Ayurvedic Perspective of Migraine and its management
Migraine is one of the worst headaches a person can experience. It is described as a throbbing or pulsating pain that can be on one side of the head.It can begin in a specific area and then spread while it builds in intensity. A migraine is associated with nausea and vomiting. The person will also be
sensitive to light, sounds and even certain smells. Sleeping can be difficult and many people become depressed. They can last for a couple of hours or for several days. The symptoms of Migraine almost simulates with the condition “Ardhaavabhedaka “ which is one among the 11 types of Shiro rogas explained
in Ayurvedic classics .Lets discuss about the causative factors, pathology and management of Migraine in Ayurveda.
General Pathology
Vagbhata in the Ashtanga Hridaya explains the causative factors of Shiro ruja (Different types of head aches) as Air pollution, too much exposure of sun, cold, over use of water activities, too much sleeping or less sleep, sweating of head,
stress and related conditions, holding of tear, too much water intake, alcohol over use, infections, blocking natural urges, not being tidy and clean- both internally and externally, reduced oil application on body, use of computer or similar activities where the person has to look downwards for a longer period of time, digestive disturbances, talking on loud voice for longer time etc. Because of these factors, the Doshas are vitiated with the dominance of Vata, reaches head to create the pathological process. There is a migraine "pain centre" or generator in the brain. A migraine begins when hyperactive nerve cells send out impulses to the blood vessels, causing them to clamp down or constrict, followed by dilation (expanding) and the release of
prostaglandins, serotonin, and other inflammatory substances that cause the pulsation to be painful. The hyper action of the nerve cells and expansion and dilation of blood vessels are caused because of the Vata vitiation due to the above factors. This further vitiates Pitta and Kapha Doshas in our body, which
causes the inflammatory process. Charaka also mentioned that if this condition left untreated, it can lead to blindness or deafness.
Management in Ayurveda
Ayurveda has a variety of efficacious procedures and medications with no drawbacks and incidence of recurrence in the treatment of Migraine. Internal preparations, external treatments and Panchakarma (purification) treatments
are adopted for the management. This is done after a detailed diagnosis according to Ayurvedic methods. History of the disease with duration, previous disease history, mental state, pattern of sleep, appetite, food habits, activities, analysing the sense organs, analysing the pulse, character of stool and urine,
menstrual history, etc are examined in detail. This helps to get knowledge regarding the involvement of Dosha and the intensity of the disease. Treatment is done according to these two factors. First phase in the management of Migraine (Ardhavabhedaka) is Nidana Parivarjana (avoiding Triggering factors). Ayurveda enlists various nidanas (Reasons) which includes aharaja (diet born), vihaaraja (lifestyle related), manasika (mind and emotions related) factors. Most of the nidanas mentioned in Ayurveda go in similarity with migraine triggers, which has an active part in the diagnosis as well as in planning the treatment modalities.
Therapies Generally Used.---
External treatments along with the internal preparations are very effective in chronic conditions. Panchakarma helps to remove the accumulated toxins and help to strengthen the nerve system. Involvement of other systemic disorders is also taken into account before deciding the treatment protocols.
1. Thala pothichil : Various kinds of paste (grinded mixture of selected herbs in suitable liquid media ) over the forehead / entire head help for the sudden relief from the ache. The preparations help to normalize the hyper action of the nerve cells and regulates the blood circulation towards the brain
2. Thalam : Special herbal powders suitable to reduce the Dosha vitiation, are selected and mixed with suitable liquid media(oils/ghee) and this medicated herbal paste is applied lukewarm over the crown of head (Anatomically over the Bregma point on skull). (Dur 25-45min).
3. Shiro abhyanga : Head Massaging with Oils suitable for the Dosha vitiation, helps to increase the blood circulation towards brain and also helps to relax the spastic muscles on head. Special care is taken to massage the Marmas or the Vital points on head which have marvelous results.
4. Nasya : Nasya (application of herbal preparations through nostrils) is one of the treatments which directly acts on the nerves and removes the toxins accumulated in the sinuses. Mucus lining inside the nostrils are one of the areas where numerous nerve endings are exposed. The medicated oils applied through Nasya directly acts on these nerve endings and help to pacify Vata Dosha in disturbed nerves and control the abnormal impulses gernerated by these nerves. The special preparations used for Nasya drains the mucus deposited in the sinuses there by the pressure in this area is relieved. The
medicinal contents of the oils administered, stimulate the higher centers of brain which have actions on regulation of endocrine, nervous system and circulatory functions.
5. Shiro dhara : Shiro dhara with Takram (medicated butter milk) is also another important therapy which is used to control the vitiated vata kapha doshas localized head.(Dur 25-75min) Other Panchakarma treatments like Vasti (a course of medicated oil and decoction enemas), Virechana (purgation) also helps to put the toxins out from the body.
After the Panchakarma therapies, special preparations called Rasayana (immuno regulatory) is administered. Rasayana preparations improve the immune system further improving the perception of sense organs. Migraine due to other systemic involvement like psychological problems, digestive problems,
blood pressure, ophthalmic problems, immune problem, improper menstruation, etc will be relieved when treated according to the specific treatment told for these diseases.