By Dr. Jason Slagel | June 20th, 2022

Today we are talking about migraines. We are taking a more conceptual approach, so we are looking for understanding rather than a list of dos and don’ts. We’re not talking about a laundry list of remedies to try, we are not giving helpful hints, we are going through a conceptual understanding of migraines.

The first thing you need to understand is that migraines are multicausal. The key to fixing them is identifying the major contributors and eliminating them. Migraines are caused by multiple things. Most of the times there are many different pieces to the puzzle. When you go about eliminating the major contributors of a migraine you don’t need to eliminate all the contributors to your migraines to get rid of your migraines. Migraines work according to a threshold. There is a certain threshold, and if you cross it, you start getting a migraine. If you are below that threshold, then you don’t get a migraine. Different things can add up to make you cross that threshold. The things that cause migraines need to be identified so that they can be eliminated. There are four basic categories for what causes migraines, and they are: outside factors, psychosomatic, physiological, and structural.

Let’s go through these one at a time.

Number one, outside factors. These are things like allergies, environmental allergies or seasonal allergies, weather, barometric pressure, photosensitivity, like if the sun is in your eyes. So, those are outside factors.

The second thing is psychosomatic. Here we are talking about stress, anxiety, mental fatigue, that type of thing. For some people depression is a trigger. When we break down the word we have psycho-meaning psychological and somatic- meaning body. How does your psychology impact your physical body?

The third category of what contributes to migraines is called physiological. We are talking about physical fatigue, like if you are tired, or for women, if you are on your period. Men and women both can have hormonal issues that could contribute. There are food sensitivities where your body reacts in a certain way. Those are all physiological contributors to migraines.

The fourth category is called structural issues. Now, structural issues are things like structural shifts in your spine, especially your head and neck, causing brainstem pressure. If that structural shift is causing pressure in your brainstem, if there is a blood flow restriction up into the head of some kind, if there is an aberrant flow or improper flow of cerebral spinal fluid. Cerebral spinal fluid (CSF) is the fluid that your brain sits in, and the same fluid that fills your spinal cord as well. A CSF problem will cause something called normal pressure hydrocephalus. This is when there is too much CSF in your head. In a baby that is called water head, where their head swells out a lot from the CSF not draining out of their head properly. However, in an adult the skull is fused, so that pressure doesn’t push the skull outward it pushes the brain inward, so migraines can come from that, and that’s a structural issue.

In my office I fix structural issues. This is why I see good improvement with most of my patients with migraines and it’s because I only accept people with structural issues that I can fix. So, if you have a structural shift, brainstem pressure, blood flow issues, CSF flow issues, all that kind of stuff, then I know exactly who has those issues and I know exactly what I can do about them to fix them.

What I do in my office is look at a person’s head and neck to see if it is shifted out of place. If it is, then we take very precise x-rays and we measure down to 1/100 th of a degree to measure that shift and calculate how to fix it. Once we fix it, then the pressure is off the brain stem, the head and neck are positioned properly, the stress is off the spine, the blood flow is restored back up into the head, and CSF drainage is restored back out of the head. All those things can resolve, which are normally big players as far as contributors to migraines. Now, there are still those other three categories and if those three other categories are still impacting the person, they can continue to get migraines, but they will be much less frequent and much less severe once we fix the structural issues. The key is to get under your threshold. After I fix the structural issues, then if there are any lingering headaches left, we can look at the other three areas. At this point I normally send the patient to someone that addresses one of those areas to look at it to see how big of a contributor they think it is.

Last point, if your healthcare provider is talking about managing your migraines, instead of resolving your migraines, then think about finding somebody else. There are a lot of people out there like me who are offering solutions and not just patches. Migraines are caused by certain things, which means that if you figure out which things are causing the migraines then you can fix them. Or, if you figure out the major contributors to migraines you can fix those things and get below that threshold.

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