Headaches and Migraines - Blackmore Wellness Homeopathy

The Homeopathic Treatment
of
Headaches and Migraines
and other
Alternative Treatments
Ravi’s Blog (2012)
Canadian College of Homeopathic Medicine
Independent Research Project
by
Mary Paterson Blackmore
©2015
Table of Contents
Introduction ..................................................................................................................... 3
What is the Difference between a Migraine and a Headache? ........................................ 6
Headaches ...................................................................................................................... 7
Disorders Causing Secondary Headaches.................................................................... 10
Characteristics of Headache Disorders by Cause ......................................................... 11
Migraines ....................................................................................................................... 12
Dietary Triggers ............................................................................................................. 17
Treatment ...................................................................................................................... 21
Conventional Treatment ................................................................................................ 23
Drugs for Migraines and Cluster Headaches and their Side Effects .............................. 24
Supplements and Herbs ................................................................................................ 25
Acupuncture .................................................................................................................. 30
Chiropractic ................................................................................................................... 32
Osteopathy .................................................................................................................... 33
Massage and Physical Therapy .................................................................................... 34
Homeopathy .................................................................................................................. 35
Homeopathic Case Taking Techniques to Determine Remedies .................................. 36
A look at HEAD, PAIN in the Synthesis Repertory ........................................................ 39
Acute Case.................................................................................................................... 42
Chronic Case ................................................................................................................ 43
Common Homeopathic Remedies for Headaches and Migraines ................................. 45
Conclusion .................................................................................................................... 52
References .................................................................................................................... 53
Page 2
Introduction
Homeopathic treatment, over time, can raise one’s level of wellness and vitality.
Chronic headaches and migraines can be reduced in frequency and intensity by treating
the totality of the symptoms of the individual. On occasion, it is necessary to treat
migraines and headaches therapeutically in acute situations. In both chronic and acute
cases, it is most useful if the root cause of the ailment can be determined and all
maintaining factors should be identified and removed as much as possible. Maintaining
factors would be anything preventing someone from getting well and that would depend
on the situation of the individual. For example, an individual could be receiving
homeopathic treatment for chronic asthma and living in a damp, mouldy, basement
apartment. That patient will likely not make significant progress toward health until that
maintaining cause is removed.
Samuel Hahnemann (1842), as summarized by Brewster O’Reilly (1996, pages 6164)states in §7 of the Organon, “In cases of disease where there is no obvious
occasioning or maintaining cause (causaoccasionalis) to be removedª, we can perceive
nothing but the disease signs. Therefore, it must be the symptoms alone by which the
disease demands and can point to the appropriate medicine for its relief, along with
regard for any contingent miasm and with attention to the attendant circumstances.( §5)
The totality of these symptoms is the outwardly reflected image of the inner wesen of
the disease, that is, is of the suffering of the life force. The totality of the symptoms must
be the principal or the only thing whereby the disease can make discernible what
remedy [curative means] it requires, the only thing that can determine the choice of the
most suitable helping-means. Thus, in a word, the totalityb of symptoms must be the
most important, indeed the only thing in every case of disease, that the medical-art
practitioner has to discern and to clear away, by means of his art, so that the disease
shall be cured and transformed into health.
Page 3
§ 5 It will help the physician to bring about a cure if he can find out the data of the most
probable occasion of an acute disease, and the most significant factors in the entire history of a
protracted wasting sickness, enabling him to find out its fundamental cause. The fundamental
cause of a protracted wasting sickness mostly rests upon a chronic miasm. In these
investigations, the physician should take into account the patient’s:
1. discernible body constitution [especially in cases of protracted disease]
2. mental and emotional character [character of the Geist and the Gemüt]
3. occupations,
4. lifestyle and habits,
5. civic and domestic relationships [relationships outside and within the home],
6. age,
7. sexual function, etc.
7a. It goes without saying that the intelligent physician would immediately clear away any
occasioning or maintaining causes,, after which the indisposition usually gives way of its own
accord. For example, the physician would:
1. remove from the room the strong smelling flowers that are arousing faintness and
hysterical plights,
2. extract from the cornea the splinter that is arousing inflammation of the eye,
3. loosen the overtight bandage on a wounded limb that is threatening to cause gangrene,
and apply a more suitable one,
4. lay bare and tie off the injured artery that is inducing faintness
5. seek, through vomiting, to expel belladonna berries, etc. that have been swallowed,
6. extract foreign substances from the orifices of the body (nose, throat, ears, urethra,
rectum, genitalia),
7. crush bladder stones,
8. open the imperforate anus of the newborn infant, etc.
Page 4
7b. From time immemorial, adherents of the old school (often unaware of any other
expedient) have used medicines in an attempt to combat and, wherever possible, to
suppress a single one of the various symptoms of a disease. This one-sidedness,
called symptomatic treatment, has rightly aroused general contempt because through it,
not only is nothing won but much is also spoiled.
A single symptom of disease is no more the disease itself than a single foot is the man
himself. This procedure is so much the more reprehensible because the single
symptom is treated with an opposed means which acts in an enantiopathic and
palliative manner. After a short period of relief, the symptom is only made all the
worse”.
*****
The main purpose of this research paper is to explore, and outline homeopathic
treatment for headaches and migraines as a more natural alternative to prescription and
over the counter drugs, while keeping in mind the principles that homeopathy’s founding
father has laid out in the Organon. Other alternative treatment for headaches and
migraines will be explored and presented along with conventional treatment. There
should always be a choice for the individual and often that choice encompasses a
variety of treatments.
Page 5
What is the Difference between a Migraine and a Headache?
A migraine is really only one type of headache. It is categorized as a vascular
headache and it is usually severe. Because of the nature of migraine headaches, it is
worthwhile to look at migraines in a separate class compared with other types of
headaches.
Migraines and headaches are governed by the nervous system. The nervous system is
a very complex structure controlled by the brain. The brain has over 14 billion nerve
centres, each receiving stimuli from both inside and outside of the body. The brain
processes the information received by the nerve cells and using the nervous system
sends a response to different parts of the body. Nerve cells can be damaged and they
don’t have the ability to repair themselves. Brain and nervous system disorders can be
very mild (nerve twinges) to extremely serious (stroke).
Page 6
Headaches
Types of Headaches
1. Vascular
Migraine headaches are the most common type of vascular headaches. We will
explore migraines separately. Other types of vascular headaches are:
headaches resulting from fever, cluster headaches, and headaches resulting
from high blood pressure.
Cluster headaches affects mostly men, aged 20 – 40. It is common for
cluster headaches to be episodic and for 1 to 3 months patients can
experience at least one episode on a daily basis. They can go into
remission and not recur for months or years…or they may not go into
remission at all. The periodicity can indicate a hypothalamic dysfunction.
Cluster headaches are severe and one-sided, usually occurring during
sleep. On that one painful side, the nostril tends to lose its shape and
hang down slightly. The eye is often red and the eye will tear up.
2. Muscle Contraction (Tension)
Many people use this label to describe the type of headache brought on by stress
but in fact, tension headaches involve the tightening or tensing of the muscles of
the upper back, neck, and scalp. This may result from emotional or physical
stress. As noted by Cummings and Ullman (2004), loss of sleep, extreme heat
or cold, poor posture are examples of physical stresses that can lead to these
types of headaches.
Cummings and Ullman (2004) further note that the body responds to stress by
increasing muscle tone and prepares for a fight or flight response. One is not
always able to act physically in some situations and the muscle tension will build
to a point when headaches occur. The muscle is sore from overwork and this
tension constricts blood vessels and slows the blood flow to the overworked
muscles. Muscle contraction pain is usually a steady, dull ache that could be felt
at the temples, across the forehead. It may also be at the base of the head and
neck and these locations are often sensitive to touch. It might feel as if a tight,
constricting band were wrapped around the head.
Page 7
3. Traction
Traction headaches indicate that there is another disorder in the body.
According to Walker, Hall, and Hurst (1990), traction headaches can be caused
by a wide variety of organic diseases of the head…
These include intracranial mass legions such as metastatic tumors, hematoma,
or abscesses. The tentorium (tentorium cerebella, meaning the tent of the
cerebellum), separates the occipital lobes from the cerebellum. If the mass is
above the tentorium, there can be pain in the frontal area or the vertex. If the
mass is below the tentorium, there can be pain at the occiput with cervical
muscle spasm.
The cerebellopontine angle is the space between the pons and the cerebellum.
Acoustic neuromas can grow in this space and the proximity to the cranial nerves
can cause a neurological problem. In this case, the patient would likely feel pain
behind the ear.
A headache resulting from an intracranial tumor can become more intense when
coughing, urinating, or straining to stool. These headaches are generally worse
on waking in the morning and gradually become less severe as the day
progresses. This is because standing and moving in an upright position
throughout the day decreases the intracranial pressure.
Connective tissue disease such as Giant Cell Arteritis can cause headaches.
The quality is intense, burning, throbbing, and persistent. Patients often present
with ocular chief complaints and chewing food can cause pain. Temporal Arteritis
is another disease that can cause vision loss in elderly patients.
Stroke or Transient Ischemic Attacks (TIAs) can also cause headache. The
patient will experience pain usually in the occiput when there is a lack of oxygen
to the basilar artery. There will be more pain in anterior region when the lack of
oxygen is in the carotid artery.
Trigeminal Neuralgia is another condition that can cause headaches. This
cranial neuralgia most often occurs in the elderly or middle aged. The patient
would experience brief, intense, shooting pains in the trigeminal nerve or one of
its branches.
Page 8
Disease or dysfunction of the temporomandibular joint (TMJ) can cause
headache. The pain can be referred from the jaw and neck and can be
aggravated by chewing or talking.
4. Inflammatory
Headaches caused by inflammation indicates that there may be something else
very serious going on. It could be a disorder of the sinuses, spine, neck, ears, or
teeth.
If a patient presents with a headache concomitant with stiff shoulders and neck,
consider that the individual may have inflammation of the meninges or bacterial
meningitis. This can be caused by a virus, blood disease, tumors, or fungi.
For individuals suffering from headaches more than 3 times per month, the focus should
be on prevention. The best method is usually by making some lifestyle changes.
Effective therapies are to reduce stress, modify dietary habits, and to get regular
exercise.
Some types of headaches are indicators of more serious disorders in the body and
should be dealt with immediately. Examples are:

Sudden, severe headaches

Headaches that suddenly disappear with exertion (sub-arachnoid)

Headaches associated with a stiff neck

Headaches associated with fever or convulsions

Headaches following a blow to the head

Headaches accompanied by a loss of consciousness

Headaches associated with pain in either the eye or the ear

Headaches in someone who has previously never suffered from headaches

Recurring headaches in children
Page 9
Disorders Causing Secondary Headaches
Headaches can occur as the result of primary or secondary disorders. Vascular and Tension
headaches would be considered primary disorders. Some Traction and Inflammatory
headaches would be examples of secondary disorders. The following table (178-1)taken from
page 1716 of the 19th Edition of the Merck Manual, outlines disorders causing a secondary
headache.
DISORDERS CAUSING SECONDARY HEADACHES
EXAMPLES
CAUSE

Extra-cranial disorders
Intracranial Disorders












Systemic Disorders
Drugs and toxins















Carotid or vertebral artery dissection (which also causes neck pain)
or vertebral artery dissection (which also causes neck pain)
Dental disorders (e.g. infection, temporomandibular joint
dysfunction)
Glaucoma
Sinusitis
Brain tumors and other masses
Chiari type I malformation
SDF lead with low-pressure headaches
Hemorrhage (intracerebral, subdural, subarachnoid)
Idiopathic intracranial hypertension
Infections (e.g. abscess, encephalitis, meningitis, subdural
empyema)
Meningitis, noninfectious (eg. carcinomatous, chemical)
Obstructive hydrocephalus
Vascular disorders eg. vascular malformations, vasculitis, venous
sinus
thrombosis)
Acute severe hypertension
Bacteremia
Fever
Giant cell arteritis
Hypercapnia
Hypoxia (including altitude sickness)
Viral infections
Viremia
Analgesic overuse
Caffeine withdrawal
Carbon monoxide
Hormones (e.g. estrogen)
Nitrates
Proton pump inhibitors
Page 10
Characteristics of Headache Disorders by Cause
The following table (178-2) taken from pages 1716 and 1717 of the 19th Edition of the Merck Manual,
outlines the characteristics of headache disorders by cause.
CHARACTERISTICS OF HEADACHE DISORDERS BY CAUSE
CAUSE
SUGGESTIVE FINDINGS
Primary headache disorders *
Migraine headache




Tension-type headache


Cluster headache

Unilateral orbitotemporal attacks at the same time of day
Deep, severe, lasting 30-180 min
Often with lacrimation, facial flushing, or Horner’s syndrome; restlessness
Frequently unilateral and pulsating, lasting 4-72 h; occasionally with aura, nausea,
photophobia, sonophobia, or osmophobia
Worse with activity, preference to lie in the dark, resolution with sleep
Frequent or continuous, mild, bilateral, and viselike occipital or frontal pain that
spread to entire head
Worse at end of day



Unilateral
Halos around lights, decreased visual acuity, conjunctival injection, vomiting
Fever, altered mental status, seizures, focal neurologic deficits
Giant cell arteritis


Age > 55
Unilateral throbbing pain, pain when combing hair, visual disturbances, jaw
claudication, fever, weight loss, sweats, temporal artery tenderness, proximal
myalgias
Idiopathic intracranial hypertension

Migraine-like headaches, diplopia, pulsatile tinnitus, loss of peripheral vision,
papilledema
Intracerebral hemorrhage
Meningitis



Sudden onset
Vomiting, focal neurologic deficits, altered mental status
Fever, meningismus, altered mental status
Sinusitis

Positional facial or tooth pain, fever, purulent rhinorrhea
Subarachnoid hemorrhage



Peak intensity a few seconds after headache onset (thunderclap headaches)
Vomiting, syncope, obtundation, meningismus
Sleepiness, altered mental status, hemiparesis, loss of spontaneous venour
pulsations, papilledema
Presence of risk factors (e.g. older age, coagulopathy, dementia, anticoagulant
use, ethanol abuse)
Eventually altered mental status, seizures, vomiting, diplopia when looking laterally,
loss of spontaneous venous pulsations or papilledema, focal neurologic deficits
Secondary headaches
Acute angle-closure glaucoma
Encephalitis
Subdural hematoma (chronic)

Tumor or mass

Page 11
Migraines
According to the Office of Communications and Public Liaison of the United States
(2015), migraine headaches are a neurological syndrome and they are characterized by
nausea and severe pulsating or throbbing headaches. Migraine symptoms are directly
related to changes in the blood vessels. In the initial stage of a migraine there is a
decrease in blood flow to the brain and that leads to a constriction.
There is often a warning symptom before any pain is felt. Approximately one third of
migraine sufferers are able to predict the onset of a migraine because it is preceded by
an "aura," or a visual disturbance. The aura may appear as flashing lights or lines in a
zig-zag pattern and occur with a temporary loss of vision. There can be other
indications of neurological impairment such as dizziness, slurred words, and numbness
on one side of the body.
The pain actually begins when the blood vessels that were narrowed open up too wide.
The nerve endings in the walls of the blood vessels are stimulated by the return of the
blood flow but there have been chemical changes in the blood that cause inflammation.
This combination of inflammation and stretched blood vessel walls causes pain in the
nerve endings. The pain will likely be localized to one side of the head but it can spread
to the other side.
“The International Headache Society diagnoses a migraine by its pain and number of
attacks (at least 5, lasting 4-72 hours if untreated)".(Office of Communications and
Public Liaison, 2015) Other symptoms include vomiting, increased sensitivity to light
and sound, and numbness and tingling in parts of the body.
More women experience migraine headaches than men. In fact, migraines are three
times more common in women. In some cases this may be attributed to changes in
hormone levels during menses. Over all, migraines affect approximately 10% of the
world’s population.
According to Platt (2008), many people believe they suffer from sinus headaches, but in
fact, the majority of these types of headaches fall into the category of migraines.
Studies suggest that about 90% of so-called sinus headaches are actually migraines.
When there is pressure around the eyes, behind the cheekbones, and in the forehead, it
indicates a problem with the sinuses. Acute sinus headaches are rare as it comes with
a bacterial infection of the nose and sinuses.
Sinus pain is easily confused with migraine pain because both conditions have some
common symptoms. The pain in the forehead and behind the eyes and cheekbones are
common and those symptoms can be accompanied by nasal discharge. Both
conditions can also be triggered by weather changes.
Page 12
Phases of Migraines
1. Prodrome (Early Symptom) Phase
One or two days before a migraine, there may be slight changes an individual will
notice that signify an oncoming migraine. Changes may include:

Constipation

Depression

Food cravings

Hyperactivity

Irritability

Neck stiffness

Uncontrollable yawning
2. Aura
Auras are symptoms of the nervous system and they can be visual, sensory,
motor, or verbal disturbances. Not every individual suffering from migraines
experiences an aura but if they do, each symptom usually begins very gradually
and builds. Symptoms can last 20 to 60 minutes. An aura immediately precedes
the headache. Examples of aura symptoms are:

Visual phenomena (various shapes, bright spots or flashes of light)

Loss of vision

Sensation of pins and needles in the arm or leg

Aphasia (speech or language problems)

Weakness of the limbs concomitant with aura (hemiplegic migraines)
3. Pain– Headache or Attack Phase
A migraine usually lasts from four to 72 hours if it is untreated, but the frequency
with which headaches occur varies from person to person. During a migraine the
following symptoms may be experienced:

Pain on one side or both sides of your head

Pulsating, throbbing pain

Sensitivity to light, sounds and sometimes smells

Nausea and vomiting

Blurred vision, lightheadedness, sometimes followed by fainting
Page 13
4. Postdrome (late symptoms following attack)
The final phase, known as postdrome, occurs after a migraines attack. Some
people can feel mildly euphoric but most feel drained and washed out.
At this point in time, it is not really known what causes migraines. According to the
Office of Communications and Public Liaison (2015), scientists believed for many years
that migraines were linked to the dilation and constriction of blood vessels in the head.
Now, researchers believe that migraines have a genetic cause.
The pathophysiology of migraines is not fully understood yet so from a medical
perspective there is no cure. The main approach to treatment is to try to prevent the
attack in the first place. The best way to do this is through behavioural changes. Since
everyone will experience a migraine in their own unique way, it may be useful to keep a
diary of the experiences and the triggers that initiate the migraine. (Ehrlich, 2011).
There are certain common triggers for migraines that can be categorized as
environmental, behavioural, infectious, dietary, chemical, or hormonal. For example,
a chemical trigger may be monosodium glutamate that is commonly found in Chinese
Food. Some other dietary triggers can be fermented foods like pickles and red wine,
dairy products, chocolate, and nuts. Lack of sleep and the lack of a regular sleep
pattern can also play a role in triggering migraines. It is also believed that obesity can
contribute to migraines.
Doctors and researchers agree that migraines tend to run in families. There have been
studies done to locate genes that cause migraines but that research is just beginning.
According Health Union (2015), studies on family history with regard to migraines show
the following:
 70 % of migraine sufferers have family history of migraine
 one study showed a 50% greater risk of suffering from migraines if an
immediate family member suffered from migraines
 research indicates if one parent suffers from migraines there is a 40% chance
that his or her child will also suffer from migraines
 further research indicates that if both parents suffer from migraines there is a
90% chance that the child will also suffer from migraines
 studies also show that a child is more than twice as likely to suffer from
migraines if his mother does
 in a large study of 5,000+ twins in the United States research indicated that
for identical twins, if one twin suffered from migraines, there was a 35%
chance that the other did as well.
 in that same study, done on fraternal twins, there was a 16% chance that if
one twin suffered from migraines the other twin would also suffer.
Page 14
Usually, migraines will appear for the first time in those in their early teenage years,
around puberty. However, some younger children do experience migraines earlier
when they are unable to describe the sensations. An alert for a parent would be
recurrent vomiting in a young child between 2 to 4 years old. There may be some
stress in the child’s life that a parent will need to elicit somehow from the child in order
to remove that stressor from his or her life.
Often, migraines are triggered by psychological stress and other mental and emotional
issues. Stress at work is a common trigger. Ironically, it is not until after the stress is
relieved that the attack begins. Often, a business executive will be under constant
pressure and stress Monday to Friday at work and then he will suffer a migraine attack
when he is relaxing reading the newspapers on a relaxing weekend morning. Others
may experience migraines after the death of someone close to them. Other stress can
come from sleeping too long, fasting, certain foods and drinks, menstrual cycles, and
fluctuations in hormone levels.
According to the National Headache Foundation of the United States (2015), migraines
may also be triggered by abnormal electrical changes in the brain which may be linked
to high levels of calcium and glutamate and low levels of magnesium. A certain
phenomenon, “Cortical Spreading Depression”, starts with a wave of stimulation of the
neurons which is followed by a wave of depression. This change in electrical activity in
the nerve cells stimulates the release of peptides that irritate the nerves, especially the
trigeminal nerves. The trigeminal nerves transport sensation to the face and a good
part of the head.
The diagram on page 16 depicts the pathways of migraine headaches. It show the path
of the migraine from the onset in the brain: the electrical charges that cause the
migraine to spread throughout the brain, the changes in the nerve cell activity and blood
flow that sometimes result in numbness or tingling and visual disturbances, the dilation
of blood vessels and tissue inflammation caused by chemicals in the brain, and finally,
the spreading of the inflammation to other nerves fed from the transgeminal nerve that
causes the pain.
Page 15
* National Headache Foundation (2015)
Page 16
Dietary Triggers
It is challenging to identify food triggers for migraines because those triggers can be
different for many people. Sometimes certain foods become triggers when they are
combined with other factors such as stress and hormonal changes. A particular food
may not trigger a migraine each and every time. It could depend on the amount eaten.
The migraines may not come immediately following the trigger so that trigger becomes
harder to identify.
For those prone to migraines, it may be useful to keep a food diary. That way, food and
drink consumed around the time of migraine can be reviewed to detect patterns and
potentially point to triggers.
Although it may be difficult to identify a reliable list of migraines triggers for everyone,
the following is a selection of common migraines triggers that apply to many people.
Alcohol
Any type of alcoholic beverage can incite headaches in those susceptible to migraines.
This is a substance that affects many sufferers. Red wine is one of the most common
culprits. Sometimes, only a sip or two can cause pounding head pain.
Caffeine
This is an interesting substance because it can ease headache pain in some people
and in others it can trigger a migraine. Caffeine can help with the absorption of certain
medications for head pain. It is wise to limit the amount of caffeine to about 8 ounces
per day. That is a reasonable amount that is not usually enough to spark a migraine in
many migraine sufferers. For those who are excessive users of caffeine, it is best to
reduce intake gradually and never stop cold turkey. This can result in rebound
headaches.
Chocolate
“Chocolate is one of the few foods which has been investigated in double blind
controlled studies, to determine how much of a trigger it really is - unlike many other
food products, which have merely been included as part of larger studies using a wide
range of possibilities”. (Healy and Alexander, 2008) They elaborate on these studies to
show that there is not much evidence to support that chocolate is actually a trigger for
migraines.
Page 17
In 1974 a study was done at London Hospital that concluded that chocolate may be a
trigger for migraines but it was not a significant one. (Healy and Alexander, 2008)
Another study at the University of Pittsburgh Pain Evaluation and Treatment Institute in
1997 also was inconclusive. They used a double blind protocol and placebo. Results
showed that there was no difference in frequency and intensity of migraines between
participants that were given chocolate and those who were given a carob placebo.
(Healy and Alexander, 2008)
That being said, hundreds of thousands of people who suffer from migraines say that
chocolate is a trigger for migraines. Many have said that when it is removed from their
diet that the migraines stopped and that when they re-introduced it the symptoms came
back immediately.
It isn’t clear whether chocolate actually triggers migraines. It may just signal that a
migraine is coming. Many people find that chocolate cravings increase when they are
under stress and also when they are undergoing hormonal changes, such as women
experience during the menstrual cycle. Stress and hormonal changes are common
triggers for migraines.
Tyramine and Tannins
Tyramine and Tannins are natural food compounds that can trigger migraines.
Tyramine is produced in the breakdown of the amino acid, Tyrasine. It can cause
blood vessels to dilate and this may trigger migraines in some people.
Tyramine is found in:










Red wine
Beer
Avocados
Overripe bananas
Aged cheese
Pork
Soy products
Some processed meat
Nuts
Chocolate
Page 18
Tannins are compounds from plants that can prevent the human body from absorbing
proteins and minerals. They generally leave a bitter taste in the mouth. They actually
can be found in food dyes and household cleaners as well. It isn’t clear why tannins
may be a trigger for migraines in some people but they certainly deprive the body of
nutrients it needs and that can make a body feel worse.
Tannins are abundant in:





Coffee
Tea
Chocolate
Red wine
Apple juice
Food additives
Monosodium Glutamate (MSG) is a food additive that is commonly found in fast food,
take out, such as Chinese food (Shimer Bowers and Lliades, 2014). Many people say
they feel ill after consuming products with this additive. According to research
published in the Journal of Allergy and Clinical Immunology, it was noted that those
individuals sensitive to migraines as a result of food triggers were more likely to get a
headache after eating foods containing MSG than they were after consuming a placebo.
(Shimer Bowers and Lliades, 2014) Glutamates tend to widen blood vessels and this
has been linked to triggers for migraines.
Nitrates are found in processed deli meats and other smoked meat products. They can
also be found naturally in certain vegetables like broccoli and root vegetables. Texas
Neurology states, “Definitive clinical data is lacking, but migraine sufferers have
reported sensitivity to nitrites”. (Renee, 2014) Nitrates and Nitrites may contribute to
migraines because the body converts nitrates to nitrites. Renee (2014) further explains
that the body produces nitric oxide, a gas that expands the blood vessels. Nitrates
cause an increase in the production of nitric oxide, which can trigger migraines in
sensitive people. She goes on to discuss a study published in the journal, “Cephelagia”
June 2010, where results showed that prior to the onset of a migraine, nitric oxide stress
was present. The data suggests that consuming foods with a high nitrate content may
trigger migraines by increasing nitric oxide in the body, and in turn, increasing the risk of
nitric oxide stress in those who are susceptible to migraines. Renee (2014)
Page 19
Artificial sweeteners
Aspartame is an artificial sweeter commonly used in diet soft drinks and other “diet”
foods. It really acts like a drug in the body releasing a neurotransmitter in the brain. It
may lower serotonin levels, which can alter an individual’s mood, cause depression, and
contribute to migraines. Studies have been conducted that do indicate a correlation
between aspartame and migraines.
The New England Journal of Medicine conducted one study that showed that study
participants who did not take Aspartame had a migraine attack on 24% of the days of
the study while those participants that did take Aspartame experienced migraines on
33% of the days. Migraine Headache Rx.com (2015) Another study indicates that
90% of migraines are triggered by allergic reactions to food additives or the actual food
and that 10% of migraine attacks can be linked to aspartame. Migraine Headache
Rx.com (2015) A study by the University of Florida reported that migraine frequency
increased by 50% in patients taking aspartame. Migraine Headache Rx.com (2015)
Avoiding Dietary Triggers
It is difficult to eliminate foods and drinks that we desire from our diet but it makes sense
to pay attention and to regulate the amount of those substances that we know to trigger
migraines or other ailments in our bodies.
It is a good idea to have regular meals and healthy snacks to help minimize the chance
of migraines. Many people find that going without food for as little as four or five hours
can trigger migraines.
On the flip side, eating too much can also trigger migraines. Obese people have a
higher frequency and intensity of migraines than do people who have a healthy body
weight. (Peterlin, 2011)
People that are prone to migraine attacks should eat a balanced, healthy diet, not
smoke, drink alcohol in moderation, get lots of exercise, and try to reach and maintain a
healthy body weight.
Page 20
Treatment
Medical doctors have had some success in migraine prevention with drugs originally
used for epilepsy, high blood pressure, and depression. Botulinum toxin A, commonly
known as Botox, has been effective in the prevention of chronic migraines and it has
been approved for use in Canada.(Barton, 2012).Other drugs commonly prescribed for
prevention and acute treatment are outlined in the Merck Manual. An excerpt from that
book is found on page 24. However, with all of these drugs, there are certain side
effects.
Many people are now looking to more natural methods for dealing with chronic
migraines. Homeopathy is a safe, effective way to prevent and treat migraines. In the
case of chronic migraines, we want to look at the totality of the symptoms of the
individual. Achieving the best match between an individual’s symptom picture and
symptom picture of a homeopathic remedy will offer the best chance of eradicating this
neurological disorder.
In acute flare ups of the chronic migraines condition, over the counter drugs like
ibuprofen, aspirin, and Tylenol can lessen the severity of the symptoms. However, it is
possible that these types of drugs can cause headaches and migraines. The Merck
manual talks about the overuse of analgesics as a cause of secondary headaches.
The evidence shows that there is increased sensitivity after each successive migraine
attack. This can lead to a daily chronic migraine state, which is all the more reason for
one to take measures to prevent an occurrence. According to Platt (2008), “Powerful
drugs can treat the acute symptoms of migraines, but overusing these medications can
actually increase an individual’s susceptibility to further headaches, creating an ongoing
cycle of pain”.
Other therapies that are being tested for effectiveness in treating migraines are:
magnesium, coenzyme Q10, vitamin B12, riboflavin, fever-few, and butterbur. Also, “In
2010, a team of researchers found a common mutation in the gene TRESK, which
contains instructions for a certain potassium ion channel”. A role of a potassium
channel is to keep a nerve cell at rest. Mutations in potassium cells can cause the
nerve cells to be sensitive to lower levels of pain. Further genetic analyses may identify
other genes that are linked to migraines.
Page 21
In the next sections the various treatments for migraines and headaches will be
explored, based on the following categories:






Conventional Drugs
Supplements and Herbs
Acupuncture
Chiropractic
Osteopathy
Homeopathy
*****
Page 22
Conventional Treatment
The chart on page 24 outlines the conventional drugs used in the prevention and
treatment of migraine and cluster headaches. Although these medications may help to
prevent headaches and relieve acute conditions, there are some serious side effects
with them.
Prevention
Some medications are better in helping to prevent migraines and cluster headaches.
Amitriptylines can also help with insomnia but a negative side effect is weight gain.
With Divalproex, there can also be weight gain. In addition, the gastro-intestinal (GI)
tract can be affected, tremors can be experienced, and that medication can cause a
condition called, alopecia, where the hair tends to fall out. Lithium can cause polyuria, a
condition in which great quantities of urine is passed. It can also cause weakness and
tremors. Topiramate can actually cause weight loss but it can also cause confusion and
depression, and other problems in the central nervous system (CNS). Verapamil can
cause constipation and hypotension, which can lead to weight gain.
Treatment
Other medications are better for acute treatment. One of these drugs is
Dihydroergotamine. It can help treat a migraine but it can also cause nausea and has
severe side effects on over use, such as vascular dysfunction of the extremities.
Triptans can cause flushing and a sense of pressure in throat or chest. It can also
cause paresthesias, a sensation of tingling or prickling, like pins and needles. Valproate
is similar to the preventative Divalproex in terms of its side effects; the weight gain, the
GI tract upset, the tremors, and the alopecia.
With all of these drugs, it is important to note the restrictions on taking them. Some are
contraindicated for people suffering other ailments or conditions. For example, Triptans
should not be given to individuals with coronary artery disease. Some of these drugs
should not be taken concurrently with other drugs. Dihydroergotamine should not be
taken concurrently with Triptans.
With all of these kinds of potential side effects, and the worry of taking a drug that
conflicts with another substance, is it really worth the benefit from migraine relief?
Page 23
Drugs for Migraines and Cluster Headaches and their Side Effects
The following table is based on table (178-4) from page 1721 of the 19th Edition of the Merck Manual,
outlines the various drugs and dosages for prevention and treatment of migraines and cluster headaches.
DRUGS FOR MIGRAINES AND CLUSTER HEADACHES
DOSAGE
DRUGS
COMMENTS/SIDE EFFECTS
Prevention *
Amitriptyline
Beta Blockers






Divalproex

10-100 mg po at bedtime
Atenolol 25-100 mg po
once/day
Metoprolol 50-200 mg po
once/day
Nadolol 20-160 mg po
Once/day
Propranolol 20-160 mg po bid
Timolol 5-20 mg po once/day
Lithium

Regular release 250-500 mg po
bid
Extended release 500-1000 mg
po once/day
300 mg po bid to qid
Topiramate

50-200 mg po usually once/day
Verapamil

240 mg once/day to tid
Dihydroergotamine


0.5 – 1 mg sc or IV
4 mg/ml. nasal spray
Triptans







Almotriptan 12.5 mg po
Eletriptan 20-40 mg po
Provatriptan 2.5 mg po
Frovatriptan 2.5 mg po
Naratriptan 2.5 mg po
Rizatriptan 10 mg po
Sumatriptan 50-100 mg po, 520 mg nasal spray, or 6 mg sc
Zolmitriptan 2.5-5 mg po or 5
mg nasal spray
500-1000mg IV







used only for migraineshas anticholinergic effects – causes
weight gain
helpful for insomnia
small doses are effective
used only for migraines
only beta blockers without intrinsic sympathomimetic activity
used
avoided in patients with bradycardia, hypotension, or asthma

can cause alopecia, GI upset, hepatic dysfunction,
thrombocytopenia, tremor, weight gain






used only for cluster headaches
may cause weakness, thirst, tremor, and polyuria
weight loss
CNS adverse effects – confusion, depression
most useful for cluster headaches
can cause hypotension and constipation


can cause nausea
contraindicated in patients with hypertension or coronary
artery disease
cannot be used concurrently with triptans
can cause flushing, paresthesias, and sense of pressure in
chest or throat
can repeat doses up to 3 times/day if headache recurs
contraindicated in patients with coronary artery disease or
uncontrolled hypertension
injections or nasal spray used for cluster headaches
Treatment *

Valproate








usually for patients who cannot tolerate triptans or
vasoconstrictors
can cause alopecia, GI upset, hepatic dysfunction,
thrombocytopenia, tremor, and weight gain
Page 24
Supplements and Herbs
There has been a growing interest in recent years in more natural treatments for
managing headaches and migraines. Herbs, vitamins, and supplements can be used
effectively in the prevention and therapeutic treatment of headaches. Coenzyme Q10,
Magnesium, Riboflaven, Butterbur, Feverfew, and Ginger are some of the more
effective natural treatments.
Coenzyme Q10 (CoQ10)
Coenzyme Q10 is a compound that was initially identified in 1957. It is believed that it
works by boosting the energy reserves in the brain.
Sources of CoQ10 include: soybean oil, canola oil, hering, mackerel, cauliflower,
broccoli, chicken, beef, roasted peanuts, sesame seeds, pistachio nuts, strawberries,
oranges, and boiled eggs.
According to Robert (2014), an article in the April 2002 issue of the Journal of the
International Headache Society, Cephalalgia, reports very encouraging results from an
open label trial of coenzyme Q10 as prevention for migraines.
In the study, 150 mg of coenzyme Q10 was the daily dose used. There were some
side effects that participants experienced, mostly related to gastrointestinal upset,
including nausea, diarrhea, heartburn, and loss of appetite. In a large study, the
incidence rate was less than 1%, which is very favourable. It was found that in most
cases, participants could handle doses of up to 600 mg per day without negative side
effects.
Other points from the study worth noting are:

61.3% of participants in the trial experienced at least a 50% reduction in frequency of
migraine attacks by the end of the four-month trial.

study data suggests that it takes 5 - 12 weeks to achieve more than a 50% reduction
in migraine frequency

Coenzyme Q10 is effective for both the classic type of migraine (with aura) and the
common migraine (without aura).
Page 25
Coenzyme Q10 can be given to almost any age group without worry of any significant
side effects. Although, in some individuals, there can be side effects of nausea, diarrhea,
and heartburn, for the vast majority of people, it appears to be a good choice for
preventative therapy.
Magnesium
Magnesium is one of the most abundant minerals found in the body. It is mineral that is
naturally found in green, leafy vegetables, whole grains, seeds, and nuts, as well as in
nutritional supplements.
Women who are prone to migraines during menstrual cycles often have lower levels of
Magnesium and could benefit from Magnesium supplements. It may even help prevent
the migraine in the first place. It also is beneficial for women who suffer migraines
during pregnancy.
Magnesium helps regulate the body’s 24 hour clock that governs sleep, body
temperature, and hormone levels. It can calm nerve cells in the brain which affect
migraines. It usually takes about 3 cycles for the Magnesium to be effective. Some
people find it can cause diarrhea and an alternative in that case would be magnesium
Gluconate.
Wong (2015) discusses several studies that have been done to determine the
effectiveness of Magnesium in treating migraines. In one study, 81 participants were
given either a 600 mg per day dose of magnesium or a placebo. The study ran for 9
weeks. After that, in the group taking Magnesium, a 41.6% reduction in frequency of
migraines was reported. The statistics for the placebo group indicated only a 15.8%
reduction in migraine frequency. In total, 18.6% reported diarrhea as a side effect and
4.7% reported digestive irritation. Other studies indicate that magnesium does reduce
the frequency and also the severity of migraines.
Page 26
Elements of the Body
* Anatomy & Physiology Connexions website (2013)
Butterbur
Butterbur root is a plant extract that can reduce the frequency of migraines by as much
as 50% when it used on a daily basis for 3 to 4 months. Scientists believe that
Butterbur works by decreasing inflammation and helping to promote the relaxation of
the smooth muscle lining of the cerebral blood vessel walls. 50 to 75mg of butterbur
extract taken twice per day for up to 4 months has been proven effective in preventing
migraines.
Platt (2008) discusses the effectiveness of Butterbur in reducing the number and
frequency of migraines. A small study of 60 participants in Germany had 33 adults take
50 mg of Butterbur extract two times per day while the remainder took a placebo twice
daily, for a total of 12 weeks. At the beginning of the study, the average was 3.3
migraines per month for the group. In the group taking Butterbur, after 4 weeks, the
average number or migraines was down to 1.8. After another 4 weeks, the average
was reduced to 1.3 or a 61% reduction. After another 4 weeks, the average was 1.7, a
49% reduction at the end of the study duration.
Page 27
In a larger 4 month study of 245 participants, one third were given 75 mg of Butterbur
extract twice per day, another third were given 50 mg of Butterbur extract twice per day,
and the final third were given a placebo twice per day. At the end of the study period,
those taking the 75 mg. dose of Butterbur extract reported that migraine frequency had
been reduced by 50%. Those taking the 50 mg. dose had a minor reduction in
frequency of migraine relative to the placebo group. The results indicated by taking 50
to 75 mg. of Butterbur extract twice daily were comparable to the results achieved by
some preventive prescription medications. However, Butterbur is safer and has less
negative side effects than those drugs.
B12 (Riboflaven)
Research so far has shown that those who suffer from migraine headaches have
reduced mitochondrial energy reserves in between migraine attacks. Vitamin B12, or
Riboflaven, is critical to mitochondrial energy production and has been proven effective
in the prevention of migraines. (Erlich, 2011).
In a trial of 55 migraine sufferers, it showed that 60% of those who took 400mg of
Riboflavin each day had at least 50% reduction in migraines at three months. A further
study of 23 patients confirmed these numbers and further to that, those patients had
continued results at 6 months.
Ginger
Ginger is known for its anti-inflammatory benefits and its action on nausea and pain. In
a double blind clinical trial of 100 migraine sufferers, the efficacy of Ginger was
compared to a conventional treatment, Sumatriptan, in treating migraine headaches.
(Hudson, 2014) Participants were given a 250 mg capsule of ginger or 50 mg of
Sumatriptan at the onset of a migraine. The study was conducted over a one month
timeframe and checkpoints were done at 30, 60, 90, and 120 minutes then again after
24 hours. Research indicates that 70% of participants taking Sumatriptan felt relief after
2 hours. 63% of those taking Ginger felt relief after 2 hours. These are similar results
but the real difference is in the side effects. With participants taking Ginger, the only
clinical side effect reported was mild dyspepsia, while those taking the Sumatriptan
reported dizziness, vertigo, heartburn, and a sensation of being sedated.
Page 28
Feverfew
Feverfew, or Tanacetumparthenium, is a plant of the sunflower family. It is also called
Wild Chamomile. It has been used extensively in Europe as an herbal medicine.
Feverfew contains parthenolide, which is a compound that may reduce inflammation,
help muscle spasms, and also help prevent constriction of blood vessels in the brain.
There have been some studies done to determine the effectiveness of Feverfew.
(Erlich, 2011). In Britain, a survey of 270 migraine sufferers reported that 70% felt much
better after taking 2 or 3 fresh Feverfew leaves daily. It was found in further studies that
Feverfew can be used to treat chronic migraine as a preventive method and it can also
be used in acute cases. The studies suggest that Feverfew, taken in dried leaf
capsules daily may reduce the occurrences of migraine in chronic migraine sufferers.
Another study gave migraine sufferers a combination of Feverfew and White Willow
(Salix alba) twice daily for 12 weeks. The White Willow has similar properties to aspirin.
Results indicated that participants had a reduced number of migraines that were shorter
in duration and less painful.
Another 3 month study with 49 participants combined Feverfew, Magnesium, and
Vitamin B12. Results were a 50% reduction in the number of migraines.
It may depend on which supplement is taken whether the Feverfew is effective in
treating migraines. Further studies are needed.
Page 29
Acupuncture
Acupuncture is an ancient therapeutic technique using needles to pierce the body. It
has been around since 200BC and was developed in China. Acupuncture can have an
effect on the nervous system, the spinal cord, and the brainstem. It works on areas of
the brain that control the transmission of pain and the individual’s emotional response to
it. There are two different styles of Acupuncture practiced today, each with their own
philosophical approach.
Traditional Chinese Acupuncture
Illness and disease are a disturbance of qui. The qi is an energy form or the vital force
which is very similar to a concept used in homeopathy. Qi flows along 14 meridians on
the surface of the body where the acupuncture points are located. The purpose of the
acupuncture treatment is to repair the flow of qi through those meridians. There has
been a disturbance of the vital force that requires intervention. This procedure is
individualized to the person requiring treatment. The needles would not necessarily be
placed in the same location on different individuals.
Western Medical Acupuncture
Western Medical Acupuncture uses a more modern scientific philosophy. It is based
on the biological effects of the procedure as well as on clinical research. It uses local
points like the head and the neck in addition to distant points like the feet and hands.
Also used is “trigger point” acupuncture in which the needles are placed in tender spots
in the muscles in an effort to release a muscle spasm.
Studies
Studies done to date have almost exclusively focused on prevention of headaches.
There has not been much research into acute treatment.
Berkovitz, (2010) states that evidence supports the value of acupuncture in the
treatment of idiopathic headaches based on the Cochrane systematic review of 16
studies involving 1151 participants. Since then, large clinical studies have been done
and the results compared with standard allopathic treatment. The results indicate
persistent and clinically relevant benefits equivalent to specialist drugs. However, no
convincing evidence of superiority to “sham” acupuncture has been shown for
headaches. Sham acupuncture is a method where needles are inserted less deeply
Page 30
into the skin and away from the traditional acupuncture points. The purpose is to
simulate a placebo for studies. It is really only useful for patients that have never
experienced acupuncture before and do not know what the needles are supposed to
feel like or where the acupuncture points really are. So what does this really mean?
Some believe that acupuncture doesn’t work at all and is no better than a placebo.
Others believe that the study shows that it doesn’t really matter how the acupuncture is
done, and where and how deep the needles are inserted into the skin. They believe that
acupuncture is considerably better than no treatment at all and that it is as good if not
better than conventional treatment and has less side effects.
In another study, chronic headache sufferers were given 12 sessions of acupuncture for
3 months. Results indicated: 34% less days with headaches, 15% less sick days, 15%
medication required, and 25% fewer visits to the doctor.
Safety
Obviously when dealing with needles, a trained practitioner is a must and sterile, singleuse needles are required. However, side effects can occur. There may be some slight
bruising and bleeding as the needle does puncture the skin. Sometimes existing
symptoms are temporarily worsened but that is generally only about 1% of people. 3%
actually experience a kind of euphoria. It is extremely rare to have severe side effects
such as puncturing of the lung or the heart membrane.
Page 31
Chiropractic
Some studies have indicated that spinal manipulation therapy may be beneficial in
treating migraine headaches. (Erlich, 2011) In one clinical trial, 22% of patients
receiving chiropractic treatment reported a 90+% decrease in the number of migraine
attacks experienced. Of those people, 49% also reported a very significant decrease in
the intensity of the migraines.
In another study, migraines sufferers were assigned randomly to receive either Elavil
medication taken daily, chiropractic spinal manipulation, or a combination of both of
those treatments. The results indicated that the chiropractic treatment was as effective
as the Elavil in reducing the number of migraines and it had much fewer side effects.
Combining the Elavil and chiropractic treatment did not increase the effectiveness.
There have been additional studies done comparing chiropractic with other medications
and results showed that both were equally effective in reducing the number of
migraines. More research is needed to determine if chiropractic can actually prevent
migraines.
Page 32
Osteopathy
Osteopathy is alternative medical treatment that focuses on the physical manipulation of
the muscle tissue and bones. The philosophy of osteopathy is that the body has a
natural ability to heal itself. It is important for all of the fluids of the body (blood, lymph,
synovial fluid, digestive juices, cerebrospinal fluid, etc), to circulate freely, without any
blockage. The blockages can be either structural or non-structural. Structural
blockages can be twists and curves inside the body in bones, organs, or tissues that are
misaligned. They can affect the circulation of fluids in the body.
Some recent studies have provided some controversial results with regard to the benefit
of osteopathic treatment for migraines. Cerritelli, F. et al, (2013) discuss one study that
did show the efficacy of osteopathic treatment for migraines. The study was conducted
at the Department of Neurology at Ancona United Hospitals in 2010, from March to
November. Participants were divided into three groups: patients receiving osteopathic
treatment, patients receiving conventional medication (triptans), and patients receiving
sham therapy. The results showed a significant difference between the osteopathic
group compared to those groups receiving conventional medication and sham treatment
which suggests that osteopathic treatment can be considered a valid therapy in
managing migraines in patients.
Page 33
Massage and Physical Therapy
Erlich (2011) discusses the benefits of Reflexology for migraine sufferers. Reflexology
is a technique that applies pressure to specific locations or “reflex points” on the hands
and the feet. The theory is that these locations correspond to other locations within the
body. There has not been a great deal of research done on this to date but preliminary
studies indicate that Reflexology may provide pain relief for migraine sufferers.
As noted by Quin, Chandler, and Moraska (2002), muscle specific massage therapy
can help decrease the frequency and duration of chronic tension headaches. A study
was done where chronic tension headache sufferers were treated with a structured
massage therapy directed specifically at the neck and shoulder muscles. The intensity,
frequency, and duration of the headaches were recorded and compared with baseline
measurements. Results showed that the frequency of headaches was significantly
reduced during the first week of treatment and the duration of the headaches decreased
over the full study period, but the intensity of the headaches remained constant.
Page 34
Homeopathy
Homeopathy has been used throughout the world since Samuel Hahnemann introduced
this system of medicine in the late 1700s. Homeopathy is based on the Law of Similars,
like cures like or “Similia Similibus Curentur”, which means that a remedy produces
symptoms in a healthy person that will cure a persona in a diseased state. It is the
opposite of allopathic medications that suppress symptoms.
Although it has been proven over and over by homeopaths for hundreds of years, some
are skeptical of its efficacy. Some say that remedies contain nothing and that they are
so dilated they do not contain even a trace of the original substance.
There are a number of theories on how homeopathy works but nobody has been able to
explain it plausibly in terms of conventional science or show research to back up those
theories. Of late, there has been much scientific research into nanoparticles. One study
done in India using state of the art measuring devices reports that nanoparticles of the
original homeopathic substance can be found floating in the top layer of the water
solution. (Chikramane, P. et al, 2010) So far this has been found in potencies of up to
200ch. Research is ongoing and it is encouraging that there is beginning to be real,
concrete, scientific proof that there is substance to homeopathic remedies! News on
this research is very timely, considering that Homeopathy was regulated in Ontario
effective April 1, 2015.
Page 35
Homeopathic Case Taking Techniques to Determine Remedies
1. Determine Onset of headache
What triggers the headache?
Is it the individual’s mental or emotional state? Is it stress related? What does that
really mean? The homeopath must “chunk down” to get to the bottom of what that
means to this individual. Stress can come from many things and what is stressful for
one individual may be invigorating for another. Is the person suffering a grief? Did
they lose someone close to them? Are they going through a divorce? It could be
many things and they are all unique to an individual.
Is it brought on by lack of sleep? Has the person been working long hours and not
getting enough sleep on a consistent basis?
Could strong odours like gasoline, paint, garlic, and other substances be triggering
the migraine?
Is the migraine brought on by eating or drinking too much? Perhaps it is only certain
foods that trigger the migraine. Does skipping a meal or meals bring on a migraine?
2. What type of pain is it?
Throbbing? Pulsating? Cutting? Stabbing? Hammering? Burning? Aching? Dull?
Pressing? Constant? Gnawing? Bursting? Radiating?
3. Where is the pain located?
At the occiput? In the forehead? At the vertex? At the temples? Is it only one
sided? Which side?
Does the headache start in one place and travel to other places?
Page 36
(Hershoff,2000, p.176)
Page 37
4. What other symptoms are associated with the headache?
Is the face flushed? Are the pupils dilated? How about the pulse? Is the vision
affected? Does the headache come on only around the menses? Are there
digestive or bowel issues? Are there concomitant symptoms with the headache? Is
there vertigo?
5. What makes the headache either worse or better?
Time modalities are perhaps the most important in terms of reliability and general
quality of the symptom. For example, if a person has a recurring headache that
always begins at 3pm, it is significant and most useful when narrowing down the
selection of remedies. If it is worse from 4pm to 8pm, that is another significant
differentiating symptom.
Other modalities will deal with what may make the pain better or worse such as how
it is affected by hot or cold applications, grief, emotional upset, light, pressure, noise,
motion, standing, sitting, movement of eyes, movement in general, being in a warm,
stuffy room, being outside in open air, being in the dark.
6. What sensations does the patient feel?
The more the patient can express the sensation using a metaphor, the better the
value of the symptom. For example, if the patient says the pain is “like a vice or
band around my head”, this will be useful as it is descriptive. Sullivan and Rees,
(2008) say that the word “metaphor” comes from the Greek “amphora”, a storage
container used for transporting valuable goods. Since we use metaphor as a way to
transport meaning from one kind of thing to another, the word, “metaphor” is itself a
metaphor.
Page 38
A look at HEAD, PAIN in the Synthesis Repertory
To repertorize headache or migraine symptoms it would be useful to begin with HEAD –
PAIN in the repertory. For this example, the Synthesis repertory from Radar Opus
software will be used. It is important to repertorize using descriptive symptoms,
considering the root cause of the pain, the location of the pain, the side affected, the
characteristics of the pain, what aggravates the symptom, what ameliorates the
symptom, what other symptoms are concomitant, what sensations are present with the
symptom, and if there is any periodicity or time modalities. The repertory chart on page
40 shows the top remedies that cover the majority of headache and migraine symptoms
and also the remedies that score high for each individual symptom. It does not cover all
possible symptoms, only the main ones. In addition, it should be pointed out that this
repertorization is strictly for visual illustration. A good homeopath will never take the
repertory results at face value. She will use it as a tool to narrow down the selection of
remedies but will go the Materia Medica and Provings to choose the similimum, or the
remedy that has the symptom picture that best matches the symptom picture of the
individual.
Page 39
Repertory Chart for HEAD –PAIN with location, modalities, sensations
Page 40
The following chart groups a selection of migraine and headache symptoms by location, sensation, modalities, and
concomitants and shows the remedies that score highest in the Synthesis Repertory based only on those symptoms.
It shows only the remedies that scored at least a “3” in the repertory for a particular symptom (of the top 30 remedies
ranked). The purpose is to stress the main remedies or those remedies strongly indicated based on that symptom.
This is most useful in acute cases. When we look to a chronic remedy as a means of prevention of headaches and
migraines we would be more interested in seeing that the remedy covers all or most of the symptoms, regardless of
the repertory score, rather than strongly covering only a few symptoms. The following repertory chart represents a
good selection of headache and migraine symptom and the remedies
Symptoms
Remedies
Location
Left Sided
Right Sided
Forehead
Temples
Vertex
Occiput
Sepia
Sepia, Calcarea Carbonica, Belladonna
Natrum Muriaticum, Sulphur, Belladonn, Phosphorus, Bryonia, Nux Vomica,
Pulsatilla, Mercurius, Silica, Spigelia, Natrum Carbonicum, Ignatia
China, Belladonna, Pulsatilla, Kali Carbonicum, Lycopodium, Thuja
Sulphur
China, Sepia, Belladonna, Bryonia, Nux Vomica, Silica, Petroleum, Glonoinum,
Causticum
Sensation
Aching
Compressed
Sore
Bursting
Natrum Muriaticum
Bryonia, Pulsatilla, Ignatia
Nux vomica, China, Belladonna, Mercurius, Silica, Nitric Acid
Sepia, Bryonia, Phosphorus, Lachesis, CalcareaCarbonica, Natrum Muriaticum,
China, Belladonna, Glonoinum, Mercurius
Burning
Phosphorus, Mercurius
Sepia, Belladonna
Nux Vomica, Cina, Sulphur, Mercurius
China, Sulphur, Pulsatilla, Kali Carbonicum
Nux Vomica, Pulsatilla
Sulphur
Kali Carbonicum
Boring
Drawing
Stitching
Dull
Pressing
Shooting
Modalites
Worse Stooping
Worse Open Air
Worse Walking
Worse during menses
Worse standing
Worse motion
Better walking
Sepia, Sulphur, Belladonna, Bryonia, Pulsatilla, Mercurius, Sigelia
China, Mercurius
Bryonia, Belladonna, Glonoinum, Lycopodium
Natrum Muriaticum, Sepia, Belladonna, Lycopodium, Glonoinum
Pulsatilla, Spigelia
Belladonna, Bryonia, Nitric Acid
Phosphorus, RhusTox, Lycopodium
Time Modalities
Afternoon
Morning
Belladonna
Nux Vomica, Agaricus
Concomitants
Nausea
Vomiting
Constipation
Conium
Pulsatilla
Bryonia
Page 41
Acute Case
In this simple hypothetical example, a 45 year old woman has experienced a headache
for the past 3 days, always around 3:00pm, with violent, bursting pain in her right
temple, and red, flushed face. Belladonna looks to be an excellent choice for this
woman because it covers the totality of her headache symptoms. It is important to note
the high rankings of 3s (meaning that the remedy has been effective for most people
most of the time) for the symptoms in acute cases because the situation is intense and
immediate action is called for.
Page 42
Chronic Case
In this chronic case a young woman, 28, reports chief complaints of: nasal migraines,
social anxiety, and problems with self-acceptance. Her migraines start in the morning
and follow the arc of light intensity during the day. She has a fear of going to sleep
because she fears that she won’t wake up and will die in her sleep. She also is very
disappointed in the relationship she has with her mother. She has a history of inflamed,
swollen tonsils and had three occurrences in the past summer. The characteristic
migraine symptom in this case is that the migraine pain increases in the morning until
noon and then decreases until sunset, when it goes away. If one were to prescribe on
only that symptom, the choice might be Glonoinum, as it has a stronger ranking than
other remedies, as can be seen in chart 2 on the following page.
However, this is a chronic case and it is important to look at her total symptom picture.
As it can be seen in Chart 1 on the following page, Natrum Muriaticum is the only
remedy that covers ALL of the characteristic symptoms of the case. In a chronic case,
that is more important than selecting the remedy specifically for the migraine
symptom(s). The repertory is not the authoritative source. The repertory only provides
some direction in exploring Materia Medica and Provings to match the symptom picture
of the remedy with the symptom picture of the individual.
Page 43
Chart 1 – Most Characteristic Total Symptoms
Chart 2Note: Glonoinum has a value of 3 for the first migraine symptom but it does not at all
cover the other symptoms and the totality of the case
Page 44
Common Homeopathic Remedies for Headaches and Migraines
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Aconite
Left
Apprehensiveness, sunstroke
Cold limbs
Comes on suddenly
Temples, top of head, forehead
throbbing
Worse in cold or drafty surroundings
Like a tight band/hot iron around head or as if brains are being forced out of head
Apis
frontal, left, right
Cerebral diseases
Vertigo, nausea, vomiting
Comes on suddenly
Pain from gums into head, eyeballs
Stinging, stabbing, burning, pressing, or general aching
Worse, hot, stuffy surroundings, motion, stooping
Better: pressing head firmly with hands
Body feels bruised and tender, head feels as if it has gone to sleep, tingling, head
as if too full, seems too large, pain as if a bee had stung her
Argentum Nitricum
One sided, usually right
Over studying, eye strain, sugar, exertion, stomach upset, hysteria
Fear of failure, crowds, heights anticipation, impulse, obsession, chilliness
Forehead, eyes
Frontal area of head, forehead, extends to eyes and lower jaw
Digging, stabbing, vice-like, pressing
Worse: warmth, on waking, mental work
Better: hard pressure, open air
Band/vice-like, head feels expanded, hollow, dizziness,dullness, trembling
Arnica
both
Mechanical injuries, concussion
Greenish vomiting
forehead
Pressive headache as if head was being distended from within outward, drawing
in vertex and occiput, tearing towards temples
Aching, sharp, pressing, darting, as if a knife was drawn through head
transversely from left side – followed by internal coldness of head
Worse stooping, near warm stove, motion, ascending stairs
Head feels bruised, as if rolled up in a lump, sensation as if a liquid was
fluctuating in brain on day following an attack
Page 45
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Time Modalities
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Modalities
Sensation
Belladonna
Right
Colds, sinus, migraines, sun, head injury, getting head chilled
Cold extremities, hot skin and flushed red face, eyes sensitive to light
in back of skull or upper neck
Spreads to forehead and temple, dilated pupils
Violent, throbbing, pounding, sudden, intense
Worse at 3pm, often begins in late morning or afternoon
Worse: jarring, light, noise, touch, sun, climbing or descending, afternoon
Better from sitting or firm pressure
Delirious, drowsy
Bryonia
Left
Stress, constipation, anger, coffee, onset am on first motion
Nausea, vomiting, constipation, irritability
Left eye or forehead
Centered over left eye, side and front, extending to occiput
Sharp, stabbing, steady aching, throbbing, bursting, stitching
Worse: slightest eye or head movement, morning on first movement, stooping,
jarring, touch, cough
Better: firm pressure, lying, dark
Head feels bruised, crushing weight
Cimicifuga (sinus)
n/a
Indulgences or excessive activity
Vertigo and dizziness, congestion
Occiput or vertex
Occiput, extending to vertex and forehead, eyeballs
Aching, bursting, pressing, shooting
Better: warmth, eating, open air
Worse: morning, cold (except headache), during menses; the more profuse the
flow, the greater the suffering.
Brain feels too large, head sensitive to pressure, top of head as if it would fly off
Cocculus
Loss of sleep, mental, emotional strain, injury, during travel
Very weak muscles, feelings of guilt, worry for others, upset by others rudeness,
nausea, vomiting
occiput
Occipital area, forehead, temples, vertex
Worse: talking, motion, jarring, noise, light, during menses, loss of sleep, alcohol
Better: warmth, rest, in doors
Heavy head as if in a daze, head feels empty, separate from body, numbness, as
if something forcible closed eyes, or as if eyes were being torn out
Page 46
Symptoms
Gelsemium
Right
Side
Cause
Concomitants
Starts
Affected Parts
Weakness, inability to face a challenge, emotional excitement
irritable, blurred vision, weakness, confusion, trembling, preceded by dim vision
At occiput, extending upward or to the forehead
Type of Pain
Time Modalities
Modalities
Sensation

Right sided, face purple and congested-looking, expression dull and heavy
Dilated pupils, limbs weak and shaky
Dull, sore, sharp, neuralgic, aching
Worse at 10am
Worse: light, noise, motion, jarring
Better: napping, urinating
Head feels full and swollen, like a band bound tightly around the head, light headed,
sensation of falling
Symptoms
Glonoinum
Side
both
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Side effect of overuse of nitroglycerine, sunstroke
Sensation
Injection of the sclera, flushed face, bounding carotids
Root of nose
Temples mostly, forehead
Violent throbbing, pulsating, bursting
Worse: stooping, shaking head, alcohol, motion, jarring, heat, tight collars sun(headaches
come and go with the sun even without direct exposure)
Better: external pressure, lying in the dark
Every heartbeat sets up an answering thump and throb in the head, as if skull too small
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Hypericum
both
A fall
Tingling, drawing pains in cheek and chin
vertex
Hypersensitive scalp, vertex, cheeks, chin
Bursting, aching, shooting, dull, heavy
Worse in damp, foggy weather
As if whole brain would be pressed asunder, brain feels compressed, sensation of being
lifted high in air with a fall on occiput
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Time Modalities
Modalities
Sensation
Ignatia
Right, frontal
Grief, abuse of coffee, smoking, alcohol
Nausea, vomiting, eyes red and swollen
Right side of forehead beginning at inner end of right eyebrowrunning around eye
Frontal head above root of nose,
Pressing, throbbing, jerking
8 A. M. every morning, worse until 10.30 gradually improves and disappears about 1 P. M
Worse: light, sound, thinking, raising eyes
Better: lying on painful area, warmth
Feels like a tight band across forehead or a nail driven out through side of the head,
sensation as if eyeball would be pressed out
Page 47
Symptoms
IrisVersicolor
Side
Cause
Concomitants
Starts
Right – can alternate sides
Begins during day of rest after stress (weekend), sweets
Dimness of vision just prior, nausea and vomiting follow headache
Blurring of vision prior to onset of headache, comes on at regular intervals,
headache preceded by dimness of vision or visual changes, at temples, forehead
Affected Parts
Type of Pain
Modalities
Centered in temple, above or below eye
Constriction like a band
Worse: after vomiting, lying, rest, evening
Better from moving around, walking in open air, gentle motion
Scalp feels tight
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Time Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Affected Parts
Type of Pain
Time Modalities
Modalities
Sensation
Kali Bichromicum
Both but usually one sided
Suppression of nasal discharge
Nausea, vomiting food and bile, vertigo
Morning - with blindness followed by headache in Temples or above eye
Temples, eyes, forehead, extending to back of head as day goes on
Sudden, violent, shooting pain over eyebrow, throbbing
Better: heat, lying, pressing head against anything, open air
Worse: beer, morning, hot weather, undressing. Stooping, moving around
Headache every day at same time, attack at 9am
As if head would burst
Lachesis
Left
Hormone imbalance, sun, alcohol, colds, menopause, PMS
Heat and flushing, palpitations, heat on top of head, dim vision
Onset am
Vertex and left side of head, extending to nose, back
Pulsating, stabbing, pressing, bursting, heavy
Worse: after sleep, touch, sun, heat, before menses Better: flow of menses and
mucous, lying, pressure
Sensitive scalp
Lycopodium
Right
Skipping meals
Dizziness, stiff neck, constipation
Frontal, neck, face, teeth, eyes
Hammering, throbbing, pressing, dull, burning, tearing, boring
Worse: 4pm – 8pm
Worse: concentration, right side, warmth of bed, warmth from walking
Better: lying down, open cold air, uncovering head
Feels like temples are being screwed into each other
Page 48
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Time Modalities
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
NatrumMuriaticum
Often Right
Sunstroke, mental exertion
Eyes sensitive to light, constipation, nausea, vomiting
Often right sided, attach preceded by numbness and tingling in lops, nose, and
tongue
Eyes, forehead, vertex
Pounding, throbbing
10am – 3pm, occurs just before or after menstrual period
Worse: grief, emotional upsets, too much sun, eye strain, warmth, moving around
Better: lying in dark, perspiration, cold applications, quiet
Feels like a thousand little hammers were knocking on the brain, head feels
overstuffed and congested
Nux Vomica
Right
Overeating, excess of alcohol, coffee or drugs, loss of sleep, excessive mental
work, stress
Irritability, sick feeling, vomiting, gas, sour or bitter taste, constipation, vertigo
Occiput, forehead
Dull, dizzy, bruising, pressing
Worse: first thing in morning, sounds, cold air to head
Better: wrapping head, warm room, leaning head on something, by evening
As if beaten around the head, light headed, as if a piece of forehead would fall out
Pulsatilla
Semi-lateral
Rich, fatty foods, ice cream, menses
Weepiness, patient wants company and consolation
Temples, forehead, eyes
Forehead, one side, changes location frequently
Stinging, pulsating, dull
Worse : in evening, during menses, from rich fatty food, blowing nose, staring
intently at something, raising eyes
Better: gentle motion especially walking slowly in open air, pressure
Head feels like it will burst, bruised sensation
Sanguinaria
Right
Missing meals, nasal blockage, menopause, heartburn, sun
Digestive problems, allergies, nausea
at back of head, pain extending into right eye, right shoulder, recurs periodically
Extends to forehead, tension in neck and shoulder, bursting feeling in eye
Bursting, sharp, splitting, knifelike, throbbing
Worse - jarring, light, noise, morning, motion
Better for vomiting, burping, passing gas, after sleep, firm pressure
Sinking feeling
Page 49
Symptoms
Side
Cause
Concomitants
Affected Parts
Type of Pain
Time Modality
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Time Modality
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Sensation
Sepia
Left
Anxiety, vexation, fatigue
Dizziness, nausea, weariness, coldness, irritability, anxiety in pit of stomach
Forehead, vertex, temples
Pain in shocks or jerks, shooting pains from inside out, pressing, pulsating
Periodical headache comes on at 2pm and lasts until bed time
Worse: missing meals, menses, menopause, indoors, migraines after catching
least cold
Better: lying on painful side, open air, closing eyes, rest in dark room
As if head would burst, eyes would fall out
Silica
One sided
Mental exertion, menses
Nervousness, chilliness, head sweats, nausea
Usually right sided, starts in back of head then shifts and settles above one eye
vertex, occiput, forehead, nape of neck
Violent, shooting, pulsating burning
Headache every 7th day, morning
Worse: drafts, going out in cold without a hat, noise, motion, light, stooping
Better: wrapping head up warmly and tightly, hot compresses, warm room, dark
Headache as if everything would press out and burst skull ; as if brain and eyes
were forced forward.
Spigelia
Left
Rainy weather, bright lights
Stiff neck and shoulders
Headache beginning at cerebellum (in morning), spreading over left side of head,
causing violent and pulsating pain in left temple and over left eye
in or around eyes extending to eye sockets, frontal part of head,
Violent throbbing, stitching pain, sharp pain, pulsating pain, shooting
Worse: stooping, motion, noise, cold stormy weather
Better: lying with head propped up, temporary relief from washing with cold water
but pain is worse after (for other symptoms reverse is true)
Pain seems to pulse with every heartbeat
RutaGraveolens
N/A
Fatigue, alcohol, a fall, reading
Heat in head with much restlessness
forehead
Frontal to temporal bone
Pressing, bruising
Worse from reading, better from rest
As if a nail were driven into head
Page 50
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Time Modalities
Sensation
Symptoms
Side
Cause
Concomitants
Starts
Affected Parts
Type of Pain
Modalities
Time Modalities
Sensation
Sulphur
both
Loss of fluids, suppressed eruptions, excess of spirits
Nausea, alopecia, pimples on forehead
Usually temples or above eye
Vertex, temples forehead, occiput
Throbbing in crown, pressing on vertex, tearing or stitches in forehead or temples,
from within outward, aching in forehead, pinching from temple to temple
Worse: on waking, eating, stooping, open air, in sun, warm food, wet weather,
catching cold, worry
Better: indoors, sitting in a warm room, closing eyes
Often begins at 9am and gradually gets worse throughout day and ends at 4pm
as if head were enlarged , as of a weight pressing on top of brain and a cord tied
around head, as if emptiness in occiput, continuous feeling of cold spot on vertex
Thuja
Left
Tea, nervous, sycotic or syphilitic headaches, sunstroke
Nervous, weak, anemic
Forehead, temples
Forehead, temples, vertex, occiput
Boring, drawing, sticking, violent, neuralgic, rheumatic
Worse: sexual excesses, overheating, overlifting
Better: exercising in open air, looking upward, turning head backward
Severe bone pain 7pm-9pm, pressing in vertex 3-4am and worse afternoon
as if head were screwed asunder in articulation of malar bone and upper jaw, as
if a nail were driven into vertex with a jerk, as if forehead would fall out, on left
side as if a convex button were being pressed on part
This chart was compiled using a variety of sources including the following: Allen (2000),Boger (2011),
Cummings, Ullman (2004), Desy (2015), Gursche (1997), Hershoff (2000), Lockie (2000), Morrison
(1993).
Page 51
Conclusion
Although scientists say there is currently no cure for migraine headaches, they really
mean that there is no allopathic cure.
Homeopathy can be used effectively in the prevention of headaches and migraines by
determining the chronic remedy for the individual that will improve the overall health and
well-being of the individual by stimulating the Vital Force so the headaches never
happen in the first place. It can also be used in acute flare ups, therapeutically, to
alleviate the condition.
Other alternative treatments can complement homeopathy but it is important to pay
attention to antidoting factors. Certain homeopathic remedies can be antidoted by
strong odors, nutritional supplements, and certain foods.
Arguably, acupuncture has been used effectively in alleviating migraine symptoms and
probably is more useful for migraine prevention. It is more of a chronic treatment. It is
an energy medicine like homeopathy so it is best to use one treatment at a time so the
energy does not conflict. Osteopathy is also another energy therapy.
There is a place for all types of treatment and even allopathic or conventional
medication has its place. All treatments can have side effects. Even homeopathy, if
used incorrectly, can have side effects. In comparing treatment for headaches and
migraines, the best treatment, is one that gets to the root of the problem and provides a
lasting solution. Homeopathy, when used to treat the chronic case has the potential to
eradicate the headache and migraine symptoms from an individual’s total symptom
picture.
Page 52
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