Improve Migraine Headaches with Mindfulness
By John M. de Castro, Ph.D.
“When we allow our minds, hearts, and bodies to be heard and felt through mindful attention, they will say back to us, “Thank you for listening,” not because we tried to fix anything but just because we paid attention with gentle, nonjudgmental awareness. This nurturing umbrella of awareness is the key. It is both a form of refuge and a means of really being able to take control of and managing our lives. It is a way we can cultivate and honor the wholeness of our being. It is how we heal.” – American Migraine Foundation
Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head. They last from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. They disproportionately affect women with about 18% of American women and 6% of men suffering from migraine. In the U.S. they affect roughly 40 million men, women and children. While most sufferers experience attacks once or twice a month, 14 million people or about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.
There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.
In today’s Research News article “Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292107/
Grazzi and colleagues recruited patients who were diagnosed with chronic migraine headaches with accompanying overuse of medications. They were withdrawn from medications over a 45-day period. The patients then volunteered to participate in a research study and were assigned to receive and 8-week Mindfulness Based Stress Reduction (MBSR) program or prophylactic (preventive) migraine medication. They were measured before and after treatment and at 6-months and 12-months later for headache frequency, frequency of pain reliever use, headache impact, migraine disability, depression, and anxiety.
They found that both MBSR and prophylactic medication treatment produced clinically significant reductions in headache frequency, pain reliever use, headache impact, migraine disability, and depression. These benefits were maintained at 6-monmth and 1-year follow-ups. These are preliminary findings as there wasn’t a control group present. But, the findings are exciting and the effects large, suggesting that mindfulness training is as effective in treating migraine headaches as prophylactic medications. Since the MBSR training, unlike the drugs, has no known adverse effects, it would appear to be a preferred treatment for migraine headaches.
Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. Mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.
So, improve migraine headaches with mindfulness.
“Can you namaste your migraines away? A new, small study published in the journal Headache suggests that meditation may help relieve the intensity and duration of migraines.” – Mandy Oaklander
CMCS – Center for Mindfulness and Contemplative Studies
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Grazzi, L., Sansone, E., Raggi, A., D’Amico, D., De Giorgio, A., Leonardi, M., … Andrasik, F. (2017). Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up. The Journal of Headache and Pain, 18(1), 15. http://doi.org/10.1186/s10194-017-0728-z
Chronic Migraine (CM) is a disabling condition, worsened when associated with Medication Overuse (MO). Mindfulness is an emerging technique, effective in different pain conditions, but it has yet to be explored for CM-MO. We report the results of a study assessing a one-year course of patients’ status, with the hypothesis that the effectiveness of a mindfulness-based approach would be similar to that of conventional prophylactic treatments.
Patients with CM-MO (code 1.3 and 8.2 of the International Classification of Headache Disorders-3Beta) completed a withdrawal program in a day hospital setting. After withdrawal, patients were either treated with Prophylactic Medications (Med-Group), or participated in a Mindfulness-based Training (MT-Group). MT consisted of 6 weekly sessions of guided mindfulness, with patients invited to practice 7–10 min per day. Headache diaries, the headache impact test (HIT-6), the migraine disability assessment (MIDAS), state and trait anxiety (STAI Y1-Y2), and the Beck Depression Inventory (BDI) were administered before withdrawal and at each follow-up (3, 6, 12 after withdrawal) to patients from both groups. Outcome variables were analyzed in separate two-way mixed ANOVAs (Group: Mindfulness vs. Pharmacology x Time: Baseline, 3-, 6-, vs. 12-month follow-up).
A total of 44 patients participated in the study, with the average age being 44.5, average headache frequency/month was 20.5, and average monthly medication intake was 18.4 pills. Data revealed a similar improvement over time in both groups for Headache Frequency (approximately 6–8 days reduction), use of Medication (approximately 7 intakes reduction), MIDAS, HIT-6 (but only for the MED-Group), and BDI; no changes on state and trait anxiety were found. Both groups revealed significant and equivalent improvement with respect to what has become a classical endpoint in this area of research, i.e. 50% or more reduction of headaches compared to baseline, and the majority of patients in each condition no longer satisfied current criteria for CM.
Taken as a whole, our results suggest that the longitudinal course of patients in the MT-Group, that were not prescribed medical prophylaxis, was substantially similar to that of patients who were administered medical prophylaxis.