A new understanding of migraine headaches reveals how spas can help.

ThinkStock/Dean Mitchell

Headaches are a frequent byproduct of our busy and stressful lives. Clients suffering from common headaches may find relief just from unwinding and recharging at your spa. But those plagued by migraine headaches require special treatment and understanding.

Migraines can be debilitating, impacting the affected person’s abilities and mood to the point where they can’t enjoy a normal lifestyle. Some studies are even looking at a connection between migraines and depression. Fortunately, wellness professionals are able to help many of these clients.

Migraines are a specific type of headache characterized by throbbing or pulsing pain that is felt at the temples, in the back or front of the head, or on one or both sides, according to the National Headache Foundation (NHF). Often the pain is accompanied by extreme sensitivity to light and sound, nausea and even vomiting. A migraine may begin as a dull ache, then intensify and last as long as 72 hours. Within the classification of migraine are some specific subtypes, such as the classic “aura” migraine, in which a visual disturbance, tingling in the arms or face, or difficulty speaking occurs prior to the onset of pain. Another subtype is the menstrual migraine, which corresponds to a woman’s cycle.

The NHF reports that more than 29 million Americans suffer from migraines—three times as many women as men. The condition may begin or end at any age, but the typical sufferer is 15 to 55 years old. Of all sufferers, 70% to 80% have a family history of migraines.

What causes migraines? Researchers previously thought they were triggered by a constriction of arteries, but modern science now points to abnormalities in the trigemino-vascular system. During a migraine, the trigeminal (fifth cranial) nerve releases chemicals that irritate and cause swelling to the blood vessels on the surface of the brain, sending pain signals to the brainstem.

However, the underlying causes of this chemical release vary. Causes of chronic migraine include hypertension, diabetes, hormonal problems (menstrual migraines are associated with drops in estrogen),
thyroid deficiency and severe vitamin B12 deficiency. The condition can first appear during the onset of puberty, pregnancy or menopause, or with the use of hormonal replacement therapy or oral contraceptives.
And because underlying causes vary so widely, so do treatments.

A Specialist’s Prescription

Some people experience migraines only occasionally, while others have them chronically and even daily. (With this, as with any case of migraine, spa practitioners should advise clients to consult a physician for a proper diagnosis before seeking relief via spa treatments.) The first step to effective treatment is for the sufferer to keep a headache diary that records the frequency, severity and characteristics of each migraine, along with any triggers that can be identified.

Dr. Alexander Mauskop, board-certified neurologist and director and founder of the New York Headache Center, cites stress, changes in weather, certain foods and odors, menstrual cycles and sleep disturbances as typical triggers.

The next step is to devise an individual treatment plan. “The first thing we try is a schedule of regular aerobic exercise. That can help tremendously,” Mauskop says. “Then we go to biofeedback therapy.” This technique uses monitoring equipment to teach patients how their bodies react to pain, so they can be trained to diminish it. Mauskop also recommends nutritional supplements—magnesium and Coenzyme Q10 in particular. In some cases, he’ll prescribe from a class of medications called tryptans, vasoconstrictors that narrow the swollen blood vessels and moderate chemical reactions in the brain to restore pain-blocking serotonin.

“Migraines are so debilitating. People experiencing migraines can’t get their thoughts in place.”

But the most cutting-edge medical treatment for migraines is Botox injections, which Mauskop recommends with a caveat: “Spa owners should look to partner with a neurologist rather than a plastic surgeon or dermatologist for migraine patients. We use it in the forehead but also at the temples, back of the head, and neck and shoulders.” Botox injections stop nerve endings from being excitable which, in turn, blocks pain. “For patients who are in so much pain that they can’t touch their scalp or brush their hair, this works beautifully. The injections are only superficial so they’re safe in small amounts,” says Mauskop. “And used over time, Botox can prevent migraines from reoccurring.” The FDA recently approved Botox use for chronic migraines, which means that many insurance companies may provide benefits to patients.

Hands-On Relief

An experienced bodywork therapist can help clients detect when migraines or other headaches are being caused by muscular or skeletal problems. “With myofascial techniques we say, ‘Find the symptom, look elsewhere for the cause,’“ says Jill Rehrig, owner and operator of New Beginnings Myofascial Release Therapy Center in Kresgeville, Pennsylvania, and therapist at The Seventh Moon Wellness Spa in Lehighton, Pennsylvania. Rehrig uses a particular type of myofascial therapy developed by physical therapist expert and author John F. Barnes.

“We’re in search of muscle, connective tissue or postural imbalances,” Rehrig explains. “For example, if restriction is palpated in the low back region, that might create migraines. Another example could be if the client had some type of abdominal surgery at some point and the scar created adhesions—that could create migraines as well. We’d concentrate on that area in addition to the head and neck.” For relief of body constrictions that are causing headaches, a course of treatments may be necessary. “Within the tissues, sustained pressure is applied over time,” Rehrig says. “We’re tapping into the elastin and collagen barriers within the makeup of the tissue. It’s like stretching out warm taffy and waiting long enough in the stretched position to not allow tissue back to its original restricted form.”

Craniosacral work, which uses a very light touch on the head, can also help. In fact, almost all bodywork therapies can assist a migraine sufferer, from massage to hydrotherapy to ancient modalities. “If it feels good, it releases endorphins,“ says Mauskop.

Another effective treatment is acupuncture. While there may be a correlation between migraines and certain meridians or organ systems, Mauskop says, “We don’t need to make a traditional Chinese medicine diagnosis. We know scientifically that if we put 20 needles into the scalp, ear, hands and sometimes legs, that will release endorphins into the brain that stimulate the serotonin system to kill pain.”

Sandie West, owner of Creative Chakra Spa in Marina Del Rey, California, uses a variety of treatments originating from around the world to help her migraine clients find relief and transformation. “We use an
ayurvedic Indian head massage in which hot oil drips onto 10 quadrants of the head,” she says. “It concludes with a drip onto the third eye and a neck and shoulder massage.”

West also brings in an ayurvedic specialist who helps clients balance their doshas—with an emphasis on a healthy diet. A poor diet alone can cause headaches—unfortunately, West has noticed, people tend to overlook nutrition when addressing migraines. “Cleansing plays such an important part,” she says. “People are sometimes just toxic from their food and environment.”

In fact, almost all bodywork therapies can assist a migraine sufferer, from massage to hydrotherapy to ancient modalities.

Mauskop agrees, and for migraine prevention suggests that patients eliminate excess caffeine, do aerobic exercise for at least 40 minutes three times a week and lose weight if they are overweight. In some cases, a gluten-free diet may help. He adds that compounds in chocolate and wine are triggers for some patients.
West also soothes migraine sufferers with aromatherapy. “Basil in particular helps, and we use a signature blend of basil, lavender, peppermint and eucalyptus,” she says. In addition to acupuncture, she recommends acupressure on the face and especially near the sinuses. Steam therapy, reiki, meditation and chakra energy work are a few more of her strategies.

“A lot of migraine problems are caused because people have so much stress that they’re not sleeping, and then they can’t sleep because of the migraine itself,” West says. Lack of sleep takes its toll on the body and can increase the risk of cardiovascular disease and diabetes.

What about the old-fashioned method of lying in a dark room and draping a cool cloth over the forehead? This may provide temporary relief, Mauskop says, “but it isn’t a remedy. It’s an escape.”

“Migraines are so debilitating,” West says. “People experiencing migraines can’t get their thoughts in place. They may not be able to express what’s happening, or even look people in the eye. They may stop drinking water or getting sunshine or taking walks. It’s a spiral down. And sometimes they need someone’s help to pull them out of the spiral. That’s what spas can do.”

For more information on migraines, visit the National Headache Foundation at and the New York Headache Center.

Andrea Renskoff is a freelance editor based in Los Angeles.

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