Preventing Migraines (and Other Headaches), Part 1

by Nina

Supported Child's Pose

A dear friend of mine, with whom I’ve stayed on many vacations and have traveled with, suffers from terrible migraines; the kind where all you can do is curl up on the fetal position for 24 hours in a dark room. So even though I don’t have migraines myself, I’ve witnessed first hand how awful they can be. Baxter had some good suggestions yesterday (see Yoga for Migraine Headaches) for how to use yoga to get through a migraine headache. But wouldn’t it be nice if you didn’t have to get a migraine in the first place?

Unfortunately, since there are many different triggers for migraines, including different types of food,  it is impossible for us to give you any guaranteed solutions. However, we do have some recommendations for yoga practices you can try. Suffering from a migraine is such a miserable experience and these yoga practices will benefit you in many other ways, so it really seems worth giving them a shot. And everything we’re going to suggest here applies to ordinary tension headaches as well as to migraines, so listen up, everyone!

In his book Yoga As Medicine, Timothy McCall identifies two possible triggers for migraines and other headaches that we can address with yoga: stress and muscle tension in the head, neck and back areas. Today I’m going to talk stress and tomorrow I’ll post something about muscle tension (see Preventing Migraines and Other Headaches, Part 2).

Okay, now to address stress. In his book, Timothy says, “Since stress is a major factor in both tension headaches and in migraines, yoga can certainly play a role in prevention.” And he goes on to say that “There is scientific evidence that relaxation techniques and biofeedback can be effective for both tension and migraine headaches, lessening the duration as well as the frequency of attacks.” That sounds pretty promising to me!

I’ve been ranting about the subject of chronic stress and the importance of stress management since we started the blog (see Chronic Stress: An Introduction  and The Relaxation Response and Yoga), but as a reminder, I’ll simply reiterate that yoga provides a huge selection of possibilities for stress management and you can pick and choose from amongst them according to your experience level, temperament, schedule, and/or personal preference. All of the following yoga techniques reduce your stress levels by switching your nervous system from stress mode (Flight or Fight) to relaxation mode (Rest and Digest). This type of relaxation is something you cannot achieve with a nap or even a full-night’s sleep (see Conscious Relaxation vs. Sleep).

•    Meditation. See How to Meditate for information on how to meditate.

•    Breath practices (pranayama). See Your Key to Your Nervous System for information your nervous system and your breath. For stress reduction and headache prevention, be sure to avoid stimulating and/or overly complex breath practices and focus on simple, calming practices.

•    Restorative poses with a focus for the mind (such as your breath or the relaxation of your muscles).

•    Inverted poses. Studies by Dr. Roger Cole proved that inverted and semi-inverted poses, where your heart is higher than your head, trigger the relaxation response through the mechanisms that control your blood pressure. This is why supported inversions, such Legs Up the Wall pose and Easy Inverted Pose (legs on a chair), are so effective for stress management (See Just in Time for the Holidays: Inverted Poses).

•    Corpse pose (Savasana) with a focus for your mind (such as your breath, the relaxation of your muscles, or peaceful imagery). See Savasana for information.

•    Yoga nidra (yogic sleep), a long, structured form of Savasana. See What is Yoga Nidra? for information about yoga nidra and the Audio Tracks tab at the top of the page for a mini version of yoga nidra that you can stream or download.
 
If you find it difficult to settle in and relax because you’re too restless or anxious when you lie down, first try any active asana practice to burn off steam (although you might want to be careful with backbends—I’ll address that tomorrow) and then move on to relaxation practices.

If you are interested in practicing a combination of inverted and restorative poses, you might like to check the headache sequence in Yoga As Medicine, which includes the following poses:

1. Legs Up the Wall pose
2. Supported Reclined Cobbler’s pose
3. Chair Shoulderstand
4. Half Plow Pose (with chair)
5. One-Legged Forward Bend with head support
6. Full Seated Forward Bend with head support
7. Breath Awareness

Note that this sequence was designed for an experienced practitioner, and if you aren’t familiar yet with or can’t get comfortable in Chair Shoulderstand and Half Plow pose, you may want to skip over those two poses. An easier alternative to those two poses would be to do a Supported Straight Leg Bridge pose (must photograph that for our blog one of these days!). The teacher who designed this sequence also recommended his student use a head wrap (a large bandage that is wrapped around the head to relax the eyes) while practicing, so that may be something you could experiment with. Start wrapping the bandage clockwise at your forehead, go down to your eyes, and then come back up again. Tuck the loose end to secure the bandage.

If the sequence from Yoga As Medicine is too long or complicated for you, any simple restorative sequence could be very effective. Try our Mini Restorative Sequence, which includes three classic restorative poses that almost everyone can enjoy.

So how often should you do these stress reduction practices? I think that if you are chronically stressed out and suffering from debilitating headaches, you should practice six or seven days a week for at least 15 minutes (keep in mind that could be 15 minutes of meditation or 15 minutes in Legs Up the Wall pose). I realize that sounds like a lot. It will take some work—if you can call relaxing “work”—to bring your overall stress levels down. Keep in mind that the payoffs could be huge, as stress management can result in many additional health benefits besides reduced headaches, such as lower blood pressure and a stronger immune system, as well as quality of life benefits, such as increased equanimity and maybe even happiness. And if any of you take up this headache reduction challenge, I’d love to hear back from you about the results.

Check back tomorrow for tips about how to use yoga poses to release neck, shoulder and back tension that can trigger headaches.

Stress, Your Health, and Yoga

by Timothy

As I travel around the globe teaching workshops on yoga therapy—the use of yogic tools from postures to meditation to help people heal—I am struck by what an enormous problem stress-related illness is.  Everywhere I go, from ultra-modern cities like Stockholm where I've spent the last week, to less developed nations, people young and old are suffering the health consequences of their increasingly busy schedules and sometimes even busier minds.

Surprisingly, in this time of widespread tension, unrest and economic insecurity, most doctors still seem not to fully appreciate the deadly consequences of out-of-control stress or how much something like yoga can help. In medical school we were taught about the connection of stress to such health problems as duodenal ulcers, migraine headaches and irritable bowel syndrome. But scientific evidence is increasing indicating that stress can be a factor in life-threatening conditions from heart attacks to depression to hip fractures. Ironically, doctors may be among the most at-risk members of our society, due to their endemic stress and lack of understanding of simple non-drug tools like yoga that can fight it.

When scientists talk about the stress-response system, they are referring to a complex web of events that ramp the body up to deal with an acute crisis. The sympathetic nervous system—the so-called “fight or flight” system—kicks in, which among other things increases blood flow to the large muscles that help you defend yourself or run away from a physical threat. Stress hormones like adrenaline and cortisol are also released. In response, blood pressure and heart rate go up and breathing quickens. Blood sugar and other energy stores are mobilized to fuel whatever challenge you are about to face. In case you are injured, your blood begins to clot more easily. In crisis mode, the body shunts energy away from restorative functions like digestion and reproduction, mediated by the parasympathetic nervous system, which you can think of as the “rest and digest” system.

Arctic Landscape by Michele Macartney-Filgate

This built-in stress-response system is well-adapted to acute crises but can lead to all kinds of problems if it doesn’t gets switched off after the acute crisis passes. Blood clots increase the risk of a heart attack or a stroke, as does the high blood pressure and elevated blood lipids that stress contributes to. Elevated levels of cortisol are associated with everything from major depression to osteoporosis to overeating and weight gain (and the many problems that result from that). And while the immune system initially gets stronger during an acutely stressful event, it starts functioning less well if the stress goes on too long, raising the risk of serious infections and, as at least some evidence suggests, autoimmune diseases.

The problem is that the ancient human stress-response system isn’t so well adapted to mostly non-physical modern world stressors like work deadlines, traffic jams, and even abstract ideas about whether you are happy or fulfilled. If you repeatedly mull these problems over, the chemical and physical changes that were designed to deal with an acute threat to physical health—and which are then supposed to shut off when the threat is removed—remain activated. Such mental tape loops can thus turn abstract worries into concrete threats to health and even to life itself.

Yoga is arguably the best overall system of stress reduction ever invented. More and more evidence suggests the practice can help treat and prevent a wide range of health problems (for details see my web site). Beyond the harmful effects on the body, feeling stressed is a drag. It can make you feel anxious, preoccupied, full of dread.

Yoga can—sometimes within minutes—quiet down an overactive stress-response system. One of the great insights of the ancient yoga masters is that when you move and breathe with awareness, it calms your nervous system and slows down the tape loops in your mind. When your inner monologue slows, most people experience a sense of peace, relaxation and a feeling of being centered.

At first, this only happens when you are doing yoga and perhaps for a short time afterwards. But if you maintain a steady practice, more and more you become aware of and can tap into the tranquility you find in yoga throughout the rest of your day. Over time, you can actually make your nervous system less reactive to minor stressors, and less likely to get knocked off balance by life's inevitable ups and downs. You learn that you can be in a difficult situation, but nonetheless keep the breath slow and deep, and the mind both relaxed and attentive.

This sense of inner calm can make you feel more grateful for what you have, appreciate the beauty around you (which you otherwise might not have noticed) and help you realize that some of the stuff you're getting bent out of shape about may, ultimately, not be very important. And that may be one of the best stress reducers of all.

CHRONIC STRESS: AN INTRODUCTION

by Nina

An ongoing theme that we’ll be exploring in depth on this blog is the negative effects of chronic stress on long-term health and the need for stress management as an important aspect of healthy aging. So perhaps it’s a good time for me to define exactly what we mean by “chronic stress” and to let you know a little about why it is such a serious problem.

I learned about dangers of chronic stress the hard way. Back in the early nineties, I had a job as the documentation manager and lead technical writer at a software start-up company, while at the same time I was raising two children. As you might imagine, the pressure was intense as our small company struggled to meet our first deadline, the first test of the product by real customers (who needed my manuals to teach them how to use the product!). As the deadline approached and I started working overtime, I began having difficulty sleeping. I also started losing weight because the stress made me so feel nauseated that I lost my appetite. Eventually I was so anxious, exhausted and nauseated that even though I met my deadline (and the company went on to success), I couldn’t bounce back to normal health. It took a year and half of therapy, medication, and lifestyle changes to recover completely.

Wounded Bird by Brad Gibson

Feeling stressed is not always a bad thing, however. It’s your body’s normal response to perceived danger or extreme physical activity (often called the “fight or flight response”), which is vital in keeping you safe and active. When you encounter a stressful situation, whether it is a grizzly bear or a stack of tax forms, your body releases hormones (adrenaline and noradrenaline) to provide you with the energy and alertness needed to cope with the situation. And anyone who has almost been run over an SUV knows the feeling: heart racing, rapid breathing, gut clenching. This is because in stress mode, your nervous system stimulates your organs and mobilizes energy by:

• raising your blood pressure
• increasing your heart rate and the blood supply to your skeletal muscles (and away from your gut)
• dilating your pupils and bronchioles, providing improved vision and oxygenation
• generating needed energy by breaking down sugar and fat stores for immediate use

Between stressful situations, your body needs to rest, recover, and acquire new energy, so your nervous system responds by:

• lowering your blood pressure
• reducing your heart rate, diverting blood back to the skin and gastrointestinal tract
• contracting your pupils and your bronchioles for reduced oxygenation
• stimulating your salivary gland secretion, accelerating digestion, and promoting normal movement of food through the gut

But what if the stress is long term? When you almost get hit by a car, escape from a bear or finish your taxes, the incident is over quickly and you bounce back to normal soon after. But if the stress is ongoing or “chronic,” maybe because of continuing job pressures (like mine at the software company), marriage problems, health problems, and so on, your nervous system is continuously on the alert and this can overtax your body potentially causing:

• heart disease
• hypertension (high blood pressure)
• insomnia and/or fatigue
• digestive disorders
• headaches
• chronic anxiety or depression
• weakened immune system

(Hmm, I just counted, and it seems I developed almost half of those symptoms, rather impressive in a weird sort of way.)

Of course, these symptoms are not only unpleasant but will seriously compromise your long-term health if you can’t manage to bring them under control. In addition, several age-related diseases, such as Alzheimer’s, Parkinson’s, and Diabetes are exacerbated by stress, and some theories of aging itself (such as the telomere theory I discussed last week) propose stress as a factor in the aging process itself.

I hope you’re not getting too stressed out by reading all of this! I credit yoga with helping me stay well since that breakdown. And in the coming weeks, we’ll be offering many different alternatives for managing your stress even as you take on the many challenges that life has to offer.