Archive for the ‘Headache & Migraine’ Category

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Integrated approach to migraine care

Wednesday, November 23rd, 2016

 

Migraine is a chronic pain condition of the brain. For more information about migraine, please see our article on it here.

Symptoms: Migraine pain can be very different from person to person or episode to episode. Common features are extreme head pain, light and/or sound sensitivity, nausea, vomiting. For some people the head pain is preceded by visual, auditory, or motor changes that we call “aura”.

Our approach: As integrated medical providers, we are trained and educated in using complimentary medicine, standard medication and/or a combination of both, in your treatment.

At Nature Cures Clinic, the most important goal is to find the best treatment for you, using whatever modality is safe for you and works the best. We firmly believe that this approach, our integrated approach, will be the future of medicine as increasing research is showing its effectiveness.

The benefits of this approach can be seen clearly in the results from a randomized controlled trail published in 2015. In it, 57 adults with episodic migraine used a combination of a common vitamin and a prescription medication over a 24-week intervention period. During this time, they found a significant reduction in the number of days with migraine headache when compared with using the medication alone.

Despite the small size of this trial, it is exciting to know that the benefits of an integrated approach are increasingly being measured.

In our practice, we utilize clinical and research-based evidence to formulate our integrated approach to the treatment of migraine. The following is an overview of what you may expect during your care and treatment at Nature Cures Clinic:

Evaluating Lifestyle

Diet: using a combination diet & headache diary to record food, drink, activity and headache pain for two weeks we are able to review this with you—without judgment— to see what patterns emerge.

Stress: Stress has a complex effect on the body & mind.  Evaluating symptoms of stress, recognizing causes of stress, developing self-care and stress relieving strategies is an ongoing element of preventative care.

Hormones: In addition to evaluating diet, we look closely at hormonal influences that may contribute to, trigger, or improve, your headache.

Sleep: optimizing sleep begins with understanding what sleep hygiene is and developing strategies on how to get it. We work with you as needed to determine what strategies you may benefit from to optimize your sleep.

Activity: regular exercise is important for so many different reasons. Sometimes it’s hard to know where or how to start, our motto around this is “The journey of a thousand miles begins with a single step”. We regularly develop home exercise plans specific for your needs.

Triggers: While knowing what your triggers are and avoiding them can be an important step in prevention, newer approaches to migraine treatment include supportive strategies on coping with triggers. We incorporate both strategies in an integrated approach using a variety of typical and alternative modalities.

Complimentary and Alternative Medicine (CAM) Interventions Prior to taking any CAM supplement, intervention or agent, we recommend you come talk to one of our providers about YOUR specific health conditions, medications and/or supplements you may be taking, as well as those you are considering adding.

Botanical, Mineral, Enzymatic Supplements: There are quite a few natural agents that have been well studied and have been concluded by the AAN to be effective in migraine prevention. We will discuss these with you along with dosing, timing, and interactions.

Acupuncture: classic acupuncture is a well-known treatment in pain conditions. It’s premise on the movement of blood flow, enhancing relaxation and calming overactive nerve impulses makes it a useful tool in both prevention and treatment of migraines. We often recommend a trial of acupuncture in the treatment of chronic conditions.

Over-the-Counter and Pharmaceutical Interventions Our philosophy is to support patients and ensure they are not suffering.

Our providers are familiar with typical migraine medications and have no reluctance in prescribing them. Many times we encounter patients who verbalize a strong preference in avoiding prescription medications, have had bad experiences on them or they simply do not get adequate benefit from them.

We welcome all patients and work with you to formulate a health-care plan that best meets all of your needs.

If you or someone you know suffers from migraines, Please give us a call today: 503-287-4970

 

 

References:

Buettner C, Nir RR, Bertisch SM, et al. Simvastatin and vitamin D for migraine prevention: A randomized, controlled trial. Ann Neurol 2015; 78:970.

Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012; 78:1346.

Li Y, Zheng H, Witt CM, et al. Acupuncture for migraine prophylaxis: a randomized controlled trial

Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev 2016; :CD001218.

Meissner K, Fässler M, Rücker G, et al. Differential effectiveness of placebo treatments: a systematic review of migraine prophylaxis. JAMA Intern Med 2013; 173:1941.

 

 

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Migraines

Wednesday, November 16th, 2016

Migraine is a common pain disorder of the brain affecting approximately 12% of the general population. Women have migraine more frequently than men and migraine’s are most common in ages 30-40years. Migraine is often common within families, suggesting a genetic or familial link.

Causes:While the specific and unique causes of migraine are not yet fully understood, genetics, environmental factors, inflammatory changes in pain-sensitive regions and nerves of the brain, imbalances in brain chemicals (such as serotonin), and over sensitization to nerve stimulus within the brain, may all contribute to the onset of migraine.

It was once thought that migraine was caused by the dilatation of blood vessels in the brain, while the aura of migraine was caused from vasoconstriction. This “vascular theory” of migraine is no longer widely supported.

Symptoms:A typical migraine attack progresses through four phases: the prodrome, the aura, the headache, and the postdrome

Prodrome: Approximately 60% of people are affected by a prodrome, a cluster of symptoms occurring 24-48 hrs before onset of headpain. Prodrome has been associated with symptoms such as euphoria, depression, irritability, food cravings, constipation, neck stiffness, and increased yawning

Aura: 25% of people are affected by an aura, a sensory neurologic symptom (or symptoms) that are short lasting and fully reversible. Auras are most often visual, but can also be sensory, verbal, or motor disturbances.A classic visual aura is characterized as a small area with loss of vision, however other symptoms can be visual (eg, bright lines, shapes, objects), auditory (eg, tinnitus, noises, music), somatosensory (eg, burning, pain, paresthesia), or motor (eg, jerking or repetitive rhythmic movements). Other forms of aura can include the temporary absence or loss of function, such as loss of vision, hearing, feeling, or ability to move a part of the body.

Headache: Migraines are often one-sided. Common characteristics of the pain are throbbing or pulsing sensations. Frequently sensitivity to light, sound, movement, the onset of Nausea and/or vomiting, are also associated with the pain.

Postdrome: After the pain subsides, many people experience a period of feeling drained, elated, euphoria. This period may also be associated with head movements causing pain in the location of the headache

Conventional Treatment: For many sufferers of migraine, the recommendations they receive for care and treatment are limited to pharmacologic interventions (such as non-steroidal anti-inflammatories, acetaminophen or Triptan medications) with recommendations for self-examination of potential triggers.

While we similarly rely upon both identification of triggers and pharmacologic agents as needed for our patients, the largest difference is the supportive “whole person” integrated approach we take in learning, listening and responding to your needs.

Our Approach: We provide guidance and support in an integrated, personalized approach to prevention and treatment because we recognize causes of migraine are complex and vary amongst individuals. By understanding this, we are able to respond to the person suffering from migraines as a unique individual with unique needs. Our approach is to:

1: Listen to you. What are your experiences with migraine? Do you know what triggers them, what makes them better or worse?

2: We explore and discuss migraine triggers with you- we look at both those triggers you have identified and those you may not have. By working closely with you, we are able to begin addressing what your unique triggers are and develop strategies for coping and prevention. Common triggers we evaluate for include: stress, hormones, foods, food-additives, drinks, blood sugar, sleep, emotions, habits, environment, allergies, mold, muscle or joint involvement, medications, chemical sensitivity. Often an individual has identified a single trigger, but responds with dramatic improvement when un-recognized triggers are addressed. Coping strategies to deal with known triggers are also discussed and supported.

3: Address and provide you personalized support in prevention and treatment of migraine. Our goal is support every individual as the unique person they are. This means discussing and listening to what YOUR needs are in order to determine what steps to take in both prevention and treatment.

While there is a growing body of evidence supporting the benefits of complimentary and alternative medicine in the prevention of migraines, not all migraines respond to the same treatments, just as not all migraines have the same cause. Our providers use a whole-person approach in working with you to formulate both a preventative and ‘rescue’ plan in the treatment of migraines using research and clinical based evidence.

If you or a loved one suffers from Migraines, give us a call today to discuss how we can help you: 503-287-4970

 

References:

Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia 2007; 27:394.

Kelman L. The premonitory symptoms (prodrome): a tertiary care study of 893 migraineurs. Headache 2004; 44:865.

Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache 2001; 41:646.

Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007; 68:343.

Lipton RB, Stewart WF, Stone AM, et al. Stratified care vs step care strategies for migraine: the Disability in Strategies of Care (DISC) Study: A randomized trial. JAMA 2000; 284:2599.

Silberstein SD, Rosenberg J. Multispecialty consensus on diagnosis and treatment of headache. Neurology 2000; 54:1553.

 

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Integrative Migraine Treatment, getting solutions for your pain

Tuesday, September 22nd, 2015

Chronic migraine can be a debilitating—and all too common—neurological disorder that costs families thousands of dollars in days off work, days away from school and days away from family. According to one online source, families with a migraine sufferer spend $8,00 more per year on health care than families without a migraine sufferer.

Yet, migraine pain has far greater costs than merely financial.

Chronic and recurring neurological pain is exhausting. It’s frustrating. It can impact every element of one’s life—from relationships at work/school to interactions within a family unit. Sufferers of migraines often find themselves desperate to eliminate anything that may trigger a debilitating migraine, resulting in missing out on life events, favorite activities, foods, sounds, travel, so many of the things that those who have never had a migraine take for granted.

What’s more, many who suffer from chronic migraines lose out on something far greater…hope.

As an integrated medical clinic, that’s where we feel uniquely able to help.

Working together across disciplines and medical systems (standard western prescriptive care, naturopathic & dietary care, Chinese medicine, acupuncture and herbal therapy) we provide a unique system of truly integrated medicine by our providers working together to provide you not just one route to resolve your migraines, but multiple.

Many of the people who come to our integrated medical clinic with migraines have been through the ‘medical ringer’.  Whether it is with standard medicine or alternative medicine, many of the individuals who come to us feel as if they have tried “it all” without significant relief.

But few have ever had truly integrated care providers working together to “hold all the pieces” that may be contributing to the cause of migraines. That’s what we do, and that makes all the difference in the world.

While there are some wonderfully effective standard medications used to treat, stop, and support one through a migraine, these medications (often prescriptive members of the triptan or ergotamine families of drugs, or medications to stop nausea associated with migraines) don’t resolve the underlying cause. That’s where naturopathic and Chinese medicine complete what we call the “Triad of Modalities”.

Every individual is unique. In our practice of Integrated Medicine, we not only believe this, we develop treatment plans specifically tailored to the needs of each individual. While standard medications have a direct impact on certain neurological elements of a migraine, they are a ‘one size fits all’ approach to the incredibly dynamic being that you are.

By blending across modalities (western, naturopathic and Chinese medicine), our providers use their expertise to support treatment not only to get you feeling better, but to give you hope for your future.

And while we at Nature Cures Clinic are unique in what we do, the idea that integrated medicine is key to reducing migraines, is not ours alone. Published in the British Medical Journal June 2012, the article,Integrative integrated migraine care: preliminary evaluation”, yielded such positive results as to inspire greater prospective research studies. The authors of the study concluded that “The integrative integrated migraine care model seems to be effective in reducing frequency and intensity of migraines and helps reducing migraine medication use.”

Stop Suffering. Let us support you in feeling hope for your health. Give us a call today:

503-287-4970

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The wonders of CUPPING!

Wednesday, October 17th, 2012

As many of you know, I LOVE cupping and use it often in my

practice.  It feels amazing, its deep therapeutic effects last for weeks, and the hickeys left behind are a great conversation starter.  You may recall seeing images of Gwyneth Paltrow sporting cupping marks on a red carpet  in 2004 – oh, the gossip that ensued!

What exactly is cupping, you ask?  Cupping is an ancient therapy using suction cups on the body to relieve pain, promote circulation, enhance detoxification, activate the lymphatic system, and facilitate movement of qi and blood within.  Traditionally, a flame is used to draw air out of a glass, ceramic, or bamboo cup.  The cup is then quickly placed on the body, most often the back, allowing the suction to pull tissue, toxins, blood and qi  up to the body’s surface.  At Nature Cures Clinic, we use plastic cups with a handheld pump (like those pictured to the left) to precisely adjust the amount of suction used.

I find cupping most effective when used in conjunction with acupuncture, and apply it frequently to treat:

  • Neck & Back Pain
  • Headaches
  • Stress & Anxiety
  • Fatigue
  • PMS
  • Allergies
  • Muscle pain
  • Sluggish detoxification, digestion, and metabolism

Don’t be detoured by the painful-looking cup marks.  I love the feel of cupping, and often describe it as a “reverse massage”.  Thus, rather than pushing down onto already contracted muscle fibers and tight tissue, cupping pulls the tissue up, relieving pressure, and creating space for fresh blood and qi to flow.  And because cupping has been shown to affect the body up to 4 inches below the skin’s surface, it is more effective than even the deepest of deep tissue massages.  It is a unique therapy that can be used alone, or with acupuncture, and I recommend everyone experience its benefits.

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Relieve your own headache with acuPRESSURE

Wednesday, June 13th, 2012

By Anne Carruth
Licensed Acupuncturist, Oriental Medicine Practitioner

As an acupuncturist, there are few things more satisfying than curing a headache with a few well-placed needles.  Headaches vary from person to person, but their response to acupuncture tends to be consistent.  And because headaches can be effectively treated with acupuncture, they also respond to acupressure.  What does this mean for you?  It means that when you can’t get in to see me, you can do some acupressure at home!

There are three areas I recommend targeting when a headache creeps up:

1.  Occiput:  Many headaches result from neck and shoulder tension incurred by stress, posture, or activity.  Multiple neck and upper back muscles attach to your occiput (the base of the skull), and can refer pain into the head when tight or inflamed.  My personal go-to treatment for headaches, especially those associated with occipital or neck pain, involves lying on the floor with a rolled up towel under my neck.

  • Lie on the floor, grab a roll of paper towels, or roll up a towel – about 5 inches in diameter,  and place it under the curve of your neck.  Adjust the diameter of the towel, so that you feel fully supported under your neck, with your head still resting on the ground.
  • Be sure the towel is pushed up against the base of your skull (away from your shoulders), putting pressure on the two big neck muscles attached at the base of your skull.  There is an acupuncture point on each of those tender attachments, thus, you’ll be stimulating them with acu PRESSURE.  These points are part of the Urinary Bladder Meridian, which begins at the eye, wraps up and around the skull, parallels the spine to the hips, then runs down the legs to the little toes.  Pretty fitting for head, neck, and back pain!
  • You may also wrap the towel in a heating pad while lying on it, to further encourage muscle relaxation in your neck.
  • Lie on your towel roll for 10-30 minutes. You will begin to feel your headache dissipate as those neck muscles unbind.

2.  Hand points:  There is a magic little point on each hand that works wonders for headaches.  The point, located in the fleshy webbing between your thumb and index finger, is considered the “Command Point of the Face”.  It is part of the Large Intestine Meridian, which begins on the index finger, runs up the arm and neck, curves around the mouth, and ends next to the nostril.  This point lessens nearly any headache, but is  particularly effective for frontal or facial headaches.  Think forehead pain, dehydration headaches, sinus headaches, allergies and toothaches.

  • Use your right thumb and index finger to locate the acupuncture point on your left hand.  Squeeze the thickened, muscular webbing between  the bones of your left thumb and index finger.  You should notice a tender spot near the junction of the thumb and finger bones.  The correct point will be in the meaty area of your hand, verses the thinner webbing, and noticeably achy when squeezed.
  •  You can squeeze with constant pressure, or “pulse” your squeezing.
  • Hold or pulse until your headache begins to lessen (usually 1-3 minutes), and then repeat on the opposite hand.  You may need to repeat this several times until the headaches fully resolves.

3. Temples:  Many people don’t realize that they clench or grind their teeth, especially in times of stress.   Several muscles of the jaw reach up and attach to the temple region, referring pain to the sides of the head.  There are also multiple acupuncture points located on the temples.  Most of these points are on the Gall Bladder Meridian (imaged below), which works with the Liver Meridian to combat stress and irritability, detoxify your body, and relieve physical tension.

 

  • Find these points by slowly sliding your fingers up and down along your temples and hairline.  You will probably hit upon tender, ropey bands of muscles running back into your hair, along the sides of your head.
  • Most of these points will be between the level of your eye and mid forehead, just within your hairline.  Get adventurous, though, and explore your own anatomy.  Palpate higher, lower, more forward on your face, and farther back into your hair.  You’ll know you are in the right spot when you find those achy, ropey bands of muscle running more or less horizontally.
  • After locating these knotted bands, apply direct pressure to the muscles until the ropiness melts under your fingers (usually within 1-3 minutes).  The pressure will be unpleasant initially, but once those muscles let go, you’ll feel a wave of relief.
  • Repeat this throughout the day, especially when you notice yourself clenching, or feel a temporal headache manifesting.  If you know that you clench or grind your teeth at night, or have TMJ issues, massage those muscles before going to bed, too.  Encouraging this muscular release before drifting off will reduce nighttime clenching, and can help break the pattern.

For stubborn headaches, or those not specific to your occiput, face, or temples, use all three techniques together.  All will mitigate stress and tension, and send energy down to relieve pain and pressure in your head.

So the next time you catch yourself reaching for some Excedrin, give these techniques a whirl.  Be patient, and repeat the acupressure over 15-30 minutes – about the same time it would take for a pain killer to kick in.  I bet you’ll be pleasantly surprised with your body’s own healing abilities.

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Our Approach to Headache Relief

Friday, November 16th, 2007

Listen to Naturopathic Approach to Headaches

In this podcast, Portland naturopathic doctors, Dr. Greg Eckel and Dr. Greg Nigh discuss an issue that sends more than 8 million people to the doctor every year: headaches.  They’ll explain what you might expect from a conventional doctor visit, which usually includes a prescription to “manage” the symptom.  A naturopathic visit will address the underlying cause of your headaches and they will explain to you what that approach would look like.

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