Migraine Headaches and Food Triggers: Gary J. Maguire, PT Physical Therapist

MIGRAINE HEADACHES

Severe pain on one or both sides of the head, an upset stomach, and at times, disturbed vision characterize migraine headaches. Women are more likely than men to have migraine headaches, according to the National Institute of Neurological Disorders and Stroke. Migraine headaches may last a day or more, several times a week or as rarely as once every few years. Noise, bright lights and concentration often make the headache worse.

Physiologic Mechanism

Current migraine headache research indicates that the initial stage starts with contractions of the inner and exterior brain blood vessels, followed by blood vessel dilation. During the initial stage there may be generalized cerebral ischemia, or blood flow and oxygen restriction to a part of the body. Vasodilation may affect nerve endings, causing throbbing headache symptoms. If you experience a classic migraine it involves an aura preceding the throbbing symptoms. You may see flashing lights or visual disturbances, spots or blotting out of your visual field.

Migraine Triggers

Evidence points to environmental factors that trigger the occurrence of migraines. Another major well known trigger is food. According to the National Headache Foundation, the vast majority of foods that that can trigger a migraine contain vasoactive or neuroactive amino acids such as tyramine, dopamine, phenylethylamine or monosodium glutamate. Additives such as triclorogalactosucrose or aspartame may also be trigger substances. Foods such as chocolate, wine or cheese have also been shown to contribute to the onset of migraines.

Food Intake

The relationship of food intake and onset of migraine headaches continues to be extensively researched. Evidence suggests that with migraine headaches it is not the food that is the primary cause, but due to different trigger mechanisms, foods induce or facilitate a migraine attack. In some patients consumption of food such as chocolate or red wine triggers the migraine but in other patients a combination of food is required, according to Seymour Diamond, M.D. in the Mar.1986 issue of "Postgraduate Medicine."

Diet Elimination

In the July 2010, "Cephalalgia: An International Journal of Headache," Kadriye Alpay, M.D. states that diet restriction based on IgG antibodies may prove to be an effective strategy in reducing the frequency of migraine attacks. The study confirms the importance of determination of specific IgG antibodies against food antigens for prevention and cure of food-induced migraine attacks. IgG antibodies help battle infections.

Food Allergy

Evidence suggests a relationship between hidden food allergies and migraine headaches. Success has been shown by developing an individualized food diet elimination in controlling migraine attacks. The allergen-specific IgG antibodies are found in a variety of foods such as milk products, food additives, sugar products, spices, seeds and nuts. Elimination diet is a challenge. It may involve eliminating all the major suspects that usually cause problems, then careful recording of headache onset as you slowly, over time, add them back into the diet one by one. Success may require consulting with a headache specialist.

Reference

• National Institute of Neurological Disorders and Stroke [http://www.ninds.nih.gov/disorders/headache/headache.htm]
• "Postgraduate Medicine"; Diet and headache. Is there a link? [http://www.ncbi.nlm.nih.gov/pubmed/3952046]
• "Cephalalgia: The International Headache Society" Diet restriction in migraine, based on IgG against foods: A clinical double-blind, randomised, cross-over trial; Kadriye Alpay et al; July, 2010 [http://www.yorktest-tr.com/pdf/15-Diet-restriction-in-migraine-based-on-IgG-against-foods-A-clinical-double-blind-randomised-cross-over-trial.pdf]

Resource

• MayoClinic.com: Migraine [http://www.mayoclinic.com/health/migraine-headache/DS00120]

Keywords

 

migraine headaches, foods affecting migraine, migraine and food, migraine and diet, causes of migraines, food causing migraines, Gary, J, Maguire, PT, Physical, Health, Therapist, Vancouver, Therapy, Pain, Headaches, WA

 

Developing Good Body Mechanics to Reduce the Risk of Injury: Gary J. Maguire, PT Physical Therapist

BODY MECHANICS

Body mechanics training is the application of proper body movement to prevent and correct poor posture, reduce stress on ligaments, joints and tendons and to enhance physical capabilities. Mechanics studies energy and forces and their affects on bodies. Mechanics derives from physics. Biomechanics is applying mechanics to biological systems, and its foundation comes from physics and bioengineering. Kinematics studies the geometry of motion and when applied to the study of joints is referred to as arthrokinematics.

Ergonomics

Ergonomics is the science of designing a person's environment so that it facilitates the highest level of function, according to the American Occupational Therapy Association. Your work environment should fit your capabilities to prevent injury and promote health, safety, and comfort. Ergonomic principles can increase your productivity and work quality. Your employer can implement a program that provides guidelines for you to follow, creates an efficient work environment, prevents injuries and helps you return to work if an injury occurs.

Proper Lifting

Start with your feet shoulder width apart. Practice lifting by squatting down to an object. Bring the object close to your body. Set your back in a neutral position. A neutral spine position is keeping your belt line of your waist level at all times. This provides greater stability to the spine and uses the ligaments and muscles to provide stability and control. Now lift the object with your hips and knee extensors which are the thigh and buttock muscles.

Pushing and Pulling

In the July 2006 issue of "Ergonomics," Dr. Kelly Lett states that in order to create safer working environments, education on proper pushing and pulling techniques is more important than the physical variables in many cases. More experience in technique leads to less shear and strain on the spine. Always try to push then pull to reduce strain. When pushing, your hand and wrist height should be between elbow and hip. When you pull your hand and wrist should be below hip level and above your knees. Lean slightly into the weight load while pushing with your legs. Keep your head up and remain close to the load.

Specificity of Training

Muscles used in a specific movement patterns gain strength. This can be applied to body mechanics training, which leads to specific adaptation to imposed demands. The direct choice of proper lift and technique towards practiced movement patterns influences the activity or sport which the pattern might be used for improved efficiency, skill and performance. Due to accommodation your muscles adapt and become inefficient and variation is necessary to create improvement.

Prevention/Solution

Training techniques, proper posture, ergonomics and body mechanics are all useful at work, sports and daily activities. When applied in a consistent manner they can become habitual. Repetition with body mechanics training can lead to improved neurological pathways in the brain, spinal cord, nerves and muscles for more efficient movement. Perform proper biomechanics over 2 to 4 weeks at least three times per week. Two weeks should establish the habit with an additional two weeks to provide good reinforcement.

 

Reference

• "Biomechanics"; Pushing and Pulling: Personal mechanics influence Spine Loads; Kelly Lett, Ph.D.; 2006 [http://biomechanics.researchtoday.net/archive/2/6/71.htm]
• American Occupational Therapy Association: Occupational Therapy in the Workplace [http://www.aota.org/featured/area6/links/link02r.asp]

Resource

• Biomechanics [http://biomech.com/]

Keywords

 

posture, lifting mechanics, body mechanics, ergonomics, biomechanics, proper body mechanics, Gary, J., Maguire, PT, Physical, Therapist, Injury, Back Pain, Posture, Work Injury, Vancouver, WA, Prevention, Physical Therapist, Health

Expert Recommendation for Treating Whiplash following a Motor Vehicle Accident: Gary J. Maguire, PT Physical Therapist

More than 50% of patients of patients injured in motor vehicle accidents receive whiplash diagnoses.  Patients with acute severe neck pain develop chronic neck pain in 15% to 40% following these type of injuries.

Unfortunately over the past years the standard treatment for whiplash prescribed by physicians consisted of rest and a soft neck brace for comfort.  This resulted in research conducted by Charles P. Vega, MD from the Dept. of Family Medicine at the University of California, Irvine who concluded that statistically patients improve rapidly with active treatment over rest.  This evidence-based study supported early mobilization after 96 hours of rest as the standard of care.

This recommendation is largely influenced by Rosenfeld's work published in SPINE, the premier peer review journal for research on spine-related pathologies.  Rosenfeld compared treatment plans for more than 100 whiplash patients.  Groups received standard care (advice from a doctor for restricted activity), active care within 96 hours of the injury, and active care within 14 days of the injury.  Active care consisted of physical therapy evaluation, postural control, and neck rotation exercises.  At six months follow-up and at 3-year follow-up, the active treatment groups experienced significantly less pain and sick leave.  Rosenfeld and colleagues also compared cervical range of motion between treatment groups and a control group that had received no trauma to the neck.  At three years, only the group that had received active treatment within 96 hours of the accident enjoyed cervical range of motion approaching that of the uninjured group (P=.06 - .08). 

In terms of pain and range of motion after three years, it was better to receive active treatment within 96 hours of the accident.  Rosenfeld also did an economic study taking into account the cost of physical therapy and the cost of time off work.  They demonstrated that active treatment was less costly and more effective.

Rosenfeld's research adds to an ever-growing body of evidence demonstrating how various approaches (manual therapy, therapeutic modalities, exercises and postural re-education) improve functional outcomes for patients diagnosed with whiplash.

The physiological benefit of initiating physical therapy after a whiplash within a 96 hour time frame has to do with the laying down of new tissues.  Put into basic terms, as the body lays down new tissues to heal a sprain or strain, it has only the one blueprint for the best way to lay those tissues down: MOVEMENT.  Without movement, the new tissue will form in counterproductive patterns.

Physical therapy intervention will introduce thorough but pain-free movement in the injured areas to help the healing response pattern create new tissues correctly and reduce chronic pain and poor recovery.

References:

Vega, C. Active Intervention Best for Whiplash (CME). Medscape: November 24, 2003.

Rosenfeld, M. et al. Early Intervention in Whiplash-Associated Disorders. Spine, 2000, 25 (14) 1782-1787.

Rosenfeld, M. et al. Active Involvement and Intervention in Patients Exposed to Whiplash Trauma in Automobile Accidents Reduces Costs.  A Randomized Controlled Clinical Trial and Health Economic Evaluation. Spine 2006, 31, 1799-1804.


Gary J. Maguire, PT
Physical Therapist




Key Words:

Gary, J., Maguire, PT, Pain, Whiplash, Physical, Therapist, Vancouver, WA, Injury, MVA, Back, Physical Therapist, Physical Therapy, Treatment, Diagnosis, Gary J. Maguire, PT

Experiencing Jaw Pain When Eating? Gary J. Maguire, PT Physical Therapist

The jaw consists of the temporal bones of the skull and the hanging hinge bone called the mandible. They form two joints, one on each side of the face. Together they are known as the tempomandibular joint, or TMJ. The jaw initially opens like a hinge and then slides forward like a sliding drawer. Within each joint is a little disc pad called a meniscus. Muscles work to open and close the jaw. Muscle tension, disc problems, poor posture or other dental problems can create upper jaw pain while eating.

How the Jaw Works

When you bite down hard, force is placed on the object between your teeth and on the temporomandibular joint. The mechanical mechanism in the jaw is the lever and the TMJ is the fulcrum. More force is applied per square foot to the joint surface than to whatever is between your teeth because the cartilage between the bones provides a smooth surface. This allows the joint to freely slide with minimal friction, according to The American Academy of Otolaryngology, Head and Neck Surgery.

Temporomandibular Joint Disorder

Temporomandibular joint disorder, or TMD, consists of a variety of conditions that affect jaw muscles, temporomandibular joints and nerves associated with facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after an injury. TMD affects more than twice as many women than men, according to the Academy of General Dentistry. Clenching or grinding your teeth, known as bruxism, can also lead to TMD.

Causes of TMD

Jaw pain can result from a variety of causes. It may occur locally within the TMJ, in the disc pad located within the joint capsule or in the ear. Pain from muscle spasms or soft tissue structures is also a source. The muscles of the jaw consist of the massater, temporalis or internal and external pterygoid. These can become out of balance and cause misalignment of the jaw. Other muscle imbalances in the neck and shoulders from poor posture can also affect the jaw.

Control of Jaw Muscles

Control your jaw muscles to reduce irritation on your teeth and joints. Start with your lips closed, teeth slightly apart and your tongue resting lightly on the hard pallet behind the front of your teeth. Breath gently in and out through your nose. Try opening and closing your mouth slowly with your tongue on the roof of your mouth. If your jaw deviates, gently use your fingers to guide it in a straight opening and closing movement. Use a mirror for monitoring.

Prevention/Solution

Reducing jaw pain while eating can be a simple problem occurring from posture, muscle imbalance or joint irritation. Physical therapy treatment can help to address these problems. If you have jaw problems from grinding or clenching your teeth, an oral specialist can fit you with a teeth appliance. This may not correct the problem but can reduce muscle tension and damage to your teeth. Psychological counseling may be necessary to deal with underlying stress that can create jaw irritation from clenching.

 

Reference

• American Academy of Otolaryngology — Head and Neck Surgery: TMJ [http://www.entnet.org/HealthInformation/tmj.cfm]
• Academy of General Dentistry: Know Your Teeth [http://www.knowyourteeth.com/infobites/abc/article/?abc=t&iid=334&aid=1351]

Resource

• MayoClinic.com: TMJ Disorders [http://www.mayoclinic.com/print/tmj-disorders/DS00355/DSECTION=all&METHOD=print]

Keywords

 

TMJ pain, jaw pain, pain when chewing, jaw irritation, jaw problems, Gary, J., Maguire, PT, Physical Therapist, Physical, Therapist, Pain, Physical Therapy, Vancouver, WA