©2019 Portland Pain Institute LLC

Migraine

This 46 year-old woman arrived for her first guided relaxation session with a severe migraine headache in progress. She had suffered frequent migraines for decades. When she first came to me, she had been getting weekly migraines that would last three or four days and leave her debilitated for the balance of the week. Her migraine medication eased some of her symptoms, and perhaps shortened the episodes, but did nothing to prevent their recurrence.

Her first and subsequent sessions consisted of simple, guided relaxation. Despite her grave history, her migraines subsided and resolved within thirty minutes at each visit. After her first session, she enjoyed two weeks without an episode. Over the next few months, during which her migraines became less frequent, she managed to secure an appointment every time she had a migraine. Finally, her migraines ceased altogether.

Especially notable with this subject is the manner in which her muscles and muscular pain responded during her sessions. During a migraine, the tension in her back muscles would be choppy and painful. As the migraine subsided in session, her back muscles would become smooth, tight, and painless. She would rise from the table feeling very well, but her muscles would be markedly tighter than usual.

Activation of the sympathetic nervous system (stress response division) can be either functional or debilitating. For example, during a systemic infection, the body maintains a functional, stable stress state—a defense mode essential to proper immune function. If that defense mode is relaxed by deep relaxation methods, the infection may worsen.

In contrast, relaxation invites the functional stress state that affords non-medicated, migraine pain relief. When the migraine subject becomes comfortable enough, the nervous system shifts from debilitating stress and pain to a stable, painless defense mode—with increased tension. The head relaxes while the trunk muscles become tighter. Such delicate balance cannot be forced with manipulation procedures. Rather, it must be invited via relaxation and comfort. When properly invited, self-regulation functions seize the supportive conditions offered.

This migraine subject’s tension response might pose an interesting riddle to a massage therapist taught that pain relief results only from reduced muscle tension. Some technical massage procedures force a softening of painful tension and, in this case, would defeat the body’s own self-regulation processes. Manual softening of tension does not equal relaxation. Relaxation is a secondary response that may or may not accompany manual softening. For the subject above, relaxation led to additional muscle tension. The correction was directed entirely by body intelligence, as opposed to external manipulation that can only guess at the conditions needed by the body.

Migraine sufferers respond differently. A few require a counseling format. Most have been found to respond well to the limited behavior procedures of the Arneson Method of Guided Relaxation.