By Dr. Zach Walker
10 Quick Facts
Estimates from the International Burden of Migraine Study suggest that the average 3-month headache-related costs were about $1,036 and $383 for chronic and episodic migraine, respectively (Goadsby, 2017).
Migraine affects about 38 million people in the United States, including 4 million chronic headache sufferers. There are more than 1 billion patients having an attack in any year (Goadsby, 2017).
Average annual all-cause costs are $13,045, with the top 25th percentile of costs at $14,120For those that have tried more than 2 preventative migraine medications, the mean all cost for the year is $18,394 (Goadsby, 2017).
Attacks of unilateral, throbbing head pain with sensitivity to movement, visual, auditory, and other afferent inputs (Goadsby, 2017).
Other Symptoms such as tiredness, yawning, irritability, and reduction in concentration can come before the headaches (up to 48hrs in some people) (Goadsby, 2017).
It is more common in females, compared to males, and the average age is 18-44.It was thought, and in some circles still is, that it is more of a vascular cause, but more and more research is supporting a NEUROLOGIC cause (Goadsby, 2017).
As of 2016 migraine has been the second cause of disability and the leading cause of YLDs (Years Lived with Disability) (Burch 2018).
CAM (Complementary and Alternative Medicine) has been shown to be a promising approach to help with migraines (Rhee 2018)
Getting to know MIGRAINE better
What is a Migraine?
📷 Up until recently the most widely known reason for a migraine to occur was from a vascular issue. This means that there wasn’t appropriate blood getting to the brain and when the blood vessels would throb that was the pulsating sensation that we feel that is associated with a migraine. Recently, there is been a bigger push and research into a migraine and what is exactly causing it. I still don’t think we know exactly what causes a migraine, mainly because there can be multiple factors such as genetics, more stress, or inadequate sleep, but recently it has been found that it is a more neurological issue. This can be bad because as we know the nervous system controls everything and now we have to worry about a migraine being apart of it if it goes bad, but I think of it as a good find. The reason I saw this is because if it is more of a neurological issue we can still utilize our brain based rehabs to help with a migraine attack.
Again, we have mentioned that it is more common in females compared to males, about 3:1, this could have to do with more hormonal imbalances. Most people on average spend about $400-$1,000 dollars in a 3-month span to try and alleviate their migraine issues. What is more troubling is that it is one of the leading causes of YLDs and not being able to work or return to work. If you have ever had a migraine you know that it can be one of the most painful sensations and/or debilitating conditions to have. The fact that a migraine can have a premonitory phase up to 48hours (the time you feel a migraine coming on and it actually happens), it can be a 10/10 pain, and can last anywhere from 4 – 72hours in duration isn’t something to take lightly.
NEUROLOGICAL CAUSE:
📷 One of the biggest pushes towards a more neurological approach is for a couple of reasons. One of the biggest is what is called altered brain excitability. As we have mentioned before the brain loves to be excited and learn different aspects of life, but when the brain is too excited or is excited in a way that it cannot handle then we may have issues. The brain has different parts for smell, taste, sight, etc and this is especially the case for migraine and head pain. Even though the brain has different parts or regions for these different sensations there is one big area that takes in all of these sensations before they go to different brain areas. It is this area of the brain that if managed appropriately these different sensations to start to get better *discussed later this month).
Another big reason for this neurological push is what is called cortical spreading. This spreading is thought to be the cause of being sensitive to light, sound, noise, smells, etc when the headache phase occurs. We know that these sensations are in different parts of the brain and when the brain cannot take in different sensations properly these normal sensations can get amplified and a normal light stimulus can be overbearing. As the name implies it starts in one part of the brain and can spread into others causing sensitivities in different forms. You can think of this like a storm that is slowly moving and spreading to different parts of an area and growing. Just a vascular issue wouldn’t explain altered excitability, spreading, or why there is a genetic component to migraine. This is where it is from a more neurological issue; however, this is where proper nutrition, sleep, or different genetic issues come into play. If our brains are in an altered state and spreading happens not getting enough sleep or to much stress is going to make it even worse.
The brain is trying to handle normal sensations and if we are giving it more stimuli (stress, decreased sleep) we are compounding and creating a worse brain overall state.
Some treatment options and at-home therapies will be discussed later this month but what does all of this mean? In simplest terms, migraine can be a very troubling issue that affects millions of people year and costing hundreds or thousands. It not only affects your ability to return to work but even more important to enjoy our personal lives.
Yes,it can be a scary thought that our brain(s) are firing too much and we can’t process our environment (causing pain, tiredness, light/sound sensitivities, etc), but if we have a better understanding of why this is happening then we can start the healing process. Before we do that we need to dive a little deeper into a migraine attack, what is going on in the brain, and start to discuss we can do to get better. These are the topics that we will be discussing later this month, so stay tuned!!
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