Migraines are primary headache disorders manifesting as recurring attacks, usually lasting for 4 to 72 hours and involving pain of moderate to severe intensity. Typical characteristics of the headache are unilateral location, pulsating quality, moderate or severe intensity, and aggravation by routine physical activity. Sufferers may also experience auras, photophobia, phonophobia, nausea and vomiting. Migraines are thought to begin as an electrical phenomenon in the cerebrum that then affects blood vessels, biochemistry, and causes neurogenic inflammation.
Several drugs, such as beta-blockers, amitriptyline or sodium valproate, are used in the prophylaxis of migraine in an attempt to reduce attack frequency, but all these drugs are associated with adverse effects. Migraines are around 2.5 times higher in women than men, and in many cases are associated with certain fluctuations of the menstrual cycle.
There have recently been many controlled trials of acupuncture for migraines that show its overall effectiveness in prevention as well as in alleviating symptoms of acute attacks, with no side-effects.
Acupuncture helps in a number of ways:
- Providing pain relief by stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurochumoral factors and changes the processing of pain in the brain and spinal cord
- Reducing inflammation by promoting release of vascular and immunomodulatory factors
- Reducing the degree of cortical spreading depression (an electrical wave in the brain associated with migraine) and plasma levels of calcitonin gene-related peptide and substance P (both implicated in the pathophysiology of migraine)
- Modulating extracranial and intracranial blood flow
- Affecting serotonin (5-hydroxytriptamine) levels in the brain (serotonin may be linked to the initiation of migraines; 5-HT agonists are used against acute attacks)
- Helping to regulate the menstrual cycle