Massage Matters

Mindful musings on massage, muscles, and moxie

The Knot Whisperer Rides!

The Knot Whisperer Rides!

Saturday, February 12, 2011

The Shadow Lurking: Migraine Headaches

Migraines—a throbbing headache on one side of the head that lasts from four to seventy-two hours—are as yet poorly understood. They seem to occur more often in women, to run in families, and to be triggered by certain foods, as well as by stress, lack of sleep, weather changes, and missing meals. Migraines are caused by dilated or inflamed blood vessels in the head. Traditionally, migraines have been treated with various prescription and over-the-counter drugs intended either to stop a migraine once it has started or to prevent them from happening in the first place. Natural migraine relief products are also available, which use herbs rather than pharmaceuticals. For instance, Dr. Andrew Weil, a leader in the integrative medicine movement, reports on some promising alternative natural treatments on his website ( Some migraineurs, as migraine sufferers are known, have also found relief with alternative treatments such as acupuncture, magnets, and chiropractic.

Massage, too, can provide relief from migraines. Studies published in the International Journal of Neuroscience (1998) and the Annals of Behavioral Medicine (2003) demonstrated that migraineurs who received massage experienced more headache-free days, improved sleep quality, less pain, reduced stress levels, and an increase in serotonin levels. Further, the perceived level of stress of subjects was supported by measures of their cortisol (the “stress hormone”).

Serotonin levels seem to be an important factor in the occurrence of migraine headaches. Serotonin is a neurotransmitter in the brain—a sort of chemical messenger—that has an impact on sleep patterns and blood flow (both of which are issues for migraine sufferers), as well as numerous other functions. Serotonin levels are affected not only by stress, fatigue, food, and light but also by hormones: an increase in estrogen produces an increase in serotonin—which would explain why migraines are more common in women.

A 2006 European Journal of Neurology article, however, found that serotonin might not be the only culprit: trigger points—areas in the muscle that are hypersensitive to pressure—found in scalp and neck muscles might also play a role. The authors of this article hypothesize that the vascular system might not function as a distinctly independent system; rather, it is possible that trigger points might actually be responsible for blood vessel changes in the brain. Regardless, the presence of trigger points in certain muscles of the head and neck means that trigger point therapy can be a valuable tool in eliminating or at least reducing migraine headaches. It is important to know, though, that these trigger points are especially tender during a headache and, most likely, just preceding and just following a headache. This means that any trigger point therapy done for migraine relief should not be done during a headache.

I am not, myself, a migraineur and so it is hard to know what migraine sufferers go through. As a massage therapist, while I don’t need to experience each ache and pain of my clients’ in order to attend them successfully, I do find that a sympathetic understanding of their experiences helps me connect with my clients on a deeper level. No doubt you’ve heard the expression “a picture’s worth a thousand words.” Well, sometimes, a few select words are better than a picture. And few people select words more skillfully than a poet. That’s why I was delighted when I came across the poem below by the poet Gail Mazur (reprinted here with her permission), which gives the reader a sense of what it might be like to experience this sort of headache.

Dear Migraine,

by Gail Mazur

You're the shadow shadow lurking in me

and the lunatic light waiting in that shadow.

Ghostwriter of my half-life, intention's ambush

I can't prepare for, ruthless whammy

you have me ogling a blinding sun,

my right eye naked even with both lids closed—

glowering sun, unerring navigator

around this darkened room, you're my laser probe,

I'm your unwilling wavelength,

I can never transcend your modus operandi,

I've given up trying to outsmart you,

and the new thinking says I didn't invent you—

whatever you were to me I've outgrown,

I don't need you, but you're tenacity embodied,

tightening my skull, my temple, like plastic wrap.

Many times, I've traveled to a dry climate

that wouldn't pander to you, as if the great map

of America's deserts held the key to a pain-free future,

but you were an encroaching line in the sand,

then you were the sand. We've spent the best years

of my life intertwined: wherever I land

you entrap me in the unraveled faces

of panhandlers, their features my features—

you, little death I won't stop for, little death

luring me across your footbridge to the other side,

oblivion's anodyne. Soon—I can't know where or when—

we'll dance ache to ache again on my life's fragments,

one part abandoned, the other abundance—