 

Physical triggers

 

Hormonal Triggers

 

The best way to determine what is causing a patient’s migraine is for them to keep a headache diary. The patient should list all of the suspect factors that they encounter in the hours before a migraine occurs. This should include things like the weather, what was eaten that day, what the person was doing around the time of onset and even their emotional state at the time. After a couple months, a clear pattern should develop. If you are not seeing any pattern ask the patient to start considering and recording other factors that could be involved. Often the trigger is not as simple as, for instance, if I drink beer I get a migraine. A real world example would be a patient that only gets migraines when he drinks beer in a smoky bar or when he is dehydrated. Another example would be a patient who gets migraines when she gets sleep deprived and stressed out and then gets an extra triple shot latte in the afternoon. These complex triggers can be difficult to deduce but the fact that we look for complex patterns in our diagnosis makes us particularly well suited to this task.

Triggers can also shift over time. This is because the trigger is not the cause of the migraine but instead just the proverbial straw that breaks the camel’s back. If a patient comes in and says that they have known their triggers for years but their migraines have recently gotten worse, search for new ones.

The knowledge of what is causing an individual’s migraines can be used in several ways. If the trigger is dietary the person should avoid the trigger at least until their digestive system can be tonified to the extent that they can then tolerate the substance. At that point if the patient wants to they can rechallenge the food or drink and see if a migraine occurs. Frequently it will not. We obviously can not control the weather. But once the person is aware of what weather patterns can cause their migraines they can come in for a treatment before the migraine occurs or in the initial stages in order to avoid a day ruining headache. In the case of lights and geometric patterns the person must learn to avoid this sort of stimulation whenever possible. The goal then is to reduce their sensitivity to such stimulation. With migraines associated with the menstrual cycle the idea is to regulate the menses and schedule preventative treatments around the time of the headaches. Of course your treatment particulars should be based upon your Oriental medical diagnosis and your personal treatment style.

Treating migraine triggers often requires lifestyle and dietary advice. Make any changes to a person’s routine slowly and incrementally. This helps the person to slowly adjust to their new lifestyle and avoids the tendency to get overwhelmed and revert to their comfort zone. The fact that we see our patients several times a month allows us to give the ongoing support that a patient needs in order to successfully make this transition. This is one of the advantages that we have over the western medical system in which patient practitioner time is severely limited. Learning to avoid triggers can make a huge impact in a patient’s life.

Finding a patient’s migraine trigger can be the key to treatment success. Even if that is all you are able to do for a patient, they will be eternally grateful. Once the trigger has been identified it can help you create a long-term treatment plan. Controlling triggers is a great step but without addressing the underlying issue the person will most likely develop another trigger over time and be back to square one. Controlling someone’s migraines and allowing them to return to their family and work life is a very gratifying experience. Our medicine is an extremely effective way to do this.