Complementary treatments
Many people, concerned about the side effects of medication or the possibility of long term adverse events, are seeking to explore the options offered outside mainstream medicine. They often erroneously believe that they can do no harm. 25% of Migraine Action s membership have consulted a complementary practitioner over the past year. [1.]. Whilst it is important to be open minded, any treatment, intervention or medication (whether traditional or alternative, bought over the counter or prescribed by a healthcare professional) should be considered with a healthy degree of scepticism. Although many branches of complementary medicine have done a lot to put their house in order and have excellent training and accreditation procedures in place, charlatans do still exist who can quite freely set up in business with no training, recognised qualifications or monitoring. What is complementary / alternative medicine? Diagnosis, treatment and / or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy, or by diversifying the conceptual frameworks of medicine. Complementary or Alternative Medicine (often referred to as CAM) should not be considered in isolation but as part of an overall approach to general well being (including improved control of headache and migraine). CAM practitioners take a holistic view of health (i.e. viewing the whole person not just a particular part of them as often happens in mainstream medicine) taking into account all symptoms, individual preferences, lifestyle and family history; they will spend a long time during the first consultation asking many different questions which you may feel are totally unrelated to your migraine.
Which treatment? The following are treatments for which there is some evidence of efficacy in the treatment of migraine: Acupuncture Homeopathy Manipulative therapies Physical therapies Relaxation Vitamins and minerals Herbal remedies Allergy tests Medical lenses For details of registering bodies for various branches of complementary medicine, please refer to the back pages of this booklet. Your GP surgery may have a list of accredited practitioners in your area. Acupuncture Acupuncture is endorsed by the British Medical Association and can be an effective treatment for headache and migraine. Treatment consists of small fine sterile needles being inserted into your skin at certain points, they may be left in for just a few seconds or for several minutes. Traditional Chinese acupuncturists will position the needles at various points along the body s energy meridians, according to their assessment of each individual (i.e. different migraineurs could have differently positioned needles). Practitioners of Western acupuncture will usually be healthcare professionals (e.g. GPs, physiotherapists or doctors and specialist nurses working in pain clinics) who have received additional training in this method of treatment; they will position the needles in certain areas determined by the condition they are treating (i.e. all migraineurs are likely to have the needles placed in similar positions). If Western acupuncture has not helped you it may still be worth considering traditional acupuncture. Acupressure is a method of applying pressure at various points along the body s energy meridians but there is no published evidence from controlled trials to demonstrate its efficacy in the treatment of migraine. However, a small study has found evidence that applying pressure to the P6 acupuncture point on the inside of the wrists using Sea-Band acupressure wristbands can help to relieve migraine nausea.
Homeopathy Although homeopathic remedies can be bought over the counter, it is advisable to consult a homeopath as there are over 100 remedies that can be prescribed for headache disorders, according to the needs of each individual. The principle of homeopathy is treating like with like. Particular substances have been shown to produce certain symptoms in healthy individuals; a heavily diluted form is given to cure a sick person who has these symptoms. The dilutions can range from one drop of the active ingredient in 99 drops of water (1 / 100 or 1c) or diluted further to by one drop of the 1c solution in another 99 drops of water (1 / 1000 or 2c) and still further with one drop of the 2c solution to another 99 drops of water (1 / 100000 or 3c). The minimum effective dose is used. Remedies are usually supplied in very small tablets to be dissolved on the tongue. Manipulative therapies Tension in the neck and shoulders can trigger migraine attacks in some individuals. These manipulative therapies help to release tension and improve blood flow: Chiropractic: diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and the effects of these disorders on general health. Emphasis is on manual treatments including spinal manipulation. McTimoney Corley chiropractic: a gentler form of chiropractic. Osteopathy: a way of detecting and treating damaged parts of the body, such as muscles, ligaments, nerves and joints. Cranial osteopathy: a very gentle manipulation of the bones of the skull. Believed to be particularly helpful for people who experienced a difficult birth. Physiotherapy: concerned with human function and movement and maximising potential. It uses physical approaches to promote, maintain and restore physical, psychological and social well being. Bowen Technique: a very gentle therapy, applying light pressure to rechannel the body s energy for healing. Reflexology: a gentle massage / manipulation of the feet. It is believed that particular areas of the feet relate to certain organs in the body.
Physical therapies Biofeedback: a method of educating your body to induce certain responses and thus control your symptoms. This requires training and practise, and has had good results in children. Alexander Technique: postural re-integration and (un)learning, with particular emphasis on the relationship between the head and neck. This also requires training and practise. Relaxation: anything that helps you lower stress levels and encourage relaxation can be beneficial. This may be deep breathing, progressive muscle relaxation (as taught at ante-natal classes), yoga, meditation or just taking a few minutes to yourself. For further information please visit www.migraine.org.uk/physical. Vitamins and minerals Magnesium: 400mg - 600mg daily. Vitamin B2: 400mg daily - you will not obtain the required amount from a Bcomplex product. Co-enzyme Q10: 150mg - 300mg daily. Ginger: can be helpful in treating the nausea associated with migraine and there is some evidence of efficacy in preventing attacks. For further information please visit www.migraine.org.uk/vitamins. Herbal remedies Following a consultation, a herbalist will prepare a combination of plants (usually dried to prepare as an infusion) according to your individual needs. Beware of buying loose dried plants for medicinal purposes in High Street herbal shop as the quality control cannot be guaranteed (even qualified experts in botany cannot identify some of the products) and staff may not be adequately trained to advise you. Feverfew: 4-6 fresh leaves daily, 50mg in dried form or 125mg in tablet form (0.2% parthenolide). Butterbur petasin: 50mg twice daily. Do not eat the fresh plant as it is poisonous. For further information please visit www.migraine.org.uk/herbal. Allergy tests Various methods of testing for allergies are available commercially. Prices vary, as does the sensitivity of the tests. Although there are anecdotal reports of people giving up the foods identified and reaping substantial benefit, it has been argued that the tests results are not consistently reliable and the benefits of following the advice given are not reproducible in a general population. As migraineurs seldom have true allergies (although they may have sensitivities to certain substances) testing is seldom available on the NHS.
Dental work Migraine can be triggered by problems with the teeth and jaw. Clenching the jaw or grinding the teeth, especially whilst asleep can trigger attacks; some people have noted an improvement after being fitted with a dental splint to wear overnight. Problems with the alignment of the teeth or jaw can also be implicated but rectifying this can require substantial remedial work by a specialist and could involve the fitting of braces etc. Limited research has suggested that migraine can be triggered by the mercury in fillings and some people have benefited by having these removed and replaced. None of these are normally available on the NHS. Dental splints are not costly (around 50) but the latter two require very specialised treatment and can be very expensive. Medical lenses For many migraineurs (32 40%) light sensitivity is closely linked to their condition. [2.]. Migraineurs are specifically sensitive to the red and blue parts of the spectrum, rather than the green middle part of the spectrum. [3.]. MigraLens offers an effective migraine management option for many light sensitive migraineurs to aid visual discomfort during and between attacks. The lenses absorb the red and blue light from sunlight, artificial lighting, television, computer screens etc. and are available made to your prescription if required. There is a wide range of frame styles, or as clip-ons to fit over existing glasses. Some have fixed or detachable side shields for extra protection. For further information about MigraLens lease visit www.mediviewspecs.co.uk; for further information about migraine and light sensitivity please visit www.migraine.org.uk/lightsensitivity. Other Some people have also found the following helpful in relieving the symptoms of migraine: cooling applications to the head and neck (there are numerous masks, cap and gel patches available). Migracap is available to purchase online at www.migraine.org.uk/shop. peppermint to reduce nausea. lavender - inhaled or rubbed onto the temple.
Guidelines The following are a few guidelines to help you to find and derive optimum benefit from complementary practitioners: Always consult a properly trained, qualified professional, who has adequate insurance and is working from clean, hygienic premises. Do not assume that if a practitioner is recommended by a friend, this eliminates the need to make your own checks. Be very wary of anyone who claims to be able to cure you. Complementary treatments are seldom available on the NHS so you will probably have to pay all of the costs yourself, although some branches of complementary medicine are covered by private health insurance (check with your insurer first). Do not pay large sums in advance for a course of treatments - most practitioners work on a payment per session basis. The first consultation will usually be the most expensive (expect to pay 50-100) with follow up sessions costing 30-60 (prices will vary from area to area and according to the treatment being provided); expect to pay extra for investigations such as X-rays etc. if required and any remedies provided. If you have not experienced any significant benefit after 6 sessions / treatments, you are unlikely to do so. Do not go on and on spending money in hope. Honest practitioners will not encourage you to do this. Review the position and consider other options. Keep both your doctors and your complementary practitioners informed of ALL other treatments, drugs, remedies and therapies you are taking for ANY condition. Incompatibilities can be dangerous. Do not assume that natural = safe. If in doubt please check with your healthcare professional.
Web: www.migraine.org.uk Useful links British Acupuncture Council (BacC) Web: www.acupuncture.org.uk International Federation of Aromatherapists Web: www.ifaroma.org The Society of Teachers of the Alexander Technique Web: www.stat.org.uk Institute for Complementary Medicine Web: www.i-c-m.org.uk Craniosacral Therapy Association Web: www.craniosacral.co.uk British Chiropractic Association Web: www.chiropractic-uk.co.uk McTimoney Chiropractic Association Web: www.mctimoney-chiropractic.org National Institute of Medical Herbalists Web: www.nimh.org.uk British Homeopathic Association Web: www.britishhomeopathic.org British Hypnotherapy Association Web: www.hypnotherapy-association.org British Osteopathic Association Web: www.osteopathy.org British Reflexology Association Web: www.britreflex.co.uk The Reiki Association Web: www.reikiassociation.org.uk British Wheel of Yoga Web: www.bwy.org.uk For further information, advice on migraine management and for updates on the latest migraine research, please contact Migraine Action by calling 0116 275 8317, emailing info@migraine.org.uk, or visiting the charity s website at www.migraine.org.uk. All of our information resources and more are only made possible through donations and by people becoming members of Migraine Action. Visit www.migraine.org.uk/donate to support one of our projects or visit www.migraine.org.uk/join to become a member. With thanks to: Migraine Action would like to thank our Medical Advisory Board for reviewing this information. References 1. Migraine Action s Member Survey 2010. 2. Headache Classification Committee of the International Headache Society, 1988, Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain, Cephalalgia, 8, supplement 7, S19-S28. 3. Maine A., Vlachonikolis I., Dowson A., 2000, The wavelength of light causing photophobia in migraine sufferers and tension-type headache between attacks, Headache 2000, 40, 194-199. 4 th Floor, 27 East Street, Leicester. LE1 6NB. Tel: 0116 275 8317 Fax: 0116 254 2023 Email: info@migraine.org.uk Web: www.migraine.org.uk Registered Charity No. 207783 Copyright 2010 Migraine Action This publication provides information only. Migraine Action and its officers can accept no responsibility for any loss, howsoever caused, to any person acting or refraining from action as a result of any material in this publication or information given. Whilst this booklet has been reviewed for accuracy by members of Migraine Action s Medical Advisory Board and other experts, the information does not necessarily reflect the views of individuals. Medical advice should be obtained on any specific matter.