I have been successfully treating thousands of migraine sufferers with a set of protocols I have been perfecting since 1997. The course of treatment is framed in three phases:
Foundation Phase: Experience has shown me that, if I am going to be able to help you, you should start to feel an improvement in at least one aspect of the migraines - intensity, occurrence, or area effected, within the first three treatments over a two week time span.
Integration Phase: Once we start to see improvement, even if it is temporary, I know we can take that healing further and we move on to the . This is when we see how far we can take symptom improvement. Treatments are now spaced out to once per week or once every two weeks for four to eight treatments.
Continuance Phase: In this final phase we lock in the improvements gained in the first two phases. Treatments are now spread out to monthly, seasonally, or as needed.
My gentle and effective Japanese-style acupuncture treatments for migraine relief and control work by switching the system from one of Sympathetic Nervous System (SNS) dominance to one of Parasympathetic Nervous System (PNS) dominance or a “Ventral Vagal State”, to use some terminology from Dr. Porges, Polyvagal Theory. This in turn:
1. Increases vagal tone and heart rate variability (HRV)
2. Decreases Vagus nerve inflammation.
3. Balance neurotransmitters
This is done using precisely placed, single-use, hair thin (.14mm diameter) Japanese surgical steel needles which create a cascade of positive effects. It has been my experience that if a patient is actively having a migraine, acupuncture can provide almost immediate relief in the vast number of cases and have excellent results in decreasing the intensity and occurrence of migraine headaches over the medium and long term.
While I am Traditional Asian Medicine based, I think it is helpful to describe the how and why of migraine attacks through a western medical lens using solid studies to back it up.
While the research into how acupuncture does its migraine magic is inconclusive, I have my own hypothesis based on combining accepted science with my decades of clinical observations.
From a Western medical POV, it boils down to releasing constrictions in the diaphragm and neurotransmitter regulation through 4 possible pathways of action. The neurotransmitters involved in the first two are:
· Norepinephrine (NE - noradrenaline)
· Corticotropin Releasing Hormone (CRH)
· Acetylcholine (ACh)
· Dopamine (DA)
· Serotonin (5-HT)
In a Sympathetic Nervous System (SNS) dominance (from various causes such as trauma response) we find elevated levels of the first two and decreased levels of the other three.
The two pathways involving these neurotransmitters are:
1. Neuro-immune Pathway - This involves Vagus nerve dysregulation and inflammation due to elevated pro-inflammatory cytokines (IL-1B, TNF-a) which trigger migraines.
2. Chronic Sympathetic Activation – This is an autonomic imbalance where the SNS remains chronically activated.
Norepinephrine: Release of norepinephrine (NE) in both of these pathways is elevated, leading to increased pain sensitivity and blood vessel constriction in the brain – btw, coffee helps headaches because it causes the opposite reaction, by opening up or dilation of the blood vessels. Chronically elevated levels of NE lead to neck and shoulder tension and a hyper alert nervous system which causes a number of inflammatory and digestive issues.
Acetylcholine: The Vagus nerve’s main neurotransmitter is crucial for preventing chronic inflammatory states. Norepinephrine elevation causes a reduction in acetylcholine (Ach) release which disrupts the body’s natural anti-inflammatory mechanism, the Cholinergic Anti-inflammatory Pathway.
Corticotropin: Driving the release of cortisol as a response to stress and keeping the HPA axis (hypothalamic-pituitary-adrenal axis), located in the brain activated, it can engrain chronic Sympathetic Nervous System (SNS) dominance which further increases pain sensitivity and sleep disruption.
Dopamine: Low levels of dopamine created by SNS dominance is also implicated in migraine attacks as is heightened pain sensitivity and lack of motivation on an emotional level.
Serotonin: Crucial for vascular tone in the brain (remember, blood vessel constriction is involved in migraine attacks but not the cause), imbalances in levels can lead to increased perception of pain, mood disorders, and more importantly, in causing neuronal excitability. It is this excitation of brain neurons which current research now indicates is the primary cause of migraines.
The other neurotransmitters involved are seen in the other 2 pathways and are:
· Glutamate
· Substance P
· Gamma-Aminobutyric Acid (GABA)
The other two pathways are closely related to unprocessed trauma:
3. Diaphragmatic Dysfunction – Breathing dysregulation due to trauma response leads to tightness in the diaphragm, a horizontal sheet of muscle running under the ribcage and lungs, which acts like bellows for the lungs. It’s expansion and contraction creating your inhalation and exhalation.
Diaphragm tightness leads to shallow breathing. Chronic shallow breathing triggers decreased GABAergic activity, increasing nervous system excitability and anxiety, both triggers for migraines.
4. Afferent Vagus Nerve Dysfunction – Afferent nerves run from the body to the brain (efferent nerves run from the brain to the body) and are impacted by chronic stress and past trauma. This environment creates a situation where Substance P and Glutamate cause chronically increased sensitivity to pain and the overactivity of glutamatergic pathways in pain processing areas of the brain, triggering chronic migraines in a system already hyper-responsive to pain signals.
In a future, even more nerdy article, I will be exploring something I have found over the years to be very important in the treatment of migraines; how the body’s fascia, as an organ of somatic (body) memory, has a profound effect on diaphragmatic tension, creating the physical basis for chronic migraine headaches.
I will finish the series with a piece on something that always gets my migraine patients prickly when I bring it up – why and how chocolate is absolutely terrible for people with migraines. It is an important trigger to be aware of but that bit of news never gets a smile.
To bring this back around, it has been my experience that migraines respond very well to my time tested protocols. My experience has also shown me that if I am going to be able to help, you will start to feel improvement by your fourth treatment. Three relaxing naps in two weeks in the convenience of your home or office is what it takes to know if a medication-free end to your debilitating migraines is possible.
If you, or anyone you know who might benefit, have further questions or would like to schedule a complimentary consult, you can reach me at:
Paul Rooney L.Ac., M.Ac., NCCAOM Dipl.
Or by cell: (585) 694-6385
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